Attitudes to smoking in Romanian, Bulgarian and Lithuanian residents of North East London

Healthwatch Waltham Forest, working across North East London, explored smoking behaviours and attitudes among Eastern European communities, primarily Romanian, Bulgarian, Lithuanian, Roma and Moldovan residents. The study engaged 138 participants, many completing surveys in their first language. Most respondents lived in Waltham Forest, Barking and Dagenham or Redbridge. Smoking prevalence was extremely high, with 88% of respondents identifying as current smokers and only 12% reporting that they had successfully quit.

A key finding was that smoking was strongly influenced by social and cultural factors. Smoking was reinforced by family members, partners, friends, co-workers and wider community norms. Respondents frequently described smoking as part of socialising, stress management and coping with loneliness, boredom or emotional distress. Poor mental wellbeing emerged as one of the strongest barriers to quitting, with many people reporting increased smoking during periods of anxiety, sadness or stress. The research also highlighted a common belief that quitting smoking depends entirely on individual willpower, leading many smokers to dismiss professional stop-smoking support as ineffective. 

Although around one-third of smokers expressed an interest in quitting, only 26% said they would consider using a stop-smoking service. Most people who had attempted to quit had done so without professional support. Many successful quitters described specific health concerns, medical diagnoses or life changes as their motivation, rather than general awareness of smoking risks. Successful quitters were more likely to be Lithuanian, university educated, in stable employment, socially connected and living with non-smokers. Professional help and support from people who had already quit smoking appeared to improve the chances of success.

The report concluded that stop-smoking services need to move beyond nicotine replacement alone and take a more holistic approach. Recommendations included providing support in relevant community languages, addressing stress, loneliness and mental wellbeing alongside smoking cessation, offering peer support from trusted members of Eastern European communities, improving promotion through social media and community venues, and ensuring services are convenient and culturally competent. Healthwatch argued that success should be measured not only through quit rates but also through improvements in wellbeing, confidence and social connection.

The findings were considered particularly relevant locally because Waltham Forest has a substantial Romanian-speaking population, with Romanian being one of the most commonly spoken languages in the borough after English.