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Stop Smoking Services Reach Extension
1. Stop Smoking Services –
Extending the Reach
IPHI Workshop
June 2014
Mrs Gerry Bleakney
PHA Strategic Lead for Tobacco Control
gerry.bleakney@hscni.net
3. In Northern Ireland
• Smoking is the single greatest cause of
preventable illness, premature death and health
inequality
• 2,300 people die prematurely from smoking
related illnesses every year.
• 24% of population smoke – 32% of manual
workers smoke
• In 2012/13 - 32,714 people used Stop Smoking
Services (56.6% quit)
5. Smoking prevalence by socio-economic
group 2010/11-2012/13
Routine and manual workers
31%- 2010/11
33% -2011/12
32% - 2012/13
6. Smoking prevalence by deprivation
quintile, 2010/11-2012/13
Source: Northern Ireland Health Survey 2010/11-2012/13
7. Ten Year Tobacco Strategy for
NI
2012-2022Objectives & Priority Groups
http://www.dhsspsni.gov.uk/tobacco_strategy_-_final.pdf
8. Tobacco Strategy 2020
Prevalence
Targets
• NI: Overall 24% to 15%
• Children and young people (11-16): 8% to 3%
• Pregnant women: 15% to 9%
• Manual groups: 31% to 20%
• Additionally - To ensure a MINIMUM of 5% of the
smoking population in NI access stop smoking services
annually
http://www.dhsspsni.gov.uk/tobacco_strategy_-_final.pdf
9. Services
645 providers – specialist training, meet
Quality Standards and use Elite System
(acute/primary care/community/workplaces)
BIT and pathways
Public Information Campaign
Website – www.want2stop.info
Helpline – 0808 812 8008
Quit Kit and materials
Facebook and SMS
10. Number and location of Stop Smoking Service providers
by provider type across Northern Ireland by super output area*
multiple deprivation measure 2010 (MDM)
12. Uptake and Estimated Proportion of All
Smokers Accessing Stop Smoking Services
in Northern Ireland, 2007/8 – 2012/13
EstimatedproportionofNI
smokersaccessingservices(%)
13. Total Service Uptake by Provider
Type 2012/13
Provider type Uptake 2012/13
(n,%)
Quit rate at 4 weeks (%)
Pharmacy 23,490 (72%) 55.6
GP 3,862 (12%) 48.2
Hospital sites 3,514 (11%) 65.7
Community 1,848 (6%) 65.2
TOTAL 32,714 56.6
14. Number and estimated proportion of smokers accessing Stop Smoking
Services within each deprivation quintile 2011/12-2012/13
Source: NI Stop Smoking Services database 2011/12-2012/13. Cited in PHA Annual Stop Smoking Services Report 2012/13
15. Overall Uptake and Proportion of all NI
Smokers
Accessing and Quitting at 4 weeks
by deprivation quintile 2012/13
16. Access and effectiveness – R+M workers
2010/11-2012/13 2010/11 2011/12 2012/13
Numbers accessing service (n) 8258 10009 8159
Est. proportion of all R & M smokers accessing
services (%)
7.1 8.6 7.0
Number of R & M smokers quitting at 4 weeks (n) 4531 5575 4972
4 week quit rate (%) 55% 56% 61%
Est. proportion of all R & M smokers quitting at 4
weeks (%)
3.91 4.81 4.29
Number of R & M smokers quitting at 52 weeks (n) 1487 1958 n/a
52 week quit rate (% based on all accessing services) 18% 20% n/a
Est. proportion of all R & M smokers quitting at 52
weeks (%)
1.28 1.69 n/a
17. Smoking and pregnancy (routine data)
2010/11-2012/13
Source: Child Health System: Cited in Children’s Health in Northern Ireland. PHA 2014.
Year
2020 strategy target prevalence =9%
Overall regional prevalence of
smoking in pregnancy 2011
= 16%
18. Stop Smoking Services: Use and effectiveness
among pregnant smokers 2008/09-2012/13
2008/09 2009/10 2010/11 2011/12 2012/13
No. accessing
services (n) 363 694 1015 1462 1608
Est. proportion of
smokers accessing
service (%)
8.0 16.1 23.9 34.0 37.5
4 week quit rate (%) 60.9 53.9 52.4 58.5 59.3
Est. proportion of
smokers quitting at 4
weeks with services
4.9 8.7 12.6 19.9 22.2
52 week quit rate (%)
~
27.0 21.2 25.3 26.1 n/a
Est. proportion of
smokers quitting at
52 weeks with
services
2.2 3.4 6.1 8.9 n/a
19. Use and effectiveness of Stop Smoking
Services
among 11-16 year old smokers by area
2012/13
Belfast Northern South
Eastern
Southern Western NI
Number
accessing
service (n)
93 74 78 53 125 423
Est.
proportion
of smokers
accessing
service (%)
4.1 2.8 4.6 3.2 9.6 4.4
Number
quit at 4
weeks (n)
47 23 41 21 51 186
4 week quit
rate (%)
50.5 31.1 52.6 39.6 40.8 44.0
Source: Cited in PHA Annual Stop Smoking Services report 2012/13
20. Estimated access to Stop Smoking
Services by UK region 2012/13
(NI Strategy Target – 5% reach)
*Source: PHA Stop Smoking Services – Annual Report 2012/13
Service
uptake
(n)
Population
size: aged
16+ (n)
Smoking
prevalence
(%)
Assumed smoking
population (n)
Proportion of
smoking population
accessing Services
(%)
England
724,427 43,363,400 20% 8,672,680 8.4%
Scotland
116,198 4,398,900 25% 1,099,725 11%
Wales
6,299 2,429,800 23% 558,854 1.1%
Northern
Ireland
32,714 1,441,500 24% 345,960 9.5%
21. Four Week (self reported) Quit Rates in the UK,
2012/13
Uptake = 6,299
Uptake = 116,198
Uptake =32,714
Uptake = 724,427
Half of all regular cigarette smokers will eventually be killed by their habit
Each cigarette smoked shortens the smokers life span by 5 minutes –
on average the smokers life by 10-15 years
New info:
Since 1983, male smoking prevalence has declined from 39% to 24%
Female smoking prevalence has fallen from 29% to 23% over the same period
Smoking prevalence was higher in 2012/13 among adults living in the most
deprived areas(37%) compared to adults living in the least deprived areas (12%)
Prevalence
Based on 2012/13 data 26% of Belfast LCG smoked, 22% of Northern, South eastern and southern LCG smoked and 28% of western LCG smoked.
