Smoking and drinking among the Gypsy and Traveller communities: A population study in England

Gypsy and Traveller communities in the United Kingdom (UK) face substantial health challenges. Smoking tobacco and drinking alcohol likely contribute to health disparities, but there is little national data on the prevalence or heaviness of smoking and drinking among these communities. We aimed to estimate the prevalence and heaviness of smoking and drinking among the UK Gypsy and Traveller communities compared with people from other UK ethnic groups.

Observational study using data collected between 2013 and 2025 in a series of monthly cross-sectional surveys of representative samples of the adult population in England.

Adults aged 18+, between 2013 and 2025 (total n = 226 339; Gypsy or Traveller n = 213).

Marginal means were derived from regression models and used to estimate the prevalence of current smoking and drinking (both of which includes daily and non-daily), and the heaviness of smoking (cigarettes per day) and drinking [Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) score, units per week and estimated weekly alcohol consumption] by ethnicity; adjusted for age, gender and survey year.

Current smoking prevalence was markedly higher among Gypsy and Travellers [33.0%, 95% confidence interval (CI) = 26.3-39.8%, n = 81] than among the "Other White" ethnic group (18.7%, 95% CI = 18.5-18.9%; P < 0.001), and exceeded estimates observed across other ethnic groups (range: 9.4-19.9%; all P < 0.001). Among those who smoked, Gypsy and Travellers reported smoking more cigarettes per day (geometric mean = 12.5, 95% CI = 8.9-17.6) than the "Other White" group (geometric mean = 9.0, 95% CI = 8.8-9.1; P = 0.59), with other ethnic groups ranging from 6.8-9.7, although not all comparisons reached significance. The proportion reporting any current alcohol consumption was lower among Gypsy and Travellers (61.5%, 95% CI = 53.8-69.2%, n = 126) than 'Other White' ethnicities (77.1%, 95% CI = 76.8-77.3%; P < 0.001). Prevalence of high risk drinking was similar among Gypsy and Travellers (11.3%, 95% CI = 6.7-15.8%) and "Other White" ethnic groups (10.7%, 95% CI = 10.5-10.9%; P = 0.808) but exceeded estimates observed across all other ethnic groups (range: 1.3-7.1%; all P < 0.05). Prevalence of possible dependence was higher among Gypsy and Travellers (3.5%, 95% CI = 0.4-6.6%) compared with the "Other White" (1.3%, 95% CI = 1.2-1.3%; P = 0.027) and all other ethnic groups (range: 0.3-0.8%; all P < 0.05).

People from Gypsy and Traveller communities in the United Kingdom appear to be more likely to smoke compared with other UK ethnic groups, and those who smoke and/or drink do so at more harmful levels compared with other UK ethnic groups.