As the nights draw in and we look ahead to winter, it’s vital that we continue to focus on prevention – both to reduce avoidable demand on NHS services and to tackle health inequalities. Vaccination and weight management remain key, but this month I want to highlight one of the biggest preventable causes of ill health in both Norfolk and Waveney and Suffolk and North East Essex (SNEE): smoking.

Why smoking matters in our region

Across Norfolk and Waveney, around 100,000 adults smoke – around 12% of the population. The impact of this is significant: more than 28,000 people are living with COPD, and around 45,000 children are growing up in households where someone smokes. Each year, there are around 10,000 hospital admissions directly linked to smoking. Rates are also much higher in certain groups, with 35% of people in social housing and as many as 77% of those experiencing homelessness affected.

Pregnancy is another key concern, with Norfolk historically being a national outlier for smoking at the time of delivery – although new services are starting to improve these figures.

In Suffolk and North East Essex, 11.5% of the population smoke, COPD prevalence stands at 2% of the population (21,693 people). Around 41,100 children live in households where someone smokes, and while smoking-attributable admissions are statistically lower than the England average (1,280 per 100,000 vs 1,398 per 100,000), inequalities remain. Similar to the picture in Norfolk and Waveney, smoking prevalence is highest in households rented from local authorities, with an estimated 14,298 such households across Suffolk.

So, the more effectively we can support people to stop smoking, the more effective we will be at reducing emergency and on the day demand for healthcare in the run up to winter, and the more effective we will be at reducing health inequalities long term too!

A multi-level approach

Both systems have developed a multi-modal offer in partnership with trusts, local authorities, and public health teams, with recurrent funding now in place to support new NHS tobacco services and retain specialist staff.

Level 1: Community support

• Online tools such as Norfolk’s Ready to Change and Suffolk’s Feel Good Suffolk.
• Community grants, such as the Norfolk and Suffolk Smokefree Generation Funds, to strengthen grassroots action.
• Feel Good Suffolk and Integrated Neighbourhood Teams offering holistic support, including smoking cessation, weight management, and targeted outreach in areas of deprivation.
• Collaborative work with social housing providers shifting the culture around smoking in social housing through staff training, policy changes and tenant referrals to stop smoking services, as well as VCFSE-led programmes delivering culturally tailored support in Ipswich, Lowestoft, and Clacton.

Level 2: Clinical and inpatient support

• GP practices and community pharmacies providing behavioural advice and pharmacotherapy, with incentives in the GP contract for achieving quit outcomes.
• Allen Carr’s Easyway programme, offering 700 places for structured quit support, for those that prefer to stop smoking with no pharmacotherapy.

• New Patient Group Directions enabling pharmacies to supply Varenicline and Cytisine, Across Norfolk and Waveney, Suffolk and North East Essex.
• Inpatient tobacco dependency services are now embedded in all acute trusts across both Norfolk and Suffolk, supported by Norfolk and Suffolk NHS Foundation Trust in mental health settings.
• Swap to Stop funding is helping to provide vapes for patients in maternity and inpatient mental health services.
• A Nicotine Reduction Interventions Project for children and young people (CYP): Public Health is working with ICE Creates to co-design tools and training for staff to support young people who smoke, vape or use SNUS (smokeless tobacco). Training and resources are being tested with services now, with final resources due by year-end. Suffolk also has a VAPE information toolkit for schools available.

Level 3: Targeted specialist services

• In Norfolk, SmokeFree Norfolk continues to support Core20PLUS5 groups, alongside new outreach to Gypsy, Roma and Traveller communities, postpartum women, and ex-prisoners.
• In Suffolk, the enhanced smokefree maternity model has seen Smoking at Time of Delivery rates fall from 9% to 4% – well below the national target of 6%. Specialist midwives and support workers offer behavioural support, NRT or vapes, and tailored quit plans, including for partners and family members.
• Suffolk also has a pathway in place to support individuals with Serious Mental Illnesses (SMIs) who smoke, combining the Tobacco Dependency inpatient and community support available.

Maternity focus

Across both areas, maternity services are central to tackling smoking-related inequalities.

• In Norfolk and Waveney, the Smartstart service has already supported over 130 pregnant women to achieve a 4-week quit, with smoking at time of delivery falling to 6.4% in May 2025 (down from 13.2% in November 2023). Incentive schemes offering vouchers have proved highly popular.
• In Suffolk and North East Essex, smoking at time of delivery has halved, now standing at 4%. This reflects a combination of specialist midwives, tailored household-level support, and trauma-informed, non-judgemental care. A new smokefree maternity incentive scheme is expected to further support families to remain smoke free.

Screening and early diagnosis

Preventing smoking-related harm is always the goal – but we are also focused on detecting those harms early wherever we can.

• In Norfolk and Waveney, the Lung Cancer Screening programme has already identified 72 cancers, with almost 70% found at an early stage. A new service launched in King’s Lynn in August, and this will be rolled out across the whole system in the coming months.
• In Suffolk and North East Essex, mobile screening units are operational in Colchester, Clacton, and Ipswich, and have already detected more than 60 cancers, two-thirds at an early stage. Expansion to Bury St Edmunds and Harwich is planned for 2025 and 2026.
• We also make sure that smoking cessation support is offered alongside screening, reinforcing prevention and early intervention when people come forward for their checks, helping to make every contact count.

Looking ahead

With Stoptober just around the corner, this is the perfect opportunity to raise awareness of the support available and encourage more people to take that first step toward quitting.

I’s never too late to quit, so please do share information about the services and support available with your patients, colleagues and networks.

Final thoughts

Reducing smoking is one of the five key priorities in our joint Population Health Management strategies – and with good reason. By supporting people to quit, we can improve health outcomes, reduce inequalities, and help ease pressure on NHS services across Norfolk, Waveney, Suffolk and North East Essex.

Thank you, as always, for your commitment and hard work in helping us move closer to a smokefree future.

Warm regards,

Frankie