Smoking is the primary cause of preventable illness and death. Every year over 100,000 in the UK and almost 80,000 people in England die from smoking related diseases. Deaths from smoking are greater than the combined total of the six next greatest causes of preventable deaths. This includes alcohol, obesity, traffic accident and drugs misuse.
Smoking is the largest single preventable cause of cancer. Over one in four of all cancer deaths are attributable to tobacco use. Smoking is a major cause of heart disease and stroke with one in five deaths from cardiovascular disease. Smoking is also responsible for a third of all deaths from respiratory disease.
Treating smoking-related illness is estimated to cost the NHS £2.7bn a year, with the wider economic costs reaching over £13bn once factors such as lost productivity, tobacco litter and smoking-related house fires are taken into account. Reducing smoking prevalence therefore remains a key local public health priority and a national focus.
The first locally commissioned comprehensive regional tobacco control programme was set up here in the North East in 2005 with funding from all Primary Care Organisations and additional funds subsequently from the Strategic Health Authority. Similar programmes were launched in the North West in 2008 and the South West in 2009. All English regions had some level of tobacco control delivery from 2005-2010 with central funds from the Department of Health. Such central funds ended in 2010 across the country and investment in the regional function has only remained in the original three regions with local authorities now providing funding. Northumberland has been part of this since the beginning. Prior to Fresh, each PCT/Care Trust employed its own tobacco control coordinator only.
The regional programmes have had a powerful impact, particularly in places that have an appropriate level of investment, as recommended by NICE. In the NE, for example, smoking prevalence significantly declined at a time when UK rates were relatively static and the rate of decline has been faster.
The regional model requires a level of local coordination and delivery to support and compliment the region-wide and strategic role. This local delivery is commissioned from the SHIMP, soon to be IWS. Local activity includes work with schools and settings on policy development and reducing exposure to secondhand smoke and the coordination of a tobacco control alliance with action plan pertaining to the agreed strategic themes.
Smoking remains the leading cause of preventable death and disease in England,and is one of the most significant factors that impacts upon health inequalities and ill health, particularly cancer, coronary heart disease and respiratory disease.
Smoking is one of the most significant contributing factors to low life expectancy, health inequality and ill health. We know that prevalence is higher amongst key groups such as Routine and Manual workers, pregnant women and people with mental health conditions. People living in deprivation are more likely to smoke, smoke more, and are less likely to quit.
What can be achieved at regional level
Analysis undertaken by NICE has shown that tobacco control at a regional level is very cost effective. Interventions that can be best delivered at a regional level include tackling illicit tobacco and the delivery of cost effective communications and marketing campaigns. In addition to these issues, regional tobacco control has also played a vital role supporting regional and local activity, sharing good practice, encouraging the development of effective interventions and coordinating networks. KL view is that the former is essential but the latter could happen without dedicated coordination if needs be, but only with capacity at local level to facilitate and/or engage with networks. Northumberland has been able to dedicate less time and resource into tobacco control coordination and facilitation because Fresh do some of it on our behalf.
Highly effective and cost-effective.
Nationally, treating smoking-related illness is estimated to cost the NHS £2.7bn a year, with the wider economic costs reaching over £13bn once factors such as lost productivity, tobacco litter and smoking-related house fires are taken into account.
Research by ASH shows that £1.1bn is spent annually on social care as a result of long term conditions caused by smoking (£608m to local authorities and £451m to individuals to self-fund their care).
Northumberland has a rate of 300.3 per 100,000 population for smoking-attributable mortality. This means that 604 Northumberland residents die every year from smoking.
It is estimated that;
746 child disease incidents per year in Northumberland are from exposure to secondhand smoke.
76,696 estimated NHS appointments due to smoking in Northumberland
49,370 GP appointments
2,892 Hospital admissions
15,493 Practice nurse consultations
8,941 Outpatient visits
The above harms result in an estimated cost to the local NHS of £12.1m and a cost to local businesses of £3.7m - and overall estimated smoking and tobacco-related cost to our local economy is £16.4m.
Quitting puts money in pockets of families in need
Currently approximately 1.2 million children in the UK are living in poverty in households where adults smoke. If these adults quit and the costs of smoking were returned to household budgets, 365,000 of these children would be lifted out of poverty (ASH, 2015).
Helping smokers’ quit now reduces the cost of care in the future
The Care Act 2014 requires Councils with social care responsibilities to put in place preventive measures designed to reduce the need for care and support in the future. Helping smokers quit now means that they are less likely to require paid for care in the future.
It has been estimated using the National Institute of Health and Care Excellence's Tobacco Return on Investment Tool that cutting smoking rates to 5% across the North East by would not only save thousands of lives, but an estimated £100million a year, freeing up around £50 million for the NHS, significantly easing the strain on hospitals and GP surgeries, as well as significantly cutting the cost of smoking related sickness on local businesses.
A multi-disciplinary. multi-agency approach to tobacco control is the way to reduce smoking prevalence and the burden smoking places on our society. As explained in the SSS template, smoking cessation treatment services are a vital component in this approach but they alone will not have the necessary impact at a population level. We must work in the 3 spheres of tobacco control - prevention, protection, cessation - and aim to make tobacco less desirable, less accessible, less affordable.
Local Tobacco Control Profile
Smoking Facts Northumberland