A major new study from University College London reveals alarming trends about the link between smoking and long-term work incapacity in England. Between 2013 and 2025, the number of working-age adults not working due to long-term illness or disability more than doubled, with smokers at three times higher risk of being out of work than non-smokers.
In 2025, around one in nine smokers of working age in England were economically inactive because of poor health, totaling approximately 700,000 people — despite smoking rates declining nationally.
These findings, based on data from over 170,000 people, highlight smoking as a modifiable cause deeply connected to rising worklessness due to illness, underlining the urgent need for continued tobacco control and health support policies.
Rising Numbers Out of Work Due to Health Problems
The proportion of working adults out of work because of long-term illness or disability increased from 2.5% in 2013 to 5.5% in 2025. While health-related economic inactivity has steadily risen over the past decade, the trend accelerated sharply after the COVID-19 pandemic began in 2020.
Smoking plays a central role in this concerning development: smokers consistently experienced the highest rates of health-related economic inactivity, nearly three times higher than never-smokers. Former smokers fell in between but closer to never-smokers, especially with longer cessation durations.
Health-Related Economic Inactivity in England by Smoking Status (2013 vs 2025)
| Smoking Status | Inactivity Rate 2013 (%) | Inactivity Rate 2025 (%) | Absolute Increase (pp) | Relative Increase (Ratio) |
|---|---|---|---|---|
| Never Smokers | 1.4 | 3.3 | +1.9 | 2.33 |
| Former Smokers | 2.5 | 5.8 | +3.3 | 2.29 |
| Current Smokers | 5.4 | 11.3 | +5.9 | 2.10 |
pp = percentage points; Data adjusted for age and gender. Source: University College London 2025 Study
Why Smoking Matters for Work
Smoking is known to cause chronic diseases such as lung disease, heart illness, and various cancers—conditions that severely limit a person’s ability to maintain employment. This study confirms just how much smoking increases the risk of long-term sickness or disability leading to work exclusion.
Importantly, former smokers who quit longer ago had significantly lower rates of work incapacity — highlighting quitting smoking as a crucial step to improving both health and employment prospects.
While smoking rates have fallen over the past decade, the absolute number of smokers out of work due to illness increased, driven by population growth and worsening health outcomes.
Younger Smokers Also Affected
The analysis shows that economically inactive smokers tend to be younger than their non-smoking counterparts, with about 25% under age 35. This early work disengagement may lead to long-term exclusion from economic opportunities and highlights smoking’s heavy burden on youth health and employment.
This younger group also suffers disproportionately from psychological distress, with nearly half reporting severe mental health issues. Mental health challenges both contribute to and result from unemployment, with smoking often serving as a coping mechanism amid chronic stress.
Profile of Adults Not Working Due to Long-Term Illness (2022-2025)
| Characteristic | Current Smokers (%) | Former Smokers (%) | Never Smokers (%) |
|---|---|---|---|
| Mean Age (years) | 45.5 | 48.5 | 46.5 |
| Under 35 Years | 25.2 | 17.3 | 21.7 |
| Female | 56.2 | 60.8 | 57.9 |
| Severe Psychological Distress | 47.5 | 39.9 | 33.7 |
Data from 2254 adults in England surveyed 2022–2025
The Bigger Picture: Inequality and Systemic Barriers
The study authors stress that smoking’s impact on work capacity is embedded in broader social inequalities. Smoking is more prevalent among socioeconomically disadvantaged groups who are simultaneously more vulnerable to poor health and unemployment.
This overlap means tackling smoking alone is insufficient: policies must also address the social, economic, and environmental factors that reinforce both smoking and economic inactivity.
What Can Be Done?
Experts highlight several important steps:
- Continuing and strengthening tobacco control measures to lower smoking rates across all populations.
- Providing targeted support for quitting smoking, especially tailored for disadvantaged and vulnerable groups.
- Enhancing workplace accommodations and health services to help people manage chronic conditions while staying employed.
- Addressing mental health needs alongside physical health to reduce the cycle of distress and unemployment.
Encouraging Hope From Quitting
The study found a clear trend: the longer a person stays quit from smoking, the lower their chance of being out of work due to illness. This underscores the valuable health and economic benefits of smoking cessation — a message that supports ongoing public health initiatives.
Powerful Data to Drive Action
This comprehensive analysis paints a clear picture: smoking is a major, preventable contributor to the UK’s employment crisis fueled by poor health. Reducing tobacco use is not only a health imperative but also an economic and social priority.
Reference: here