The NHS allocates substantial resources to care for individuals who smoke, consume excessive alcohol, or lead sedentary lifestyles. Hospital admissions and treatments are expensive ventures. So, what might happen if these individuals were to alter their lifestyles by switching to vaping, reducing alcohol intake, and increasing physical activity? My research suggests that such changes could significantly decrease NHS expenditures. One of my studies indicates that if half of England’s 5 million smokers transitioned to e-cigarettes or heated tobacco, the NHS could save over £500 million annually. This shift from cigarettes would result in fewer cases of lung cancer, mouth cancer, and heart disease. While the risks of vaping remain somewhat uncertain, the harms of smoking are well-established. Another study I conducted in Italy supports this finding. It suggests that if half of Italy’s smoking population switched to alternative products, the country’s public health service could save over €700 million (£600 million) each year.
The greater savings in Italy come from differing cost structures and a higher smoking rate compared to England. That study also explores potential savings from reduced alcohol consumption and increased physical activity. Based on statistics, just under 3% of Italians are considered heavy drinkers. Excessive alcohol intake can cause a range of health issues, including liver damage, heart problems, higher blood pressure, and increased cancer risk. My findings reveal that if one heavy drinker (someone drinking over four units of alcohol daily) out of every 1,000 Italians reduced their intake to recommended guidelines (two units a day for men, one for women), the health service could save €60 million (£52 million) annually.
Another discovery was that if one inactive person out of every 100 Italians began engaging in at least 150 minutes of moderate physical activity, the annual benefit would be €223 million (£193 million). Nearly 40% of Italians do not exercise, which raises risks for cardiovascular diseases, type 2 diabetes, and obesity, as well as colon cancer, high blood pressure, osteoporosis, depression, and anxiety. Overall, with the Italian government—like many affluent countries—faced with healthcare funding challenges, almost €1 billion could be saved yearly in direct costs if a small number of individuals made modest lifestyle changes.
A similar impact could be realized on the NHS (with an annual budget of £182 billion) by focusing on smokers, heavy drinkers, and the inactive. The economic impact could be even greater than my estimates indicate, as they do not consider lost productivity due to illness-related work absences, treatment, and recovery. Some might suggest that given the risks of cigarettes and alcohol, an outright ban could be a simpler and more cost-effective solution. If successful, it might save more lives and resources. However, prohibiting activities people enjoy, even if harmful, seldom works effectively. The notion of eliminating the right to smoke or drink or mandating exercise would be challenging to accept politically.