In 2020, Bexley published the Tobacco Control Plan with the aim to help more people who smoke quit, as well as to ensure effective and consistent messaging around tobacco control. The plan aimed to reduce smoking rates by encouraging more people who smoke to quit by using vaping as a way out of cigarette smoking, as well as offering free services to people who smoke in social housing and pregnant women. As of 2023, this has been commissioned by the GP Federation in Bexley.

Bexley residents can speak to their GP about getting help and support on their journey to quitting. They will be directed to the Smoke Free Bexley service where the referral team will prioritise each patient on a case-by-case basis. Priority groups are pregnant people who smoke, those with long-term health conditions, and people referred via acute services such as patients with cancer, chronic lung conditions and respiratory issues, mental health, and advanced life limiting conditions. Patients will then be offered a telephone consultation to be assessed with the offer to sign up to a programme of support. Anyone who joins the programme will be provided with medication to help alleviate any cravings. Over the next 12-week period, the Smoke Free Bexley team will conduct regular weekly check ins.

The Smoke Free Bexley Team also work with midwives at local hospitals to offer the stop smoking services to people who currently smoke in the early stages of pregnancy. Between April and September 2023, 29 pregnant women set a quit date with a 48% success rate. Those who were unsuccessful in their attempt to quit at this time will remain within the system so that further attempts can be made to offer the service, until such time that either they are successful, or they request that they are removed.

Table 1 – Percentage of mothers who still smoke at the time of giving birth

Source: Calculated by OHID from the NHS England return on Smoking Status at Time of Delivery (SATOD)

The work done by midwives with Bexley residents has shown a consistent effect, as between 2012 and 2023 the percentage of mothers who still smoke at the time of delivery in Bexley has been steadily decreasing and remains well below the national average figure. In 2023, 4.5% of mothers in Bexley were people who smoke at the time of delivery, very similar to the 4.6% of London mothers, but well below average when compared to the 8.8% figure reported for England as a whole.

Other patients registered to a Bexley GP outside of the priority groups can also use the service, through GP or self-referral, however this generally means a longer wait time for full access to the service. The Smoke Free Bexley team will also offer free advice on stop smoking medications that can help improve the chances of quitting for good. They are also able to direct patients to local vape shops and help support them in using vaping as a valuable tool to help them quit.

Between 2021 and 2023, NHS Digital data shows that on average 94.6% of recorded people who smoke over the age of 15 who are registered to Bexley GP surgeries have been offered access to these interventions. In 2012/13, the equivalent figure was 85.5%, showing that Bexley stop smoking services have increased engagement with known people who smoke over the last decade by over ten percentage points.

Since its peak in 2012, there has been a national decline in the number of people accessing stop smoking services. The number of people who smoke who set a quit date more than halved between 2012 and 2017, a trend that continued over the next three years in Bexley. The Nuffield Trust have postulated that this may reflect reduced smoking prevalence in the population but may also be due to increased use of e-cigarettes.(20)

Figure 5 – Number of people who smoke who have set a quit date for every 100,000 people who smoke in Bexley.

*The below image of Figure 5 is not suitable for users of assistive technology (Screen reader) and does not allow users to zoom in without degrading visual quality. If you would like to understand any details about this graph, please email public.health@bexley.gov.uk.

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Figure 5 shows in 2020, 947 Bexley residents set a quit date which is equivalent to a rate of 3,394 people per 100,000 smokers, higher than London’s average of 3,173 people per 100,000 but slightly lower than the national average of 3,512 people per 100,000.

Data shows that 193 people in Bexley set a quit date between April and September 2023, with 82 of those being males and 111 being females. Of these, 51 males (62%) reported that they had successfully quit, with 13 status unknown, and 57 females (51%) reported successfully quitting, while 31 are status unknown. The remaining 41 people were unsuccessful with this attempt to quit.

Figure 6 – Number of people who are validated as having quit smoking after 4 weeks via Carbon Monoxide test.

*The below image of Figure 6 is not suitable for users of assistive technology (Screen reader) and does not allow users to zoom in without degrading visual quality. If you would like to understand any details about this graph, please email public.health@bexley.gov.uk.

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Figure 6 shows that the rate of people who smoke in Bexley that have successfully remained smoke free after 4 weeks (CO validated) was consistently well above the national average before the Covid-19 pandemic. This corresponds with a period during which nicotine replacement prescriptions were also issued in Bexley at a much higher rate than the London and national averages. In 2018, for every 100 people who smoke in Bexley, approximately 16 prescriptions for nicotine replacement products were given out whilst the average figure for London was 11, and 12 in England.

Despite this, as shown in Table 2, Bexley has consistently been below the average spend per quitter. The average amount spent by Bexley Smoke Free services for each person that successfully quit over the 7-year period from 2013 to 2020 was £360.85, where the average service spend across London was £471.14 per quitter and £452.57 across England in the same period. In 2020, Bexley spent £150 less than the London average for each person that quit smoking, despite having almost 600 more people recorded as successfully having quit.

Table 2 – Average amount spent for each person who quit smoking in Bexley.

Source: NHS Digital – Statistics on NHS Stop Smoking Services, England