York study: 1.3bn smokers lack help to quit

demoduck.co.uk editorial team 2026-08-13 18:16 3 min read

A close-up shot of a single lit cigarette against a dark background.

By Demoduck.co.uk Health Desk | 13 August 2026 | Source: University of York News

Around 1.3 billion people who smoke may be unable to get the combination of counselling and affordable medicines regarded as effective support for quitting, according to researchers at the University of York, New York University and Harvard University.

The researchers found that only 13 lower- and middle-income countries provide the full package recommended by the World Health Organization. For people trying to stop smoking, the gap can mean that proven support is unavailable, too costly or difficult to reach through routine healthcare.

Only 13 countries offer the full quit-care package

The study identifies a sharp difference between the scale of tobacco use and the availability of treatment. Its benchmark for comprehensive care is behavioural counselling combined with free or subsidised medication.

York study: 1.3bn smokers lack help to quit

The headline figure does not show that no help exists in every other country. Some services may be available, but the research found that most lower-income settings do not offer the full standard of care needed to make quitting support consistently accessible.

More than seven million people die from tobacco use each year, according to the source.
More than 80% of tobacco users live in developing nations.
Only 13 lower- and middle-income countries were found to offer comprehensive cessation support.

The heaviest tobacco burden falls on weaker health systems

Tobacco remains the world’s leading cause of preventable death, yet the countries with the greatest share of tobacco users often face the highest disease burden and the least capacity to provide treatment.

That mismatch matters beyond an individual attempt to quit. When care is built into ordinary health services, patients can be identified and connected to support during appointments rather than being left to find and pay for it alone.

Professor Kamran Siddiqi of Hull York Medical School said healthcare services have a fundamental responsibility to treat tobacco addiction. He said the evidence shows cessation interventions can be cost-effective, relatively easy to integrate and capable of delivering health and economic gains.

India and Vietnam show why one model cannot fit every country

The review, published in the New England Journal of Medicine, examined healthcare delivery in countries including India and Vietnam. It found that cultural norms, government policy, healthcare funding and political interference from the tobacco industry can all shape whether a smoker receives help.

Those conditions mean that a programme successful in one country cannot simply be copied into another. Researchers argue that cessation services need to be designed around each nation’s healthcare landscape, including how people access primary care and whether treatment costs are covered.

Professor Donna Shelly of New York University said equitable access to comprehensive tobacco-cessation support should become standard care to help prevent tobacco-related deaths worldwide.

Quitlines, community workers and funded medicines are the next focus

The researchers recommend several ways to expand reach in settings with limited resources: national quitlines, mobile health apps, community health workers in rural areas and routine screening through an Ask-Advise-Connect approach, where clinicians identify smokers and link them directly to treatment.

They also call for smoking-cessation medicines, including nicotine patches, cytisine and varenicline, to be licensed worldwide. The review argues that governments or insurers should cover full treatment courses so cost does not decide who can access support.

Source: University of York News

Context & actions About this article

Source check How this report was checked

This article is based on a 13 August 2026 University of York News report describing a review published in the New England Journal of Medicine.

Checks

Checked the reported figure of 13 countries offering comprehensive cessation care.
Checked the source’s estimate that around 1.3 billion people lack effective quitting suppo...
Checked the WHO-standard description of counselling plus free or subsidised medication.
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