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Mental health services could save the NHS money by helping people to quit smoking

Posted on 5 June 2020

Helping people who use mental health services to quit smoking is a good investment for the NHS and could save money in the longer term, a new study shows.

NHS figures show that smoking rates among people who use mental health services are among the highest of any population group.

Researchers at the University of York found that smoking cessation interventions, tailored to the needs of people accessing mental health services, are cost-effective over 12 months.  This was mainly due to lower use of expensive hospital-based healthcare services.

 Study authors said the findings were particularly relevant at present, as people with smoking related illnesses such as respiratory and heart problems are at the greatest risk from COVID-19.  

Successfully quit

 The research conducted for the Smoking Cessation Intervention for Severe Mental Ill Health (SCIMITAR) Trial developed targeted approaches to support smokers using mental health services to successfully quit.

NHS figures show that smoking rates among people who use mental health services are among the highest of any population group. This contributes to profound health inequalities, with life expectancy around 20 years lower among people with conditions such as schizophrenia and bipolar illness.  The NHS spends approximately £720m a year treating smoking-related disease in people with mental ill health.

 Study lead, Professor Simon Gilbody, Director of the Mental Health and Addictions Research Group (MHARG) at the Department of Health Sciences said: “Smoking kills large numbers of people every year and people who use mental health services have been left behind in the societal reductions in smoking rates. 

 “Working in partnership with people who use mental health services, we have used the best research methods available to us to tackle the epidemic of smoking.  The question we asked in the latest study is whether this represents good value for money to the NHS.”


The NHS Long Term Plan published last year, committed to tackling this inequality through a new smoking cessation offer for long-term users of specialist mental health services. Researchers say this plan should be guided by SCIMITAR’s research.

 This latest research published in the leading journal ‘Addiction’, the SCIMITAR team show that targeted smoking cessation strategies are effective in ensuring successful quitting, and that there are immediate improvements in quality of life and financial benefits to the NHS.  

Dr Emily Peckham, senior research fellow from the Department of Health Sciences, who managed the SCIMITAR study said: “The benefits of giving up smoking are enormous. People feel better, and they have more money when they are able to quit.  Over time, we speculated that there might also be financial benefits to the NHS since it is very costly to treat smoking related illnesses.”

Cost effectiveness

Jinshuo Li, the lead health economist to the SCIMITAR study said: We used state of the art methods to study the impact of quitting on health and costs to the NHS.  Using such methods is especially important to enable the NHS to make the best use of its money.  This is the first study of cost effectiveness within a rigorous NHS clinical trial.” 

 Professor Ann McNeill, Professor of Tobacco Addiction at Kings College London, Co-Chair of the Mental Health and Smoking Partnership said: “I would like to congratulate the team from York on producing this important research. It reinforces the case for greater levels of investment in supporting smokers with mental health problems to quit. Now, more than ever, we must support smokers with a mental health condition to quit, both for their health and for the financial health of the NHS.”

The SCIMITAR study is funded by the National Institute for Health Research (NIHR) Health Technology Assessment and supported by NIHR CLAHRC Yorkshire and Humber.

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About this research

The research is published in the journal, Addiction.

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