Objectives
Objective 1 – Fewer people starting to smoke (Chapter 3)
The Strategy identifies the following measures as key to being successful in reducing the uptake of smoking amongst children and young people:
reducing the impact of tobacco promotion;
raising awareness - about the effects of tobacco smoke on smokers’ and non-smokers’
health – through public information and education; and
reducing availability of tobacco to children and young people.
Included in proposals either underway or being considered by the Department are: banning the display of tobacco products at point of sale; banning the sale of tobacco from vending machines; tougher sanctions against retailers who break the law with regards to underage sales of tobacco products; and introducing plain packaging for cigarettes and hand rolling tobacco.
Objective 2: More smokers quitting (Chapter 4)
Cessation services need to be properly targeted for the priority groups which have been identified – children and young people; disadvantaged people who smoke; and pregnant women, and their partners who smoke - a range of services tailored to meet their specific requirements is necessary in order to reduce smoking prevalence.
The particular requirements of other groups such as those from an ethnic minority background, those with a disability, and those from the rural community, also need to be addressed by smoking cessation service providers.
Objective 3: Protecting people from tobacco smoke (Chapter 5)
Further work is required in order to reduce levels of smoking in areas not covered by smoke-free legislation, such as private homes and vehicles, and entrances and exits to public buildings.
Priority Groups
Children and young people
Disadvantaged people who smoke
Pregnant women and their partners who smoke
Groups mentioned re. targeting:
LAC
Young offenders
Ethnic minority background (immigrants)
Those with a disability
Those from the rural community
People suffering from mental illness
People serving custodial sentences
Pre-elective surgery patients
All figures based on prevalence at time strategy was set.
LES across NI since 2013/14 -
This graph illustrates the number of smokers setting a quit date from
2007/08 , trends showed from 07/08 to 12/13 the number and estimated
proportion of NI smokers accessing the services increased but then a
fall from 12/13
In 2012/13, pharmacies delivered Stop Smoking Services to 72% of
all clients, GP’s and hospitals delivered the service to 12% and 11%
respectively of all clients, while community providers delivered
services to 6% of all clients.
Specifically looking at uptake between 2011/12 and 2012/13
the numbers accessing GP services decreased by 30.8%,
pharmacies uptake decreased by 18.9%, and community services
decreased by 4.5%, however, in contrast hospital services increased
by 12% this year.
Service uptake was greatest in the most deprived quintile (n=8412), in comparison to the least deprived quintile (n=2763);
Despite the overall decrease in service uptake , three times as many
Smokers from the most deprived quintile (n= 8,412) accessed services
in comparison to the least deprived quintile (n= 2,763) illustrating the
Services are effectively targeting inequality.
8,159 routine and manual smokers set a quit date with the Stop Smoking Services equating to approximately 7% of all routine and manual smokers in NI;
At 4 weeks the Stop Smoking Services helped
4.29% of all routine and manual smokers in NI quit,
At 52 weeks the Stop Smoking Services helped
1.69% of all routine and manual smokers in NI quit
37% of all pregnant smokers in NI (n=1,608) set a quit date with the services with service uptake increasing by 10% in 2012/13 compared to 2011/12;
At 4 weeks the Stop Smoking Services helped
22.2% of all pregnant smokers in NI quit,
At 52 weeks the Stop Smoking Services helped
8.9% of all pregnant smokers in NI quit,
The IPH report stated that ‘The success in NI in reducing inequalities in smoking and pregnancy is notable – Author Dr Helen McAvoy was unaware of data from any other country showing this’
423 11-16 year olds set a quit date with the services equating to 4.4% of all 11-16 year olds who smoke at least weekly.
At 4 weeks the Stop Smoking Services helped
2% of all 11-16 year old weekly smokers quit
At 52 weeks the Stop Smoking Services helped
<1% of all 11-16 year old weekly smokers quit.
This shows how NI compares with the rest of the UK.
11% smokers in Scotland accessed services, NI the next greatest
Access with 9.5%
Important to identify any limitations associated with comparing service
Access across the UK .
In NI we have a uniform Stop smoking service with generic Quality
Standards across all settings, the uniformity of services elsewhere in the
UK is more variable
In Scotland around 25% of services are provided through specialist
intensive support whereas 75% of services are delivered through less
Intensive pharmacy support services
UK comparison of four week quit rates
Wales had the highest four week quit rates (57.5%) followed by
Northern Ireland (56.6%), England (52%) and finally Scotland had the
lowest quit rates (38.1%) 32-34
While Wales had similar 4 week quit rates to Northern Ireland, the
numbers accessing the service in Wales were considerably lower
(6,299) than that in Northern Ireland (32,714).
The four week quit rate within the Stop Smoking Services in Wales is
based on the latest published data 2012/13.
Social media success through twitter
The Public Health Agency teamed up with Translink and Cancer Focus to provide a special stop smoking bus that travelled around Northern Ireland in February to support smokers on their journey to quitting.