ASH Scotland urges politicians to prioritise driving down smoking-related deaths and save taxpayers £1.5bn each year

Up to 9,000 lives and more than £1.5 billion of NHS, social care and fire service costs could be saved in Scotland each year if the next Scottish Government takes urgent steps to reduce smoking-related illness and deaths, according to ASH Scotland.

ASH Scotland is urging politicians to make tobacco control and public health improvements a top priority ahead of the 2026 Scottish Parliament election, as smoking is responsible each year for over 88,000 hospital admissions and continues to kill more people than alcohol, drugs, fires, homicide and suicide combined.

The call comes as ASH Scotland launches its new manifesto ‘Stubbing out the tobacco and nicotine industry’s harmful products: improving Scotland’s health’, which sets out recommendations to transform people’s health, boost the Scottish economy and prevent youth uptake of tobacco and recreational nicotine products such as vapes and pouches.

These include extending smoke-free and aerosol-free environments (SAFE) to include all public indoor and enclosed spaces, areas frequently used by children and all working areas to protect people’s health from second-hand smoke or particulate aerosols from vapes.

The charity also recommends investing £10 million annually in NHS Scotland’s smoking prevention and cessation services to be targeted at deprived communities where smoking rates and health inequalities are highest. The new government is being urged to tackle the ongoing youth vaping epidemic, and to introduce a ‘polluter pays’ levy on a four-nations basis and a Scottish public health levy to hold tobacco companies and supply chain corporations accountable for the damage caused by their addictive health harming products.

Sheila Duffy, Chief Executive of health charity ASH Scotland, said: “Tobacco continues to be the biggest preventable killer in Scotland causing nearly 9,000 premature deaths each year and an annual public spending cost of £1.56 billion for health, social care and fire services, which is projected to reach £2.5 billion by 2035/36.

“It is essential for the health of people, especially in our poorest communities, that the next Scottish Government administration demonstrates strong political will and decisive leadership in prioritising actions and investments to tackle smoking-related harms and huge inequalities by driving quicker progress towards Scotland becoming a tobacco-free nation.

“The 2026 Scottish Parliament election presents a vital opportunity to spotlight the devastating human and substantial economic costs caused by the predatory tobacco industry, and to highlight how investments in tobacco control, smoking prevention and cessation would generate at least a 10-fold saving in future healthcare costs and health benefits and, more importantly, save people’s lives.”

ASH Scotland’s manifesto for the 2026 Scottish Parliament election can be viewed at www.ashscotland.org.uk/2026manifesto.

Note to editors:

• There is a smoking-related inequalities gap in Scotland with smoking prevalence in the poorest Scottish Index of Multiple Deprivation (SIMD) 1 quintiles being 23%, while it is 6% for the least deprived SIMD 5 quintiles.
• The response to parliamentary question S6W-39516 on 23 July 2025 said Scottish Government analysis estimated a public spending cost of smoking to Scotland, including wider costs to the health service, social care and responding to fire-related incidents, of £1.56bn in 2024, projected to reach £2.5 billion by 2035-36: https://www.parliament.scot/chamber-and-committees/questions-and-answers/question?ref=S6W-39516.
• The UK Parliament’s All Party Parliamentary Group on Smoking and Health estimates that tobacco companies make an estimated annual profit of £900 million in the UK with an average net operating profit margin of about 50%. A levy on tobacco companies could raise up to £700 million to support smoking prevention and cessation services: https://ash.org.uk/uploads/APPG-on-Smoking-and-Health-Manifesto-for-a-Smokefree-Future-2023.pdf
• Calculations by the National Institute for Health and Care Excellence (NICE) suggest that every £1 invested in smoking cessation could save £10 in future healthcare costs and health benefits.