Leave no one behind - Local Government Association · Leave no one behind Addressing the challenges...
Transcript of Leave no one behind - Local Government Association · Leave no one behind Addressing the challenges...
Leave no one behind
Addressing the challenges of smoking and inequalities
Sarah WilliamsTobacco Control Programme Manager, Public Health England
Overview
• Smoking and health inequalities
• Opportunities for tackling these inequalities
• The challenges ahead
• Suggestions for the way forward
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Smoking and health inequalities
Smoking is the greatest cause of health
inequalities
4 Tobacco Control in England: Reducing Inequalities
Smoking prevalence in different groups
• 40.5% of people with severe mental illness smoke
• Mothers in routine and manual occupations are five times more
likely to have smoked throughout pregnancy than mothers in
managerial and professional occupations
• 80% of the prison population smoke
• Many of the most deprived authorities also have the highest rates of
smoking
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Smoking at time of delivery (2016/17)
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0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0%
2016/17 rate of SATOD by CCG
10.1% national average6% 2022 target
Opportunities for tackling these inequalities
Towards a smokefree generation
• Reduce adult smoking rates from 15.5% down to 12% or less.
• Reduce the prevalence of smoking in pregnancy from 10.7% to 6% or less
• Reduce the prevalence of 15 year olds who regularly smoke from 8% to 3%
or less.
• Reduce the inequality gap in smoking prevalence between those in routine
and manual occupations and the general population.
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Golden Threads…
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Reducing Inequalities
• Targeting priority populations
NHS Sustainability
• Emphasis on smokers in the healthcare system
Maternity transformation
programme
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Smoking and mental health
Leading Change Adding Value - Smoking and Mental Health Programme
Smokefree prisons
• 86 out of 103 prisons smokefree
• The final phase is now underway
• Roll out has been largely without incident
• Rechargeable vaping devices are popular
• Vigilance and support levels remain high
• Support for prisoners on release is a priority
• Probation services must be linked to cessation
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More people stopping successfully
• Better and more quitting aid options, with e-cigarettes now the most
popular. Combining the most effective (stop smoking services) with
the most popular (e-cigarettes) has strong results
• More restrictions on smoking
• Banning the use of attractive brand imagery on tobacco packaging
• Developing a strong smokefree ethos, especially through healthcare
systems
• Effective stop smoking campaigns such as Stoptober
• Increase in rates of quitting in smokers from lower socio-economic
groups
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Challenges
Limited resources
Stop smoking services and wider tobacco control have seen
some of the largest reductions in public health budgets
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Source: David Buck, The King’s Fund, 2017
Suggestions for the way forward
Evidence of effectiveness
Rank Component Boosts quit rates
by*…
1 Face–to-face group support with
pharmacotherapy
300%
2 Face-to-face individual support with
pharmacotherapy
200-300%
3 Supported use of pharmacotherapy 50-100%
4 Telephone support 50-100%
5 Text message support 40-80%
6 Websites Unknown
7 Mobile digital applications Unknown
* Quit rates boosted if intervention is run properly
Pool your resources
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Use available tools and resources
• Stop smoking services: models of delivery
• Commissioning support pack: principles and indicators
• Commissioning support pack: key data
• CLeaR
• Use of e-cigarettes in public places and workplaces
• NICE ROI tool
• NCSCT briefings: Integrated health behaviour services briefing;
Prevention v cessation: effectiveness and cost-effectiveness
• NCSCT on-line training: Specialist practitioner; Very Brief Advice; E-
cigarettes: a guide for healthcare professionals.
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