Smoking Attributed Hospital Admissions Highest in North London

Islington faces a concerning health challenge as smoking-related hospital admissions reach the highest rate in North London, according to a report discussed at the Islington Health, Wellbeing and Adult Social Care Scrutiny Committee on Monday 08 December 2025.

The report highlighted that Islington has the highest rate in North Central London (NCL) for smoking attributable hospital admissions (1,728 per 100,000) and mortality (240 per 100,000) in persons aged 35 years and above. Factors that influence these admissions include community care for COPD and other respiratory conditions, and rates of flu and other respiratory diseases, which can increase admissions over winter. Vaccination plays a role in managing these winter increases.

The committee reviewed the Public Health Performance Report for Quarter 1 of 2025/26 and a report on the impact of smoking on life expectancy and healthy life expectancy in Islington. The reports detailed the council's efforts to combat smoking, including support services and initiatives aimed at preventing smoking initiation, especially among young people.

Smoking remains the leading preventable cause of illness, disability, and premature death in Islington, contributing significantly to health inequalities and economic costs. The estimated smoking-related mortality in Islington is 240.4 deaths per 100,000 people, which is higher than London (171.3 per 100,000) and England overall (202.2 per 100,000), according to the Public reports pack.

Smoking rates are disproportionately high among certain groups in Islington, including men, people aged 50-64, and those in the White ethnic group. Higher rates are also observed among individuals whose main language is Romanian, Polish and Turkish, and people living in the most deprived areas. The following groups are also at higher risk of smoking-related harm: people living with mental health conditions, pregnant women and their families, those in manual occupations, people in social housing or low-income households, LGBTQ+ individuals, people from minoritised ethnic communities, and those experiencing substance misuse or homelessness. To address these inequalities, the council is focusing efforts on key groups with higher smoking rates.

While smoking rates have declined, they remain disproportionately high among certain groups. The report also noted that people who smoke are 50% more likely to develop cognitive impairment, particularly vascular dementia and Alzheimer's Disease, than people who do not.

The council measures the effectiveness of its stop-smoking initiatives using key performance indicators, including the number of people accessing the Stop Smoking Service and the percentage of people quitting successfully who use the service.

The report highlighted the importance of preventing smoking initiation, especially among children and young people, and supporting smokers to quit. It noted that people who smoke are three times more likely to succeed in quitting if they access support from a stop smoking service, versus trying to stop unaided.

Islington offers stop smoking support through the community stop smoking service, Breathe, provision in primary care through general practice and community pharmacy locally commissioned services, and access to Smokefree, the leading evidence-based stop smoking app, for Islington residents.

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The committee heard that the Breathe model of a tiered specialist stop smoking service has been in operation since 2017 and is a well-accepted, highly effective and cost-effective service. The Breathe service continues to reach smokers from target populations and a consistent majority of its service users are from priority groups. It offers up to 16 weeks of personalised support in tier three (higher intensity), or between two and six telephone or face-to-face sessions in tier two (lower intensity service). This includes stop smoking medications, dual nicotine replacement therapy (i.e. two products at the same time) and vapes. Smokers who are interested in stopping smoking without ongoing professional support can access information and advice from Breathe online, by email or through printed materials, available in multiple languages (tier one).

The report also discussed vaping, noting that it is less harmful than smoking and is one of the most effective quit aids for adults who smoke. However, it is not risk-free and should not be used by non-smokers or young people. The council is addressing the risks of vaping, especially among young people and non-smokers. The Tobacco and Vapes Bill will enable similar restrictions to those imposed on smoking to be implemented for vaping, with a particular emphasis on controls around children and young people's access to products. The Islington Smoke Free Partnership, with renewed partnership working with primary care and education partners, has an early focus on how best to communicate with our residents about prevention, which will be importantly supported through the new regulatory and enforcement requirements which are expected to be implemented next year, and communicating with smokers about the health evidence clearly.

The report mentioned the Tobacco and Vapes Bill, which will prohibit the sale of tobacco to anyone born on or after January 2009, introduce licensing for tobacco retailers, and introduce further restrictions on product formulation and advertising.

Continued efforts to prevent smoking uptake and support more people to quit are essential to reduce the impact that smoking has on life expectancy and healthy life expectancy in Islington, the report concluded.