Snapshot of UK physicians: obesity, smoking and alcohol harm

Between 2-14 June 2025, the RCP carried out its second member snapshot survey of 2025. It included questions to gather insights into physicians’ experiences of seeing modifiable risk factors like smoking, alcohol harm and obesity among their patients.

Respondents were physicians from a range of specialties, including acute internal medicine, respiratory, cardiology, geriatric medicine, palliative medicine and neurology. The largest specialties were represented more than the smallest. The majority of respondents were substantive NHS consultants. 

“As a large number of my patients have an oncology diagnosis, a proportion of them have a diagnosis which is directly related to smoking, alcohol dependence or obesity (e.g. lung, liver and colon cancers). So not only do these factors have an impact on the ability of my patients to recover from treatments, and increase complication rates, I would argue that these have often been factors in my patients developing these diseases in the first place.”

Quote from RCP member responding to the snapshot survey

The RCP’s snapshot survey showed that 94% of the 516 physicians who responded said they saw patients with medical conditions caused or exacerbated by smoking, obesity or alcohol dependence.

Obesity

• The majority of physicians see the effects of obesity in their patients: 59% said at least half of their average caseload was made up of patients whose conditions have been caused or exacerbated by obesity. (476 respondents)
  • Of that 59%, 126 respondents (26.5%) said it was more than half, the same number said about half and 29 almost all. 1 said all.
  • 164 respondents (34%) said it was less than half, 28 said very few and 1 said none.
• There has been a significant rise in how often physicians see obesity in their work: 80% of physicians said that over the past 5 years the number of patients that they see with obesity has increased. Just 2% said it had decreased, and 15% said it had remained the same. (475 respondents)

• Treatment for other illnesses is less effective as a result of obesity: When asked about the impact of obesity on their patients, 48% said that treatment was not as effective as a result, 47% that recovery was impeded, 42% that there were complications during treatment and 33% that patients were unable to access certain treatments due to living with obesity. (483 respondents)

Smoking

• Smoking still accounts for a significant amount of ill health in clinicians’ workload: 53% said at least half of their average caseload was made up of patients whose conditions have been caused or exacerbated by smoking (475 respondents)
  • Of that 53%, 118 respondents said it was more than half, 102 said about half and 29 almost all. 1 said all.
  • 174 respondents (37%) said it was less than half, 46 said very few and 5 said none.
• More progress needs to be made to bring down smoking rates: While 41% said there had been a decrease in the number of smoking patients they’d seen in the last 5 years, 36% said it had stayed the same, and 18% said they’d seen an increase. (474 respondents)
• Smoking has a significant impact on treatment: When asked about the impact of smoking on their patients, 50% said patients’ recovery was impeded, 45% that treatment was not as effective, 31% that there were complications during treatment and 22% that patients were unable to access certain treatments because they smoked. (483 respondents)

Alcohol harm

• Alcohol continues to affect and worsen health: 25% said at least half of their average caseload was made up of patients whose conditions have been caused or exacerbated by alcohol dependence (474 respondents)
  • Of that 25%, 60 respondents said it was about half, 46 said more than half and 13 almost all. 1 said all.
  • 246 respondents (52%) said it was less than half of their average caseload, 103 said very few and 5 said none.
• Almost half of physicians have seen no change in the number of patients with alcohol dependence in the past 5 years: 48% said the patients they see with alcohol dependence had stayed the same over the past 5 years. Over a third (36%) said they’d seen an increase and 9% said it had decreased. (471 respondents)
• Alcohol dependence is impeding patients’ recovery from treatment: When asked about the impacts on their patients, 46% said that recovery from treatment has been impeded, 41% that there were complications during treatment, 40% that treatment was not as effective and 28% that patients were unable to access certain treatments due to alcohol dependence and its effects. (483 respondents) 

If you are a physician, and did not get a chance to respond to the survey, but would like to share your experiences with the RCP, please contact policy@rcp.ac.uk.