Agenda item

Report of Director of Public Health.

The OSC agree that the focus of nits review in 2017/18 will be work to address the harms caused by tobacco. The review has been carried out over a six month period and a draft interim report has been prepared on behalf of the Committee setting out key findings and suggested recommendations.

The scope of the review was to provide an overview of current activity to reduce harms caused by tobacco in Gateshead compared to best national and/or international practice, where such practice exists.

It was agreed that the above would be considered in the context of:

·         Higher than average levels of smoking in Gateshead

·         The fact that smoking remains the single cause of most preventable illness and death in Gateshead

·         Significant inequalities in the prevalence of smoking persist between different groups and areas

·         A reduction on demand for stop smoking services

·         Particularly low levels of take up of stop smoking services amongst some groups i.e. people from black, Asian and minority ethnic groups.

·         Pressure on public Health budgets now and in the future, and opportunities for future savings to primary and secondary care costs from prevention activity.

The OSC were informed that the review identified the following issues/challenges:

·         Austerity and Public Sector budget cuts

·         Complex systems and historical siloed approaches

·         The role of the tobacco industry

·         The perception that the job is done leading to a shift of focus

·         The perceived difficulty of ‘doing’ tobacco control

·         The threat to the comprehensive regional tobacco control approach posed by financial pressures across the region

·         NHS focuses on treatment not prevention – smokers not universally encouraged to quit and given support and medication to do so

·         Funding cuts to public health and local authority budgets

·         Reducing demand for the current Stop Smoking Service offer

·         Persistent inequalities in smoking prevalence between different communities

·         Mass media campaigns cut to the bone

·         Enforcement cuts

The OSC were informed that the draft recommendations arising from the review were:-

1)  Tobacco remains the greatest contributor to health inequalities and action to denormalise smoking and reduce prevalence lifts families out of poverty. The human, social and financial cost of tobacco to Gateshead means that it is vital to retain the Council’s strong commitment to comprehensive tobacco control, and in fact, increase our efforts.

2)  Refresh and reaffirm the Council’s commitment to the 2025 vision of 5% adult smoking prevalence.

3)  Invest to save principles would suggest the continuation of appropriate resourcing for this priority area.

4)  The Smoke-free Gateshead Alliance should be supported to develop a strategic Tobacco Plan for Gateshead and to drive this forward. This will clearly set out actions across the public and voluntary and community sectors to address the harms caused by tobacco.

5)  Continued support and commitment for the regional Fresh Tobacco Control Office is important to continue development of hard hitting mass media campaigns which have a strong evidence base in triggering quit attempts, encouraging quitters to stay quit, and reducing uptake among children.

6)  Action to be taken to address inequalities through community asset based approaches to develop co-produced solutions which aim to reduce prevalence of smoking in our more deprived areas and with those groups considered to be vulnerable.

7)  Aim to embed action on smoking in all other relevant Council and public sector plans through a Health in All Policies Approach to ensure recognition of the importance of public health across the public sector.

8)  Aim to embed NICE guidance (PH23) ‘Smoking Prevention in Schools’ across Gateshead schools.

9)  Ensure training is available to provide people living and working in Gateshead with skills and confidence to provide brief advice and intervention on smoking through the development of the Making Every Contact Count initiative.

10) Maintain compliance with current smoke-free legislation and continue support for the new law which bans smoking in cars that are carrying children.

11) Renewed efforts to be made to increase public support for Smoke Free environments such as smoke-free communities and specified outdoor zones.

12) Support the NHS to develop nicotine dependence pathways and to become completely smoke-free in line with NICE guidance (PH48)

13) Further develop stop smoking services to provide flexible options in a range of settings accessed by those at greatest risk.

14) Complete a Health Equity Audit (HEA) to inform development and delivery of Stop Smoking Services in areas of greatest need.

15) Undertake further work as part of Smokefree NHS work to further reduce the number of women who smoke during and after pregnancy.

16) Reduce harm through continued support for evidence based harm reduction.

17) Communication and media capacity for tobacco control is vital and the capacity to be proactive in terms of public relations activity and media should be developed so as to engage residents of Gateshead in the tobacco control agenda.

18) Advocate for a national tobacco sale and distribution licensing scheme, the tobacco industry bearing the full cost of its implementation and enforcement, with the aim of elimination the illicit and illegal trade in tobacco, and to end selling of tobacco products to minors.

19) Deliver an intelligence led and targeted enforcement programme to reduce availability and supply of tobacco products to children.

20) Ensure compliance with legislation to reduce tobacco promotion (e.g. plain packaging) and advocate further restrictions.

21) Advocate for a new annual levy on tobacco companies to ensure they pay more for the harm they cause. Funding from a levy should be used to make smoking history for more families including support and encouragement to help people quit.