Index of information on this page:
People who smoke
Key Messages
- Smoking remains the greatest contributor to
premature death and disease across Northumberland.
- It is estimated that up to half the
difference in life expectancy between the most and least affluent
groups is associated with smoking.
- In Northumberland, smoking prevalence is
around the national average.
- Death rates from smoking are
statistically significantly higher than the rest of England.
- It is estimated that 87% of deaths from lung
cancer, 73% of deaths from upper respiratory cancer, and 86% of
deaths from chronic obstructive lung disease are attributable to
smoking.
- In 2008/09 in Northumberland, 20.2% of
pregnant women were smokers at the time of delivery.
- Despite considerable effort and activity,
smoking among young people has remained relatively stable since
1998. However, there are is no local data to monitor
prevalence.
- Stop smoking support from the NHS is
available to all smokers free of charge in all communities across
England. NHS Stop Smoking Services are
extremely cost-effective compared with other healthcare
interventions and smokers who use NHS support are up to four times
more likely to quit successfully than those trying to go it alone
using ‘cold turkey’.
- Seven smokers in every ten say they want
to quit, but only around half of these respond positively when
asked about wanting to take immediate action on their smoking
behaviour. Each year, around 5% of smokers report that they
use the NHS Stop Smoking Service.
- Narrowing the gap in health
inequalities. For information on the contribution that
smoking makes to the gap in life expectancy, see health
inequalities section.
- Reducing smoking rates in deprived
communities is one of the greatest challenges in health
improvement, but is vital to closing the health inequalities
gap. There has been an increase in investment in publicity
and social marketing activities in 2008/09, particularly focused on
routine and manual workers.
- The
Health Inequalities National Support Team recommends that those
in greatest need should be targeted, recognising the multiplicity
of risk (e.g., those with CVD, those who are obese, and those who
are pregnant) and the potential for the biggest returns in health
gain.
What we know - Statistical information
More details about these headline statistics
is available in the NHS North of Tyne Strategic Health Needs
Assessment 2009/10.
National
- The General Household Survey is used to assess smoking prevalence
in adults (aged 16 years and over); this shows that smoking
prevalence for England has declined steadily over the last decade
from 27% in 2000 to 21% in 2008. More information
available from: www.statistics.gov.uk/ghs/
- For 2005-2007, it is estimated that
within England, 210 in every 100,000 deaths were linked to smoking
- we call this smoking attributable mortality. Further
information is available from the national
Health Profiles website.
- In 2008/09, NHS Stop Smoking Services
supported 337,054 people across England to quit smoking (i.e., to
be self-reported 4 week smoking quitters). This is equivalent
to a quit rate of 813 persons for every 100,000 people aged 16 and
over. Further information is available from the
NHS Information Centre.
Regional
- At regional level, data from the General
Household Survey is used to assess smoking prevalence in adults
(aged 16 years and over); this shows that whilst the smoking
prevalence for the North East had been relatively static at 27-29%
between 2000 and 2005, there have been dramatic decreases to 21% in
2008. More information available from: www.statistics.gov.uk/ghs/
- Since 2007, the North East has no longer
had the highest regional smoking prevalence and the region has made
significant progress in narrowing the prevalence gap with
England.
- For 2005-2007, it is estimated that for
the North East region rates of smoking attributable mortality are
268 per 100,000; this is significantly higher than the England
average. Further information is available from the national
Health Profiles website.
- In 2008/09, NHS Stop Smoking Services
supported 22,325 people across the North East to quit smoking
(i.e., to be self-reported 4 week smoking quitters). This is
equivalent to a quit rate of 1,063 persons for every 100,000 people
aged 16 and over. Further information is available from the
NHS Information Centre.
Local
- In the absence of robust local data,
synthetic estimates based on the Health Survey for England are used
to compare smoking prevalence in adults (aged 16 years and over) in
local authorities. These show that for 2003-2005 estimated
smoking prevalence for Northumberland was 23.5% - however looking
at the former districts of Northumberland estimated prevalence
ranged from 16.2% in Castle Morpeth to 28.7% in Wansbeck.
Further information is available from: http://neighbourhood.statistics.gov.uk/dissemination/
- Local alternatives to using the synthetic
estimates include use of GP practice register data. For
Northumberland, this suggests that smoking prevalence amongst
persons aged 16 and over is around 18%.
- For 2005-2007, it is estimated that for
Northumberland rates of smoking attributable mortality are 228 per
100,000; this is significantly higher than the England
average. Further information is available from the national
Health Profiles website.
- Northumberland also has a relatively high
rate of smoking attributable mortality when compared to similar
PCTs (using the Prospering Smaller Towns Group of the
ONS Area Classification).
