Smokers across Cumbria who signed up to NHS stop-smoking services had the lowest success rate in England over a three month period.
The latest figures, from April to September last year, show 1,027 people in Cumbria registered and set a quit date.
However, at follow up meetings four weeks later, only 237 people said they had given up, according to data from NHS England.
This was an overall quit rate of less than a quarter - 23 per cent - compared to a national average of 49 per cent.
Some local authorities no longer provide NHS Stop Smoking Services and some did not supply complete data. Of the 145 that did, the highest success rate was 85 per cent, in Slough.
In Cumbria, smoking contributes to about 2,800 deaths in over 35s every year, so it is high on the public health agenda.
Claire King, a consultant in public health at Cumbria County Council, said it was disappointing to have such a low quit rate.
However she said the figures are not an exact science, as the areas do not run like-for-like stop-smoking services.
She said officials are now looking at what they can do to help more people quit as part of their Smoke Free Cumbria commitment.
"It does look like we are quite low. The trouble with it is that each area runs their stop-smoking programme in very different ways. That means it's difficult to compare results," she explained.
Miss King explained that some areas run campaigns targeted at specific groups - such as those awaiting surgery or people receiving mental health treatment - which can have higher quit rates.
However, in Cumbria the stop smoking service is open to all, available through local pharmacies.
This means anyone who is thinking about giving up smoking can go into or call their pharmacist for advice and support - but equally they can drop out if they change their mind.
Miss King said they are therefore looking to do some more targeted campaigns, working with everyone from hospital staff to local businesses to help get the messages - and support - out there.
"I recognise that the results for Cumbria are lower. I think our pharmacists do a great job, but there is more we can do," she said.
"Smoke Free Cumbria is something we are working on with businesses, district councils and all our partners to support the smoke-free agenda. We have some great stuff planned in the next 12 months."
This includes awareness campaigns to coincide with No Smoking Day in March and Stoptober in October.
They are also working with local hospitals to screen inpatients and identify those who do and don't smoke. If they do, they will be given brief advice on the benefits of quitting and how they can go about it.
Hospital staff will be given training on how best to raise the issue with patients and information they may require.
In Allerdale, the borough's health and wellbeing forum is planning a Smoke free Allerdale workshop for later in the year, targeting small businesses to help them support staff to quit smoking.
In Cumbria, the number of pregnant women who smoke is more than 12.3 per cent - higher than the national average of 10.6 per cent.
The aim is to bring it down to six per cent or less by 2022, so they are also working with midwives to target this group.
Miss King said: "It's just about sharing these messages. If we can get a real system-wide approach to promoting stop smoking it will really help.
"The more people that get the message, the better."
Since 2016, she said there has been a gradual decrease in the number of people using the pharmacy service - possibly because people have turned to vaping. However there was a spike in January this year, coinciding with a eye-opening local public health campaign about the dangers.
Those who do use the open access stop smoking service via pharmacies will get a mixture of support, based on what suits them.
They will normally have six sessions with a trained pharmacist. Alternatively they can provide advice on the phone.
Miss King said if they are entitled to free prescriptions they will also be able to access nicotine replacement therapy. Even if they aren't entitled, they can still get advice on what's available and how to use it.
"That's what all the guidance and advice tells us works, but with all these programmes - where they are open access - you would expect there to be a significant drop out and figures show this varies significantly.
"We are going to be reviewing the stop-smoking service later in the year and looking at what we provide going forward," she added.
Miss King said although smoking rates have dropped significantly in the past few decades, it is still a big public health issue.
That is why Cumbria's public health director, Colin Cox, has urged those who struggle to quit to switch to vaping instead.
Miss King said this stance has now been backed nationally.
"Interestingly Public Health England have this week produced guidance on e-cigs. They say that if you do not smoke, don't start vaping - that's a really important message particularly for young people," she said.
"If you are a smoker and want to give up, go to a pharmacist and access that support. But if you are struggling, consider e-cigs or vaping.
She added that it is never too late to get help to quit, even if you have tried previously and been unsuccessful.
"This is still really important. What I would say is that giving up smoking is the absolute number one thing you can do to improve your health and wellbeing. It will make a huge difference," she said.
The success rate is based on self-reported results of people who said that they hadn't had a puff for two weeks since their quit date.
However 14 per cent of those who started the process had their result validated though a test that checks carbon monoxide in their bloodstream, proving they had kicked the habit.
- To find out how you can quit, call Cumbria’s stop smoking service on 0300 013 3000.
- 64,000 people (15.5 per cent) of the population smoke
- Over one in 10 (12.3 per cent) of women smoke throughout pregnancy
- Almost a quarter (22.1 per cent) of manual workers are smokers
- Smoking costs the local economy £6.7m a year
- There are more than 80,000 sick days a year due to smoking
- Smoking costs the NHS in Cumbria £16m a year
- It causes 3,500 hospital admissions a year
- About 74,000 GP appointments a year are due to smoking
- Smoking is the primary cause of preventable illness and death
- Every year it causes more than 2,800 deaths in Cumbria
- Smokers under 40 have a five times greater risk of heart attack
- About 80 per cent of lung cancer deaths are smoking-related
- About 80 per cent of bronchitis/emphysema deaths are due to smoking
- Smoking is linked to 14 per cent of heart attack deaths
- More than a quarter of all cancer deaths are smoking-related
- These include mouth, throat, kidney, bladder, stomach, liver and cervix
- About half of all life-long smokers will die prematurely
- Smoking in pregnancy can lead to premature birth and low birth weight
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