our vision and leadership for tobacco control in hertfordshire
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www.hertsdirect .org Public Health and Tobacco Control: Our Vision and Leadership in Hertfordshire Jim McManus Director of Public Health Hertfordshire County Council s presentation was developed for our CLeaR assessment for 22 nd July 2
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This presentation was developed for our CLeaR (local government tobacco control standards) assessment in July 2014. It sets out our vision for tobacco control in Hertfordshire, summarises our strategies and current position and identifies our future work including commitment to harm reduction, getting positive gains from e-cigarettes and driving tobacco related harm down
Transcript of our vision and leadership for tobacco control in hertfordshire
www.hertsdirect.org
Public Health and Tobacco Control: Our Vision and Leadership in Hertfordshire Jim McManus
Director of Public Health
Hertfordshire County Council
This presentation was developed for our CLeaR assessment for 22nd July 2014
www.hertsdirect.org
Why Tobacco Control Remains Important to us• Major importance to our public health ambitions and vision
• Single most important cause of premature morbidity and mortality
• Kills 80,000 people prematurely in England alone
• Accounts for 50% of health inequalities between better and worst off – gap is widening
• Disproportionately affects
most deprived
communities and groups
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Why we must move towards the endgame for tobacco in Hertfordshire
• Tobacco still kills and harms too many people in Hertfordshire
• It accounts for over half the gap in avoidable and preventable death between us and our statistical neighbours
• It costs far more in death, disease and disability than we can countenance
• It costs more in money than we get in tax revenue or jobs or economic gain
• The US Surgeon General’s report 2014, 50 years after the famous Dolland and Hill study, implicates tobacco in even more diseases than ever – diabetes included
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We want to
• Drive down prevalence of tobacco use
• Reduce numbers of people taking up tobacco
• Work with people not ready to give up tobacco to reduce harm as much as possible in line with NICE guidance
• Recognise, welcome and apply the potentially significant positive gains from e-cigarettes in reducing harm from tobacco for our population
• We recognise we are still “in the lab” on this
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Hertfordshire Smoking Prevalence* % District
Smoking Prevalence (%)2011
Smoking Prevalence (%)2012
Change in Percentage Points
Broxbourne 23.6 19.3-4.3
Dacorum 18.0 17.4-0.6
East Herts 15.6 15.2-0.4
Hertsmere 15.1 20.8+5.7
North Herts 20.8 17.0-3.8
St Albans 19.7 16.2-3.5
Stevenage 27.7 22.3-5.4
Three Rivers 24.6 15.5-9.1
Watford 18.5 14.3-4.2
Welwyn Hatfield 21.5 20.4-1.1
Hertfordshire 20.0 17.7-2.3
England 20.2 19.5-0.7
Local Tobacco Profiles 2012*: http://www.tobaccoprofiles.info*Note - wide confidence intervals
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Local Ambitions
• Reduce Smoking Prevalence to 18.5% or less in each district
• Reduce the uptake of Smoking in Young People to less than 9% by 2015
• Reduce Smoking in Pregnancy to 7% or less by 2015
• Reduce the harm from second-hand smoke
• Promote Smokefree public sector organisations and healthy workplaces
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Tobacco Control Progress: Reducing Adult PrevalenceReduce smoking in every district to 18.5% or less by 2015
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England Hertfordshire Stevenage Hertsmere WelwynHatfield
Broxbourne Dacorum North Herts St Albans Three Rivers East Herts Watford
Perc
enta
ge o
f Sm
oker
s
Percentage of adults who smoke
Source: Integrated Household Survey published by Public Health England
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Tobacco Control Progress: Reducing Prevalence in Young PeopleReduce smoking in young people, so that less than 9 per cent of 15 year olds smoke by 2016
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Hertfordshire Broxbourne Dacorum East Herts Hertsmere North Herts St Albans Stevenage Three Rivers Watford WelwynHatfield
Perc
enta
ge o
f ch
ildre
n w
ho s
mok
e re
gula
rly
Percentage of children aged 15 who smoke regularly
Male FemaleSource: Health Related Behaviour Survey
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Tobacco Control Progress: Reduce the number of women who are smoking at the time of delivery to less than 7% by 2015
130 142 134 119 122 125 126 1240%
2%
4%
6%
8%
10%
12%
14%
2013/14 Q1
2013/14 Q2
2013/14 Q3
2013/14 Q4
2013/14 Q1
2013/14 Q2
2013/14 Q3
2013/14 Q4
2013/14 Q1
2013/14 Q2
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2013/14 Q4
England ENHCCG HVCCG
Percentage of women smoking at the time of delivery (by CCG)
% women smoking at time of delivery Target Source: Health & Social Care Information Centre
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What we have done since the Public Health function transferred to the County Council:
1. Public Health Strategy adopted Nov 13 with clear priority commitments on tobacco
2. One of the Health and Wellbeing Board 9 Priorities
3. Hertfordshire Tobacco Control Policy approved by Cabinet (based on LGA declaration but goes further) Nov 13
4. Established multi agency Public Health board – advocates of Tobacco Control and route to sharing best practice and advocacy
5. Collaborating with national agencies on harm reduction and e cigarettes in tobacco control
6. Tobacco Control Strategic Plan 2014-2016 approved by Public Health and Localism Panel May 2014 and by Health and Wellbeing Board
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What we have done since arriving in Local Government cont.
1. Work with CCGs and Commissioners to include Tobacco Control and Smoking Cessation in NHS targets (mental health, NHS Hospital Trusts and Community Provider)
2. Public Health now lead on the JSNA
3. Detailed profiles for every District and CCG locality on impact of tobacco as part of JSNA
4. £2m investment in District Council led public health. Tobacco one of top priorities
5. Smoke free homes, cars and playgrounds campaign
6. Invested in psychology skills in services
7. 300+ stop smoking service points in Hertfordshire across a variety of settings and agencies
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Hertfordshire Tobacco Control Strategy Group
• Tobacco Control Strategic Plan 2014-2016 developed with stakeholders
• Responsible for delivery of each of these priorities working with TC Alliance partners
• Reports to DPH, Public Health and Localism Panel and to HWB Board
• Project management approach to delivering ambitions
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Coming shortly…..
• Report to the HWb Board to and advocate refresh of ambitions in view of progress in Herts
• Feasibility study from TFF/ASH/Fresh on Regional Tobacco Control Office
• Director of Public Health Report 13-14 about to be published. Focus on ‘Early Avoidable Death’ and prioritises smoking-related behaviour
• Tobacco Control in PH communication and marketing plan 2014-2015
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Harm Reduction and e-cigarettes
• We are starting to develop harm reduction guidelines in line with NICE guidance
• Our ultimate aim is to get people quitting tobacco but we recognise harm reduction is a must do
• We will include psychology skills as core to harm reduction
• We will develop e-cigarettes guidance and work with e-cigarette users and stakeholders to get this right
• E-cigarettes are an important tool in reducing harm from tobacco though we recognise we are still feeling our way on this and welcome help and guidance
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thank you
