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25 March 2015

NICE redoubles efforts to reduce harm from alcohol, smoking and physical inactivity

Smoking, excessive drinking and being physically inactive are some of the biggest causes of disease and early death in England. They cause a mounting burden for the NHS.

  • In 2013, smoking killed almost 80,000 adults aged over 351.  The number of hospital admissions for smoking related diseases has risen by 30% since 19961 – from 3,044 admissions per day to around 4,400 last year1.
  • Similarly, in 2012/13 there were estimated to be more than 1 million admissions related to alcohol2.
  • If people were more physically active, it is estimated that 37,000 deaths could be prevented each year3.

The National Institute for Health and Care Excellence (NICE) has issued three new quality standards to encourage healthy living and reduce harm from smoking, alcohol and physical inactivity in local areas.

Professor Gillian Leng, deputy chief executive and director of health and social care at NICE, said: “In England smoking, excessive drinking and physical inactivity cause too many deaths and too much disease. They cost taxpayers, through the NHS, over £7 billion every year4.

“There are areas where we can make improvements. We can help the NHS and local authorities to take action in their local area and educate younger people so that healthy choices become a life-long habit. These new quality standards include interventions to help people of all ages so we can continue to improve the health of the nation.”

The quality standards include specific actions which can be used at a local level to help prevent harmful alcohol use, reduce tobacco use and encourage people to be more physically active:

  • Healthcare services using contracts that do not allow employees to smoke during working hours to set an example to the wider community and ensure that ‘no smoking’ is the norm.
  • Local authorities using local crime and related trauma data to inform policy by mapping the extent of alcohol-related problems to help meet licensing objectives.
  • NHS organisations setting out organisation-wide programmes which employ a range of measures to encourage and support employees to be more physically active.

Promoting healthy behaviour from an early age can have a huge impact on life-long choices. The standards include statements aimed at changing attitudes in children and young people.

Around two-thirds of people who have smoked took up the habit before the age of 181. The standard on reducing tobacco use states that schools and colleges should not allow smoking anywhere in their grounds to prevent it being seen as an acceptable activity.

Whilst most school children understand the dangers of tobacco and illegal drugs, a recent report from Ofsted found they were less aware of the physical and social damage associated with alcohol misuse5. In areas where it is needed, NICE says schools and colleges can improve pupils’ knowledge by including alcohol education as part of their curriculum. In addition, trading standard officers and the police should identify and take action against retailers who sell tobacco or alcohol to under 18s.

The latest Health Survey for England showed that in 2012, 4 out of 5 children did not reach the nationally recommended minimum levels for physical activity6. The quality standard on encouraging physical activity identifies key opportunities where parents or carers should be given advice about keeping their child active. This includes during each child’s regular health review at 2 years old7 or as part of the national programme to measure the weight and height of children starting school8.

All statements are available in the full standards on the NICE website.


For more information call the NICE press office on 0300 323 0142 or out of hours on 07775 583 813.


Notes to Editors


  1. Health and Social Care Information Centre. Statistics on Smoking. England 2014.
  2. Health and Social Care Information Centre. Statistics on Alcohol. England 2014.
  3. Network of Public Health Observatories. Health Impact of Physical Inactivity. England 2014.

(Regional breakdown tables available)

  1. Estimated cost to the NHS each year is:
  1. Ofsted. Not yet good enough: personal, social, health and economic education in schools. 2013.
  2. Health and Social Care Information Centre. Health Survey for England. 2013.
  3. The Healthy Child Programme 2-year review is carried out between the age of 2 and 2.5 years by a member of the Healthy Child team, usually a health visitor, nursery nurse or children’s nurse. The review might be at a local children’s centre, GP surgery or at home.
  4. The National Child Measurement Programme (NCMP) involves measuring the weight and height of Reception and Year 6 children at state-maintained schools, including academies, in England.
  5. The quality standard for ‘smoking: reducing tobacco use’ is available at
  6. The quality standard for ‘alcohol: preventing harmful alcohol use in the community’ is available at
  7. The quality standard for ‘physical activity: encouraging activity in all people in contact with the NHS’ is available at

Facts and figures

  • One in five adults (20 per cent) aged 16 and over was a smoker in 20121.
  • In 2012-13 there were approximately 1.6 million admissions for adults aged 35 and over with a primary diagnosis of a disease that can be caused by smoking. This is approximately 4,400 admissions per day on average. The annual number of admissions has been rising steadily since 1996-97, when the number of such admissions was approximately 1.1 million1.
  • Among adults who had drunk alcohol in the last week, 55 per cent of men and 53 per cent of women drank more than the recommended daily amounts, including 31 per cent of men and 24 per cent of women who drank more than twice the recommended amounts in 20122.
  • In 2012-13, there were an estimated 1,008,850 admissions related to alcohol consumption where an alcohol-related disease, injury or condition was the primary reason for hospital admission or a secondary diagnosis2.
  • Based on self-reporting, 60% of adults aged 16 and over met the Department of Health’s UK physical activity guidelines in 2012. However, people often overestimate the amount of physical activity they undertake, meaning the real figures may be lower5.

About NICE quality standards

NICE quality standards aim to help commissioners, health care professionals, social care and public health practitioners and service providers improve the quality of care that they deliver.

NICE quality standards are prioritised statements designed to drive measurable quality improvements within a particular area of health or care. There is an average of 6-8 statements in each quality standard.

Quality standards are derived from high quality evidence-based guidance, such as NICE guidance or guidance from NICE accredited sources, and are produced collaboratively with health care professionals, social care and public health practitioners, along with their partner organisations, patients, carers and service users.

NICE quality standards are not mandatory but they can be used for a wide range of purposes both locally and nationally. For example, patients and service users can use quality standards to help understand what high-quality care should include. Health care professionals and social care and public health practitioners can use quality standards to help deliver high quality care and treatment.

NICE quality standards are not requirements or targets, but the health and social care system is obliged to have regard to them in planning and delivering services, as part of a general duty to secure continuous improvement in quality.

Quality standard topics are formally referred to NICE by NHS England (an executive non-departmental public body, established in October 2012) for health-related areas, and by the Department of Health and Department for Education for areas such as social care and public health.

About NICE

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for driving improvement and excellence in the health and social care system. We develop guidance, standards and information on high-quality health and social care. We also advise on ways to promote healthy living and prevent ill health.

Our aim is to help practitioners deliver the best possible care and give people the most effective treatments, which are based on the most up-to-date evidence and provide value for money, in order to reduce inequalities and variation.

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These new quality standards include interventions to help people of all ages so we can continue to improve the health of the nation.

Professor Gillian Leng, deputy chief executive and director of health and social care at NICE.