Consultation outcome

Proposed changes to how smoking-attributable risk is calculated

This was published under the 2019 to 2022 Johnson Conservative government
This consultation has concluded

Read the full outcome

Response to consultation on proposed changes to the calculation of smoking attributable mortality and hospital admissions

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Detail of outcome

There was a positive response to updating the relative risks used for the calculation of smoking-related harm and all options provided through responses have been explored.

Initially, we will use the relative risks listed in the Royal College of Physician (RCP) Report, ‘Hiding in Plain Sight’, as proposed in the consultation document, to produce new indicators, including a back-series from the period 2013 to 2015 (pooled) to the present.

Public Health England (PHE) will include mental health conditions as set out in the RCP report but also continue to work with colleagues on improving data sources on mental health and exploring new information on the relative risk of mental health conditions among smokers.


Original consultation

Summary

Current calculations for smoking-attributable risks are based on a single study from 1982 to 1988. In this document we propose a new calculation and data source.

This consultation ran from
to

Consultation description

Smoking remains the biggest single cause of preventable mortality and morbidity in the world and accounts for 1 in 6 deaths in England. There are well-documented links between smoking and a number of diseases such as a variety of cancers, respiratory diseases, heart disease and mental ill-health.

For these diseases, it is possible to calculate the ratio of the probability of them occurring in the exposed group (smokers or ex-smokers) versus the probability them occurring in the non-exposed group (never smoked). This is called the extent to which each of the diseases can be attributed to smoking and is calculated using a relative risk (a fraction between 0 and 1) and is specific to each disease, age group and sex, in some cases differs for smokers and ex-smokers. These relative risks are combined with smoking prevalence information in order to create a smoking-attributable fraction, which is the proportion of a disease that can be attributed to smoking. These are used to calculate various indicators for smoking-attributable mortality and hospital admissions.

The current relative risks calculation of smoking-attributable fractions are based on data from ‘The Health Consequences of Smoking: A Report of the Surgeon General’ using data from 1982 to 1988. We propose to update the list of relative risks to a subset of those in the report published by the Royal College of Physicians in 2018.

The consultation document outlines our proposal, why we propose the changes and the methodology we propose to use.

We are aware that the survey link is not currently working. Please email your responses.

Documents

Proposed changes to the calculation of smoking-attributable mortality and hospital admissions

Request an accessible format.
If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email publications@phe.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Updates to this page

Published 23 September 2020
Last updated 26 February 2021 + show all updates
  1. Added the outcomes document.

  2. Updated Ways to respond email address.

  3. First published.

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