Concern continues amongst smoking habits of the 'most vulnerable'
The number of smokers in Northern Ireland has dropped from a quarter of the population to 14%, but concern remains around prevalence among the most vulnerable.
The Auditor General Dorinnia Carville also expressed concern at a rise in the numbers who vape - from 5% to 9% of adults in the last 10 years, and an estimated 9% of 11 to 16-year-olds as well as 24% of Year 12 students.
The report, Tackling the Public Health Impacts of Smoking and Vaping, records that an estimated 320,000 people aged 16 and over currently smoke in Northern Ireland.
This is around 14% and has dropped from 24% in 2010-11.
However, Ms Carville's report finds that challenges remain, particularly with smoking prevalence significantly higher among the most deprived areas - 24% compared to the least deprived at 7%.
Speaking to Cool FM & Downtown Radio's Newsdesk Editor Chris Brennan she said:
"What is quite stark is that 15% of deaths in Northern Ireland are attributable to smoking.
"Whilst the total number of smokers aged 16 and over has fallen from 24% over a decade ago to 14%, smoking still causes some of the largest health inequalities in Northern Ireland."
She added:
"It is a problem. There are some stark, harder to reach categories.
"They include those smoking in pregnancy, and those involved in manual jobs."
It was also found that around 2,200 pregnant women continue to smoke annually, and emerging research suggests a high smoking prevalence amongst people with mental health issues.
In terms of impact on the health service, the report finds that around 15% of deaths in Northern Ireland (2,200) are attributable to smoking, as are around 35,000 smoking-related hospital admissions each year and an estimated £218 million spent on treating smoking-related illnesses.
"Lung cancer deaths account for 23% of all cancer-related deaths.
"Our report does focus on targeting future interventions, but also to improve education so those people don't start to smoke."
Meanwhile, the Public Health Agency (PHA) estimates around a £450 million cost to the local economy due to premature deaths and excess sickness absence.
The cost of smoking - for those who smoke 20 cigarettes a day - is put at £4,600.
The report also examined the impact of the "rapid emergence" of vaping.
It found that vaping levels among adults have almost doubled, from 5% to 9% between 2014-15 and 2022-23.
Ms Carville told Downtown/Cool FM's Chris Brennan:
"The presence of vaping is rising rapidly.
"It's particularly prevalent to those in the younger age brackets.
"Research to date has produced mixed findings around vaping. It does help adults to quit smoking.
"One of the concerning things we have seen in this report is that vaping in children has been increasing.
"It is a challenge for the Department because so little is still known around vaping, but we believe education will play a big part."
It also noted a Department of Health survey which suggests that 9% of 11 to 16-year-olds in Northern Ireland are vaping, with 6% doing so regularly, and added "underlying this, 24% of Year 12 children currently vape".
The report finds scope to improve enforcement of tobacco control legislation including spot checks at retailers and businesses, to identify if tobacco or vaping products are being sold to children.
While more than 5,000 tobacco test purchases were made by councils between 2011-12 and 2018-19 (identifying 570 age-of-sale offences), the report notes that targets set by the PHA for the required number of annual visits and test purchases were often not met.
In addition, the report highlights that local businesses stocking vapes do not currently have to register with councils, even though a requirement for tobacco retailers to register has been in place since April 2016.
It recommends the health service reassess the budgetary requirements for delivering a future combined tobacco and vaping strategy, and that it considers quality standards to ensure a more consistent approach to enforcement across councils.
Ms Carville described smoking as "remaining the greatest cause of preventable illness and death", as well as the cause of some of the largest health inequalities.