Agenda item

Dr Shade Agboola, Consultant in Public Health, introduced the item on Smoking in Nottingham City. She gave a brief summary of the statistics around the impact of smoking on health then went on to highlight the following points:

 

(a)  19% of adults in Nottingham City are current smokers and although there has been a trend of reducing prevalence in Nottingham the proportion of adults who smoke remains higher than the national average;

 

(b)  Nationally the number of smokers who are in routine and manual occupations has been higher, but this number has recently seen a reducing trend. This has not been mirrored in the local figures with the number remaining relatively static;

 

(c)  A new smoking cessation services has been established by the GP Alliance in Nottingham City called Stub-It. There is a targeted Public Health funded element which specifically targets smokers with mental health problems, pregnant smokers and their partners, and smokers living with a long term condition;

 

(d)  The smoking cessation service can currently be accessed from Upper Parliament Street with an additional location at the Wellbeing Hub starting to deliver from April onwards;

 

(e)  Battery operated e cigarettes are shown to be 95% less harmful than cigarettes. They aim to provide a similar sensation to inhaling tobacco smoke without the smoke. They are no licensed medicines but are regulated by the Tobacco and Related Products Regulations 2016;

 

(f)  It is estimated that 2.9 million people in Britain use e-cigarettes and of these it is thought that 1.5 million have stopped smoking tobacco cigarettes;

 

(g)  Research is showing that E-cigarettes are more effective than nicotine replacement treatment at helping smokers stop using tobacco products;

 

(h)  There have been a number of concerns raised about the uptake of e-cigarette use amongst young people (11-18 year olds), however a PHE report from February 2019 suggests that regular use of e-cigarettes amongst that age range in Britain is low at 1.7% and that the proportion of young people who have never smoked and use e-cigarettes at least weekly remains very low at 0.2%;

 

Dr David Johns, Acting Consultant in Public Health and Steve Thorne, Communications & Marketing Manager (Children and Adults) gave a presentation, on smoking in pregnancy outlining the health impacts on the mother and the unborn baby and the work being done towards reducing the number of women smoking at the time of delivery. They highlighted the following points.

 

(i)  The English average for smoking at time of delivery is 10.8%. the Nottingham average is significantly higher at 17.2%. There has been no significant reduction since 2010/11;

 

(j)   The LoveBump campaign is running across Nottingham and Mansfield and Ashfield over Local authorities and NHS trusts to encourage expectant mothers to stop smoking;

 

(k)  All maternity care staff in Nottingham are receiving a toolkit allowing them to pass on support to pregnant smokers, alongside the targeted referral to the Stub-It it campaign;

 

(l)  There will be continued community engagement throughout the year in two key areas of the city, Bulwell and Aspley, engaging groups such as Neighbourhood development officers, Small Steps Big Changes and Children’s Centres;

 

(m)The LoveBump campaign is being run alongside other healthy pregnancy messages as part of a more encompassing strategy to encourage a stronger link between the mother and unborn baby;

 

Kate Smith, Smokefree Nottingham Coordinator introduced the last part of the item, a presentation on extending smoke free outdoor public spaces with the aim to inspire a smoke free generation. She highlighted the following points:

 

(n)  Creation of smoke free outdoor public spaces reduces children’s exposure to harmful second hand smoke and tobacco use;

 

(o)  Over 70% of adult smokers started smoking under the age of 18 and children who grow up around smokers are up to three times more likely to become smokers themselves;

 

(p)  Additional benefits of extending smoke free outdoor public space include:

·  Reduction of tobacco related litter

·  Opportunity to support citizens to make healthier lifestyle choices, including supporting those smokers who would like to quit

·  Reducing expose of children to smoking making it less visible and less “normal”;

 

(q)  Achievements to date include

·  being the first authority to ensure smoke-free school gates and playgrounds in 2010,

·  Smokefree Summer – summer activity programme aimed at children and families

·  Smokefree sports clubs – support

 clubs to take action to reduce exposure to tobacco use

 

(r)  Smokefree events have had overwhelming support of citizens with almost 90% who were surveyed supporting them;

 

The following points were made during discussion:

 

(s)  Smoking cessation sessions are offered for extended hours to accommodate those who are unable to attend during standard office hours;

 

(t)  Extending the cessation service into other wards is dependent on funding. Current funding is secured for 2 years;

 

(u)  A large amount of research shows that smoking levels are higher in lower socioeconomic levels. Budget support is being given to more people who are struggling with benefit freezes and making more of tthe links between stopping smoking and improvement in finances would be hugely beneficial;

 

(v)  Some of the imagery within the LoveBump campaign material does not reflect the diverse family structures that we see today, and in order not to alienate some families’ consideration should be given to being more inclusive of diversity of family structure;

 

(w)PHE recommend that e-Cigarettes are made available at hospital shops alongside NRT and that vaping policies support smokers to quit;

 

(x)  It is essential to understand and then tackle issues that are preventing people from quitting tobacco use and to instil a change of behaviour to prevent relapse.

 

(y)  Addiction is very complicated to understand, there is no one strategy that will work to reduce smoking in Nottingham City, it will take sustained work from a variety of angles to achieve;

 

(z)   Every opportunity to reduce visibility of smoking and tobacco use in front of children and young people should be taken;

 

(aa)  Employers also have an important part to play in reducing smoking. Many employers do not understand their employees use of tobacco and so cannot support them to quit;

 

RESOLVED to:

(1)  Ask board members to:

 

Smoking in Pregnancy

  i.  Support the LoveBump Campaign across their organisations

  ii.  Support the achievement of the Council Plan commitment to reduce smoking rates of pregnant women at the time of delivery

  iii.  Ensure the NHS long term plan commitment to provide pregnant women and their partners with a new NHS stop smoking pathway including support, is designed alongside non-NHS funded services

 

Smoking Cessation

  iv.  To create awareness about smoking cessation service (Stub-it)

  v.  Encourage citizens who smoke to seek support via their GP’s especially if they are in one of the target groups for the service

  vi.  Support referral of patients who are smokers in target groups to the new service

 

Implementation of the NICE guidance supporting cessation in secondary care (PH48)

  vii.  Support continued implementation of PH48 in NUH

  viii.  Review current policies and ensure that provision is made for staff, patients, and families who wish to vape on site

  ix.  Support staff in the delivery of brief advice through completion of the “very Brief Advice Training Module” by the National Centre for Smoking Cessation Training (NCSCT)

 

  Vaping and E-cigarettes

  x.  Review current smoking cessation policies in organisations

  xi.  Consider expanding current policy to include recognition that e-cigarettes are 95% less harmful than cigarettes

  xii.  Support staff, patients, and clients who wish to vape by considering the provision of dedicated vaping locations/areas on site