Health Inequalities and Smoking, Dr. Helen McAvoy
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  • Tobacco Control Strategy Ireland – commitments on inequality

Health Inequalities and Smoking, Dr. Helen McAvoy Health Inequalities and Smoking, Dr. Helen McAvoy Presentation Transcript

  • Health Inequalities and SmokingDr. Helen McAvoy, Senior Policy OfficerInstitute of Public health in Ireland
  • 2European Week Against Cancer 2013Aviva Stadium , Dublin2Tobacco and Health InequalitiesDr Helen McAvoyInstitute of Public Health in Irelandwww.publichealth.ie2
  • 3www.publichealth.ie3All-island bodyo Inequalities in healtho North-South cooperationThree work strands:o strengthening public health intelligenceo building public health capacityo policy and programme development and evaluation
  • 44OutlineCancer & inequalities in life expectancyInequalities in tobacco-related harmInequalities in smoking behaviours Social & commercial determinants Time to develop a more comprehensiveapproach to addressing inequalities intobacco-related harm?4
  • 55Source:NI Health and Social Care InequalitiesMonitoring System – 2013An overview of changes in NI lifeexpectancy 2001-03 to 2008-10Comparison of life expectancy‘deprivation gap’ in NorthernIreland- most deprived vs. leastdeprived
  • 6Sweden and the World - Stockholm-May13/14 2013 6Source:NI Health and Social CareInequalities MonitoringSystem – 2013An overview of changes inNI life expectancy 2001-03to 2008-10Contribution of the lifeexpectancy gap of 7.6years between NI most& least deprived areas2008-10 by cause ofdeath (males).
  • 7Source: Cancer in Ireland 2011. National Cancer Registry of Ireland. www.ncri.ie7Age-standardised incidence of cancer by deprivation category of patientresidence 2007-2009 – Republic of Ireland
  • 8Source: National Cancer Registry Ireland, 2011 – Lung Cancer Incidence,Mortality, Treatment & Survival in the Republic of Ireland 1994-2008.8
  • 99Source: Cancer in Ireland 2011. National Cancer Registry of Ireland. www.ncri.ie
  • 10Source: Cancer in Ireland 2011. National Cancer Registry of Ireland - www.ncri.ie 105 year survival for cancers diagnosed during 1994-1997, 1998-2002, 2003-2007
  • 1111Source: Cancer in Ireland 2011.National Cancer Registry of Ireland.www.ncri.ie5 year relative survival forcancers diagnosed in menand women 2003-2007
  • 12Behind the lung cancer statistics Delays in presentation? (men especially) Knowledge & differentiation of symptoms Shame, guilt and stigma Inequalities in multi-morbidity Choices about where to die ( Sharp et al, IMJ, 2010) Fewer empowered survivors to carry theflag for early detection, research, politicalattention and investment
  • 1313Cancer inequalities are multifaceted Risk – incidence, type, age of diagnosis Finding out – achieving a timely diagnosis Health system, social and economicassets for optimal treatment, survival andrecovery
  • 1414Inequalities in tobacco-relatedharm Health harms Social and economic harms Socio-economic disadvantage associatedwith life-course accumulation of cancerrisk
  • 15Sweden and the World - Stockholm-May13/14 2013 15Smoking in pregnancy by deprivation in Northern Ireland 2005 – 2011Source: NI Health & Social Care Inequalities Monitoring System 2012
  • 1616Risk profile of the lowincome smoker- Exposure to tobacco inutero and SHS inchildhood-Grew up in family andcommunity with highsmoking rate-Early initiation-Heavier smoking-Equally likely to attemptquitting (?)-Less likely to succeed atquitting - definitely
  • 1717SHS exposure in childhoodYoung Persons Behaviour and AttitudesSurvey 2010 Northern Ireland – 49.8% of11-16 yr olds report adults smoke insidetheir homeISAAC study – Ireland sample 2007 – 45%CHETS study Northern Ireland – SHSexposure is socially patternedIndoor Air Pollution and Health – STRIVEreport 2013 - Mean 24-hour level in smokinghomes of 143μg/m3 4 times higher than USEPA ‘ unhealthy’ level for sensitive groups
  • Percentage of boys who report theyare current smokers18Source: The Irish Health Behaviour in School-Age Children Study 2010www.nuigalway.ie/hbsc
  • Percentage of girls who report theyare current smokersSource: The Irish Health Behaviour in School-Age Children Study 2010www.nuigalway.ie/hbsc19
  • Adult smokers by social class (2007)Source: SLAN 2007 Survey of Lifestyle, Attitudes and Nutrition in Ireland: Main Report 20
  • Percentage of cigarette smokers who reportedtrying to quit in the previous 12 months21Source: SLAN 2007 Survey of Lifestyle, Attitudes and Nutrition in Ireland: Main Report
  • 2222Tobacco industry role Recruiting ‘FUBYA’ a priority PPACTE report – adapting price strategies Roll your own tobacco Illicit tobacco
  • 23
  • 24Source:Irish Independentnewspaper2008
  • 25Sweden and the World - Stockholm-May13/14 2013 2525
  • 2626Tobacco control through an equitylens How would we judge success/failure? Health intelligence requirements Regulation of tobacco industry and supplychain Education, health promotion Smoking cessation services, monitoringand review
  • 2727Dr Helen McAvoyInstitute of Public Health in Irelandhelen.mcavoy@publichealth.ie@HelenMcAvoy227