Overview of tobacco control

The health impact of smoking

Over 200 people die every day in England (78,000 per year) from smoking-related diseases such as cancer, chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD).  Smoking also causes chronic ill health and smoking during pregnancy significantly increases the risks of miscarriage, premature birth, still birth and neonatal complications.

Vision 2030

On average more people in Sandwell smoke compared to regional and national levels.  Reducing the level of smoking in Sandwell will be a big step towards achieving the council’s 2030 ambition of Sandwell being a ‘place where we live healthy lives and live them for longer’.

 

Smoking in Sandwell

A higher percentage of Sandwell’s population are smokers compared to regional and national levels. The smoking prevalence level in Sandwell is the second highest in the West Midlands.

The percentage of women who smoke at the time of delivery is lower in Sandwell compared to regional and national levels.

 

In Sandwell, more people are admitted to hospital for smoking-related illnesses and there are more smoking related deaths.

Smoking prevalence in Sandwell is higher on average among people in routine and manual occupations.  People who have never worked or who are long-term unemployed also have higher levels of tobacco use. This contributes to health inequalities between poorer people and those who are more well off.

There is also a disparity in levels of smoking based on people’s country of origin.  Nationally, the percentage of Polish people who smoke is 12.5% higher than the England average.  This is relevant to Sandwell which has a large Polish population.

JSNA sections (click to expand)

Services

Sandwell’s approach to tobacco control consists of a combined support model incorporating two elements (specialist stop smoking support and digital self-help) alongside each other. These two elements are integrated in a way that allows service users to engage for level of support as needed.

Stop smoking service delivery

The council’s smoking cessation service is delivered by Everyone Health which aims to provide support to all smokers who are resident or work in Sandwell and / or are registered with GP practices in Sandwell.

In addition to the universal offer of cessation support to all smokers and oral tobacco users, the provider prioritises the needs of pregnant women, smokers with mental illnesses and smokers from Eastern European communities.

The model of service delivery includes:

- Training frontline staff who have contact with smokers in providing effective brief interventions (identifying smokers, motivating smokers to quit, referring to specialist help, offering stop smoking aids)

- Delivering specialist interventions for the cessation of smoking and oral tobacco use by advisors trained to National Centre for Smoking Cessation and Training (NCSCT) standard.

It is expected that 3,780 of the estimated 54,000 smokers in Sandwell will be treated annually. This is to deliver 1,890 four-week quitters and eventually 1,250 twelve-week quitters per annum.  There are also the following additional annual targets:

-50 twelve-week quits from women smoking in pregnancy

-50 twelve-week quits from smokers with mental health conditions

-50 twelve-week quits from smokers from the Eastern European communities

(Note: The element of ‘digital self-help needs further development and is not yet at the point of commissioning.)

Other tobacco control initiatives in Sandwell

Smokefree School Gates 

This initiative involves working in partnership with local schools to enable/help make their school gate areas smoke free zones.  Under this initiative, designating School Gates as Smoke-free Zones will involve conspicuous signs being attached to school gates or positioned appropriately (as agreed with the schools) to alert parents and visitors to the smoke-free status of the gate area. Signage will be provided free of charge to those schools wishing to participate. Additionally, under the scheme, participating schools able to demonstrate that they also have in place a school-wide smoke-free policy and include in their curriculum lessons on smoking will be given Gold Standard Awards.

Smokefree children’s play areas

Following public consultation which resulted in overwhelming support for the proposal to make children’s play areas smokefree zones, 75 areas were identified across the borough.

The initiative aims to develop, deliver and appropriately signpost agreed play areas as smokefree zones

National guidance and policy

The Government’s 2017 tobacco control plan ‘Towards a smokefree generation’ has four objectives:

Prevention
- Discouraging and reducing smoking among under 18s
- Reducing the number of women who smoke during pregnancy
Supporting smokers to quit
- Through effective local stop smoking services
- Reducing the number of people with mental health conditions who smoke
- Creating and supporting working environments which encourage smokers to quit
Eliminating variations in smoking rates
- Using a whole system approach to make every contact within the health and social care system count by promoting smoking cessation to service users
- Targeting local populations with higher smoking rates e.g. people in lower socio-economic groups, Eastern European migrants
- Raising public awareness of the harms of smoking and promoting smoking cessation services
- Explore further potential for smokefree places
- Using the best data and evidence to support tobacco control
Effective enforcement
- Maintaining high duty rates on tobacco products
- Tackling illicit tobacco
- Effective regulation of tobacco sales to young people

 

A key part of the Government’s strategy involves aiming to implement all relevant NICE guidelines by 2022.