Smoking and Tobacco Control

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Smoking and Tobacco Control
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Is smoking still an issue?
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Smoking and Health Inequalities

• Evidence suggests that tobacco use is the primary
  reason for the gap in healthy life expectancy
  between rich and poor

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Smoking and Health Inequalities

• Children from disadvantaged backgrounds are much
  more likely to be born to mothers who smoke, and
  to suffer greater exposure to secondhand smoke as
  they grow up. They are also more likely to grow
  up with family members and friends who smoke.
• Smoking is a social norm in many disadvantaged
  communities.

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Smoking in Walsall

• Around 22 of adults in Walsall smoke
• Has been reducing but this trend appears to be
  slowing
• More prevalent in those in routine and manual
  groups
• Significant level of smoking during pregnancy

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Where are our smokers?
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Years of life gained by stopping smoking at
different ages
Age at which stopped smoking Number of years of life gained
30 10
40 9
50 6
60 3
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Current actions

• Developing Services
• Addressing supply
• Challenging cultural norms

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Need Demand Supply
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Developing Services Introducing payment by
results

• Increase the number of providers to meet demand
  and broaden the coverage
• From 1 to 9 providers
• Ensure consistent standards of delivery
• Adherence to DH guidance on delivery and data
• Payment for outcome only
• 4 and 12 week quitter payments

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Introducing Tariff payments

• Payment system reflects
• Vulnerable groups who require additional support
  and encouragement
• Desire to move towards longer term quit status

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Progress to date

• Taken time to bed new system in quit rates
  have remained the same but lower uptake of
  services
• Have been affected by change to new system
• Lack of national advertising since May

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Progress to date

• Quit rate i.e. the number of people who having
  set a quit date successfully quit at 4 weeks has
  remained fairly stable (around 47) which is a
  positive sign
• There is an observed increase in the numbers of
  service users from routine and manual groups

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Realising the demand

• Need to increase the numbers coming into
  services through all channels

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Working in partnership

• Staff who have a one to one relationship which
  gives them access to personal information (e.g.
  social workers, home care staff, nursery workers,
  leisure services staff)
• Where appropriate offer a referral otherwise
  offer information on where to go for stop smoking
  support
• can it be done as a duty of care action?

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A Duty of Care

• Advice about stopping smoking should be based on
  the clinical/professional assessment of an
  individuals situation

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Addressing supply

• Current SLA with Environmental Health and
  Trading Standards addressing supply of illicit
  tobacco working with HMRC across the Black
  Country programme has only one year funding
• Raising awareness

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Challenging cultural norms

• Children from disadvantaged backgrounds are much
  more likely to be born to mothers who smoke, and
  to suffer greater exposure to secondhand smoke as
  they grow up. They are also more likely to grow
  up with family members and friends who smoke.
• Requires Tobacco Control strategy across
  locality about more than services, more than
  education of individuals collective action