- In 2008/09, NHS Stop Smoking Services
supported 2,203 people across the Northumberland to quit smoking
(i.e., to be self-reported 4 week smoking quitters). This is
equivalent to a quit rate of 859 persons for every 100,000 people
aged 16 and over. Further information is available from the
NHS Information Centre.
- Northumberland also has a relatively high
smoking quit rate when compared to similar PCTs (using the
Prospering Smaller Towns Group of the
ONS Area Classification) and a higher than expected quit rate,
when taking into account the estimated prevalence of smoking in the
population.
- The
Health Inequalities Intervention Tool for Spearheads presents
key data and modelling aimed at helping Spearhead Local Authorities
improve life expectancy quickly. Based on mortality data for
2006-2008, this tool shows that cardiovascular diseases (mainly
coronary heart disease), cancers and respiratory diseases
(particularly chronic obstructive airways disease) account for
69.4% of the gap for males and 54.5% of the gap for females in the
former district of Blyth Valley and 60.0% of the gap for males and
63.3% of the gap for females in the former district of
Wansbeck.
- Reducing the prevalence of smoking will
impact on all three causes highlighted above and therefore remains
the number one priority for reducing inequalities in life
expectancy. See the NHS North of Tyne Health Inequalities
Action Plan for more information.
Related Performance Indicators are:
The measure of the rate per 100,000 persons aged
16 years and over of self reported 4 week smoking quitters is
included in key plans across the local strategic partnership:
What people have told us – consultation and
feedback
Engagement activity
Over the past two years, NHS North of Tyne
focussed on developing robust mechanisms to make sure that local
people across Northumberland have the opportunity to influence
decisions about health developments and importantly, that their
comments are fed into the commissioning system and taken into
consideration whenever possible. Engagement activity includes
regular meetings with some groups in the rural communities and also
better links being developed with black and minority ethnic
communities and with the deaf community.
During 2009/10, the engagement team has
supported close involvement by the NHS Stop Smoking Service team
and NHS Health Trainers with the Health and Race Equality Forum
(HAREF) to discuss Supari addiction, which is linked with oral
cancer; further action is planned.
Social marketing
During 2009/10, NHS North of Tyne has made
concerted efforts to increase knowledge and competence in social
marketing and to formalise its use in strategic programming and the
development of public health campaigns.
Scoping work has been undertaken to help us to
tailor stop smoking messages for routine and manual groups to
attract them in to NHS Stop Smoking Services and better support
them in their quit attempts. Key messages and insights
arising from this work as follows:
- Family, and especially children, are
important to this group of people.
- They are motivated to stop smoking by
positive localised publicity, personal requests from their children
or their hope for a future family.
- They are aware of the negative effects of
passive smoking and alter their behaviour accordingly.
- Routine and manual workers would rather
be given choices on how to stop smoking - when they are ready to do
so.
- They need a friendly, supportive and
non-judgemental stop smoking service incorporated into their work
days.
- They want to take advantage of a time
when they tend not to smoke, to incorporate their new habit of not
smoking and doing other healthy, relaxing activities in their
everyday lives.
In summary, stop smoking services must be
flexible and local to routine and manual workers so they can access
the services at time that is convenient to them.
Policy and Research
National
The new tobacco control strategy for England,
published in February 2010, establishes a vision of eradicating
tobacco harms and creating a smokefree future, so that we can
support people to live healthier and longer lives. To deliver
a smokefree future, the strategy sets out three overarching
objectives to make significant progress towards a smokefree
society:
- To stop the inflow of young people
recruited as smokers.
- To motivate and assist every smoker to
quit.
- To protect families and communities from
tobacco related harm.
The Health Act 2009, which received Royal Assent in
12th November 2009, includes legislation to remove
tobacco displays in shops and to restrict the sale of cigarettes
from vending machines, which were discussed in the
consultation on the future of tobacco control.
Virtually all enclosed public places and
workplaces in England must be smokefree, including all pubs, clubs,
membership clubs, cafes and restaurants as of 1 July 2007, in
accordance with the Health Act 2006.
Provides best practice guidance relevant to
the provision of all NHS stop smoking interventions and sets out
fundamental quality principles for the delivery of services which
can be used to inform the development of local commissioning
arrangements. It also includes full details of the data reporting
requirements for NHS Stop Smoking Services
This legislation, which came into effect in
October 2007, changed the age of sale from 16 years to 18 years for
tobacco products and strengthened sanctions against retailers for
under-age sale of tobacco.
This White Paper, published in 2004, sets out
the key principles for supporting the public to make healthier and
more informed choices in regards to their health.
The document, published in 1998, set out for the
first time in the UK, a comprehensive tobacco control strategy and
announced the introduction of a new NHS Stop Smoking Service.
