Read more stories about our impact in our 2026 Annual Report
Published on 13th November 2026
Smoking remains a leading cause of preventable illness and early death in the UK. And we know that people we work alongside, particularly those facing multiple disadvantages, are far more likely to smoke and far less likely to receive effective support.
Evidence shows that stopping smoking alongside alcohol and drug interventions can lead to better long-term sobriety.
That's why smoking cessation is not an add-on, it's part of our core mission.
Closing the gap
Our approach is simple but ambitious: no one should leave Change Grow Live services without being offered meaningful support to reduce or stop smoking. We work in a way that's person-centred, trauma-informed and rooted in harm reduction. That means that whether someone wants to cut down or quit smoking completely, they are supported to start making small, achievable changes.
If someone is at risk of contracting a blood-borne virus, we offer them a test. We supply safe injecting equipment to people who use drugs intravenously, and contraceptives for anyone at risk from unprotected sex. There is a huge opportunity to do something similar with smoking – and services like ours can help bridge that gap.
The role of substance treatment services
Smoking rates among people in drug and alcohol treatment are shockingly high: around 70% compared to just 13% in the general population, and close to 80%, amongst people experiencing homelessness.
That puts substance treatment services in a unique and powerful position to make a difference.
Where smoking support is integrated into wider drug and alcohol treatment, we're seeing really positive outcomes. People cut down on the number of cigarettes they smoke, their carbon monoxide readings drop, and many notice improvements in their breathing. We're also seeing less use of illegal tobacco and fewer risky behaviours such as picking up discarded cigarettes, sharing cigarettes, or smoking around their children.
Some people have even told us that when they reduce their tobacco use, they find that they're also using less cocaine and crack. They feel more confident in themselves and more stable in their recovery.
That's why it's vital that we make every contact count.
Every conversation is an opportunity to offer encouragement, support and the right tools to help someone start their quick journey. It is never too late or too early to start the conversation.
“I feel really proud of quitting smoking – even more so than giving up alcohol as I really didn’t think I could do it because I’ve been smoking over 50 years, but felt it was worth a try. My chest feels better – no more coughing or phlegm. I’m really grateful.” - Someone supported through our Peterborough service
Barriers to supporting people
“I've got quite a lot going on in my life, so stopping smoking wasn't really at the top of my list. The advisor understood that and didn't make me feel bad about it. Even when I slipped up and had a cigarette, they just helped me get back on track. That made me want to carry on.” - Someone supported through our Birmingham service
It can be easy to assume that people in treatment have too much going on to think about stopping smoking; that we need to focus on their substance use first; or that someone doesn't want to quit. All these assumptions can be barriers to helping people to access support.
There may also be unclear information about pathways and what support is available. And there is often a lack of training around the advice we can offer.
According to OHID, smokers from deprived communities are just as motivated to quit as other smokers.
However, they tend to be more heavily addicted and face greater barriers to quitting.
We talk about reducing harm and optimising people's health all the time. We need to include conversations about stopping smoking and give people choice to help them overcome these barriers.
We need our entire workforce to feel confident to give appropriate advice, to know who their local stop smoking provider is and to have clear pathways in place.
At Change Grow Live, we have two simple tools to help initiate those conversation starters: Very brief advice, and our stop smoking quiz. We also want to ensure that all staff are familiar with local pathways and wider options for support.
The simplest of tools
‘30 seconds to save a life’ might seem dramatic, but very short conversations can have significant impact.
Very brief advice is something that professionals can use whenever they're having conversations with smokers. It’s effective, because it was designed around well-known behaviour change models.
The idea is not to take up too much time and, crucially, to not harm existing relationships.
First, we simply ask people about their tobacco use. Do you smoke? Have you ever been a smoker? The next step is advise. Giving up smoking, is one of the best things people can do for their health, and the easiest way to achieve that is with support.
Finally, the act is either to help that person refer themselves for local support, or give them the information so they can think about things in their own time, then hopefully pick up the conversation later. It's about keeping the conversation going.
Very brief advice is about having a conversation and really getting someone to think about their smoking and what it means to them. It is about making it a natural, judgement-free conversation as far as possible.
Learn more about how you can support people in our Very brief advice video.
Why it matters
Smoking remains a significant problem amongst the people we support. On average, smoking shortens a person's life by around 10 years.
That is even more obvious in the people in our services: nationally, 62% of people who died in drug and alcohol treatment were recognised as smokers.
"I feel happy because I quit smoking. My intrusive thoughts are less intense, and I feel less anxious. I feel more fit, and when I walk, I no longer get out of breath. I am grateful because I can now save all the money I was spending on smoking." - Someone supported through our Croydon service