Just under half of smokers in England who reported visiting their GP in the past year recalled receiving advice on smoking cessation, and only one in three were offered support to quit, a national survey has found.¹ However, current clinical guidelines suggest GPs should use every opportunity to ask patients about smoking and advise and encourage every smoker to stop.² There is good evidence that brief advice from a GP helps smokers to quit.

Data were drawn from the Smoking Toolkit Study (STS), a monthly cross-sectional survey of representative samples of individuals aged 16 years and over in England. The study used aggregated data from September 2016 to October 2019.

This study aimed to address five questions:

1 What proportion of smokers report receiving GP advice on smoking in the past 12 months, and what type of advice/support is given most often?

2 Has the proportion of smokers reporting receiving GP advice on smoking changed between 2016 and 2019, and has the type of advice or support changed?

3 Is GP advice on smoking associated with smokers’ sociodemographic and behavioural characteristics?

4 Is having received GP advice on smoking associated with quit attempts and cessation, after adjustment for sociodemographic and behavioural characteristics?

5 Do associations between different types of GP advice on smoking and quit attempts or cessation differ according to smokers’ occupational social grade?

Overall, 65,123 participants responded to the survey during the study period. A total of 11,588 (17.8%) had smoked in the past year, almost two thirds of whom, 7,430 (64.1%) reported having visited their GP in the previous 12 months. Rates of reported visits to a GP in that period were higher among smokers who were female, older, from lower socioeconomic groups (C2DE), living in the North of England, disabled, moderate or heavy smokers and those who reported stronger urges to smoke.

Just under half (47.2%) of those who had smoked in the past year who reported visiting their GP in the past 12 months recalled receiving advice on smoking, and slightly less than one in three (30.1%) reported being offered cessation support. The support offered most frequently was stop smoking services (16.5%) followed by prescription medication (8.1%) and consultation with a practice nurse (7.6%). A small number (3.7%) reported having been recommended to use e-cigarettes.

Smokers who were older, non-white, more addicted, and who smoked five or more cigarettes/day were more likely to recall receiving advice or support. There were no significant differences by gender, occupational social grade, disability, type of cigarettes smoked, or survey year.

GP advice with any offer of support was associated with a higher probability of attempting to quit than advice alone, adjusted odds ratio (OR) 1.52 (95% CI: 1.30-1.76). Advice alone was associated with higher odds of quit attempts than no advice in smokers from higher socioeconomic groups, OR 1.34 (95% CI: 1.10-1.64) but not lower ones OR 0.90 (95% CI: 0.75-1.08).

Cigarette smoking remains one of the leading causes of disease and premature death, and though the prevalence of smoking in England has reduced over recent decades, around one in seven adults continues to smoke.3 Guidance from NICE recommends that GPs should use every opportunity to ask people if they smoke and advise them to stop smoking.²

The study authors conclude: ‘In England, a minority (30%) of smokers who visit their GP report receiving an offer of support for smoking cessation.

‘The low prevalence of receipt of advice with an offer of support did not change during the study period, suggesting no recent progress in persuading more GPs to offer assistance.’

The study’s findings that GP advice coupled with the offer of support is associated with higher rates of quit attempts for all groups of smokers should encourage GPs to remember to give opportunistic advice and support at every opportunity.