The focus of the service would be to help all smokers quit smoking,
whilst specifically targeting young people, pregnant women and
socio-economically disadvantaged smokers.
Other tobacco and smoking related policy
documents are available from the
Department of Health website.
Regional
The North East's first ever health and wellbeing
strategy was launched in February 2008. This ambitious plan
aims to transform the region into the healthiest in England within
a generation. Tobacco is one of the key themes of this
strategy.
A dedicated tobacco control
office, was set up in May 2005 following negotiations between
key partners including the Association of North East Councils, the
Regional Assembly, the Public Health Group North East, Primary Care
Trusts and both Strategic Health Authorities. It was agreed
that a
Regional Tobacco Strategy was needed, delivered by a coalition
of organisations and partners under the umbrella term of Fresh.
Local
The ambitious five year plan aims to improve well-being and
health for almost 800,000 people living across Newcastle, North
Tyneside and
Northumberland. The Plan has been developed within the
context of health needs assessment which shows that many of the
major health conditions for the population are linked to lifestyle
choices. There is a clear link to the indicators that we have
selected as World Class Commissioning (WCC) outcomes - including
the measure of smoking quitters.
Annual operational plan
The North of Tyne annual operational plan sets out the
developments we are planning over the next year to improve health
and well-being and health services across Newcastle, North Tyneside
and Northumberland. The plan has been drafted in line with
national and local priorities and reflects discussions we have had
over the past year with key partners including members of the
public.
Action Plan to Tackle Health Inequalities
This report documents current performance
against the national health inequalities target, focussing
particularly on the life expectancy target. It includes
consideration of performance across NHS North of Tyne in the
implementation of key highlighted evidence based interventions
which have the potential to narrow the life expectancy gap and the
formulation of an action plan intended to accelerate performance
towards the target.
The current Sustainable Community Strategy for
Northumberland was adopted by the partnership in September 2007 and
covers the period to 2021. It outlines an aspirational
long-term vision for the communities of Northumberland and defines
a series of shared priority outcomes that form the basis for
delivering a fundamental step change to the quality of life in
Northumberland. “Lead healthier lifestyles” is one of the key
themes of the strategy. The Strategy will be updated during
2010/11.
Local Area Agreement
Northumberland’s
Local Area Agreement 2008-2011, and refreshed targets
as at March 2010 include a target to maintain the rate of self
reported 4 week smoking quitters.
A strategy to improve health and well-being in
Northumberland, published in 2007, includes tackling smoking as a
priority.
Our priorities for the future
We have identified reducing the prevalence of
smoking as the number one priority for reducing inequalities in
life expectancy. Action to tackle smoking prevalence is drawn
from the wider Tobacco Control agenda; increasing smoking quit
rates through the NHS Stop Smoking Service is only one element of
this work.
Due to difficulties in maintaining year on
year increases in smoking quit rates against a backdrop of falling
prevalence, the two NHS Stop Smoking Services covering North of
Tyne were recommended for internal improvement review. The
review aimed to expand the reach, appropriateness and effectiveness
of NHS support for all smokers by implementing a package of
interventions, phased in according to available resource. Key
recommendations include the following:
- The purchase of a new database and
customer recall system to facilitate systematic patient recall,
reduce numbers of people lost to follow up and improve monitoring
and data quality;
- Social marketing initiatives to encourage
routine and manual workers, in particular, to access local
services;
- A locally enhanced service agreement with
Level 2 (‘Intermediate’) providers with tiered incentive payments
and an expansion of pharmacy providers across North of Tyne;
- Take advantage of the levers afforded by
the Commissioning for Quality Innovation (CQUIN) payment framework
to engage frontline health staff in tobacco control
activities.
In response to the detailed social marking
work with routine and manual smokers, we are implementing the
following into our programme for tackling smoking:
- Deliver a campaign using ‘real’
ex-smokers who have stopped smoking, advertised locally in
workplaces, supermarkets and local pubs to meet people ‘on their
turf’.
- Take stop smoking services into their
places of work using a mobile unit/bus to vary the locations and
make it easier to engage in the service with friends and meet the
service in a non judgemental situation.
- Change service provision, including
extended opening times.
- Continue support and aftercare once users
have completed the programme.
In addition to helping smokers quit, we must
strive to reduce the inflow of young people recruited as
smokers. We are currently evaluating the young people’s
theatre in education package facilitated in 2009/10 in seven
Newcastle high schools and will develop a youth prevention
programme focusing on access to cigarettes via illicit routes, to
build on this approach.
The Northumberland Tobacco Alliance will be
reviewing its work programme in the light of the recently published
Tobacco Control Strategy for England.
