Smoking costs Wales £1.56 billion a year with deprived communities hit hardest
Published on: 07 Jul 2026
Smoking is costing Wales an estimated £1.56 billion every year, according to a new Public Health Wales report that highlights the scale of the damage tobacco continues to cause to people’s health, public services and the wider economy.
To put it in context, the annual cost of smoking in Wales is more than four times the reported £350 million cost of building the Grange University Hospital in Cwmbran, underlining the scale of the burden that smoking places on Wales.
The report estimates that smoking costs the Welsh economy around £499 per person, £622 per adult and £4,661 for every adult who smokes.
Around £650 million is spent treating and supporting smokers who experience long-term illness and disability, representing about 5 per cent of Wales’s health and social care budget. The remaining cost is driven mainly by lost productivity (£670 million), as smoking related illness prevents people from working and contributing to the economy. Environmental costs mount to £241 million including the costs of fires, litter and air pollution. These figures underline the urgent need for sustained investment in prevention, tobacco control and support to help more people quit.
The report also shows that tobacco is not a normal consumer product. Smoking remains one of the leading causes of preventable illness and death, and its health, social and economic harms continue to place a substantial burden on individuals, communities and public services across Wales.
It highlights stark inequalities with smoking rates in the most deprived communities in Wales remaining more than three times higher than in the least deprived communities, with prevalence estimated at 22.6 per cent in the most deprived areas compared with 6.8 per cent in the least deprived. The report found that the most deprived quintile accounts for nearly one-third of all smoking-related costs in Wales.
Those latest findings reinforce the importance of a whole-government approach to tobacco control, including full implementation of the Tobacco and Vapes Act. While population-wide measures are essential, the unequal burden of smoking in deprived communities means targeted support is also needed, to reduce smoking and tackle health inequalities in Wales.
The law makes it illegal to sell tobacco to anyone born on or after 1 January 2009, helping to create a smokefree generation, and gives Welsh and UK governments new powers to regulate tobacco and vape products.
Chris Emmerson, Consultant in Public Health with the Tobacco, Vapes and Nicotine Addiction Programme at Public Health Wales, said: “With these figures revealing that 5 per cent of Wales’s entire health and social care budget goes on treating and supporting those harmed by smoking, the need for Wales to remain focused on the ambitious target of a smokefree Wales has never been clearer.
“The Tobacco and Vapes Act will prevent an entire generation from becoming dependent on tobacco and also gives Welsh and UK government new powers to regulate tobacco and vapes. With Help Me Quit, NHS Wales’s national cessation service, we have expert support and tools to support every smoker on their quit journey.”
Dr Jo Davies, Head of Health Economics, Advanced Analytics and Policy Modelling at Welsh Government, said: “Behind these figures are Welsh families affected by preventable illness, lost years of healthy life and the ability to fully participate in their communities. While smoking rates are declining, this report estimates that smoking costs Wales approximately £1.56 billion each year.
“The greatest burden falls on the most deprived communities, highlighting widening health inequalities. Quitting smoking brings immediate and long-term health benefits and evidence like this supports sustained action to help those who want to quit and prevent further uptake.”
The Deputy Chief Medical Officer for Wales, Keith Reid, said: “Smoking is still one of the leading causes of preventable illness and early death in Wales. It causes cancer, heart disease and respiratory illness. It places a burden on smokers, their families, and on our health service in Wales. As smoking rates are highest in the most underserved communities, smoking is widening health inequalities across Wales – hitting the most disadvantaged hardest.
“While the number of people smoking is falling, there is still much more to do. We are working closely with Public Health Wales to prevent young people from taking up smoking and to support more people to quit, helping to achieve a smoke-free Wales and a healthier, fairer and prosperous future for all, leaving no one behind.
“Quitting smoking brings immediate and long-term health benefits, and free specialist support is available through NHS Help me Quit. If you are thinking about stopping smoking, then please take that first step and get in touch with Help Me Quit today.”
Anyone who smokes in Wales can access free expert support through Help Me Quit, NHS Wales’s national smoking cessation service. The service offers tailored support and Help Me Quit says people can access free nicotine replacement therapy by contacting the service directly. Smokers can start their quit journey by visiting Help Me Quit (external site) calling Freephone 0800 085 2219, or accessing support in their local area through the national service.