The future of tobacco control strategies - Hertfordshire
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The future of tobacco control strategies - Hertfordshire
- 1. www.hertsdirect.org Local strategies to reduce smoking: Hertfordshire Future of Tobacco Control, 7 July Teresa Heritage, Executive Member for Public Health, Localism and Libraries Jim McManus, Director of Public Health Thanks to Liz Fisher Head of Provider Services for developing this presentation
- 2. www.hertsdirect.org Changing World for tobacco control • Segmentation – E cigs – Shisha – Roll ups – Young people still initiating smoking – National campaigns • Some things keep going, more things nuanced...continuity and innovation going forward
- 3. www.hertsdirect.org Having a strategic approach is vital to get impact and value • The What • Audience segmentation • Layers and Phases – different approaches and interventions • Complex strategies • The How • Vision, Leadership • Planning • Commissioning • Partnership • Prevention and Service together
- 4. www.hertsdirect.org Herts Ambitions 2015-2017 Reduce Adult smoking prevalence • by 1% per year from 15.5% baseline* • in Routine and Manual workers by 2% per year from the 25.7% baseline* Reduce Young People uptake • continuous reduction in REGULAR and OCCASIONAL smoking in 15 year olds to 5% by 2017 (from a baseline of 10% in 2014) Reduce Smoking in Pregnancy • smoking prevalence at the time of delivery (SATOD) is less than: – 5% for women registered with HVCCG (from a baseline of 6.6% in14/15) and to – 7% for women registered with ENHCCG (from a baseline of 9.2% in 14/15).
- 5. www.hertsdirect.org Key Ingredients: Vision & Leadership • Political and senior officer support to reduce the harm from tobacco • Clear tobacco control plan with clear lines of accountability • Tobacco Control Management Board and Herts- wide Alliance • County Council Tobacco Policy – cross party political commitment to reducing tobacco harm • NHS statement of Support for Tobacco Control
- 6. www.hertsdirect.org Planning and Commissioning • Integrated tobacco control and stop smoking services within public health • TC plans agreed with Alliance members – CCGs – contracts with NHS Trusts including maternity, mental health and community services – District and borough councils - TC champions and elected members – TC action plans in place – Children Centres – Smokefree and protecting babies and children from second-hand smoke in SLAs
- 7. www.hertsdirect.org Partnership Working • Strong partnerships across systems – NHS and LG • Role of Trading Standards, HMRC and Police • Tobacco Harm Reduction Guidance – being adopted by all partners • Work to support regional and national tobacco control measures and recognise their impact on Hertfordshire • Social marketing
- 8. www.hertsdirect.org Prevention and Service Together • Both prevention and service delivery are core to what we do • Prevention – coordinated approach through Alliance – young people’s delivery group Herts Schools – Trading Standards – work on local intelligence to prevent sales to minors, illegal tobacco and remedial work with traders. • Smokefree homes and cars
- 9. www.hertsdirect.org “The Big six” issues going forward 1. Continue to develop the Alliance, 2. Keep going with nuanced strategy – segment populations 3. Audit the impact of our harm reduction guidance 4. Increase footfall into stop smoking services 5. Improve identification and services for pregnant smokers 6. Evaluate and learn from our achievements and mistakes
Editor's Notes
- You have 10 minutes in total and 5 mins for Questions
- JIM
- TERRY We feel we need a strategy to get impact on smoking, and get value for money There are two big areas of what we call “ingredients” to this – the what and the how. We feel this approach is vital to having a proper strategy The what is about understanding our audience and using different approaches and interventions for different populations and settings, really its about a complex strategy The How is about we make it happen - vision, leadership, planning and so on all underpinned by partnership. There is strategic leadership across all systems for tobacco control and HWbB and PH TC ambitions have been our driving force since 2013 It was really important for us to undergo a clear peer review to assess how well we are doing this and we have adopted the recommendations of our CLeaR peer review (July 2014) and included them in our revised action plans
- Jim Our ambitions were further developed as ‘stretch’ targets for Hertfordshire, based on the ambitions within Smoking Still Kills We recognise the importance of targeting specific populations that will have the biggest impact on reducing health inequalities and the difference in life expectancy between the wealthiest and the least well off: Routine and manual workers (largest population of smokers and more likely to be heavier and more addicted smokers) People with mental health conditions and learning disabilities Pregnant women, their partners and their families And other groups (prisoners and offenders; people with Long Term Conditions, unemployed, homeless and people with other addictions as well as tobacco; some BME groups; young people, including care leavers and those NEET; LGBT groups)
- TERRY We have a strategic plan and an established TC Alliance, with representation from partners including, Trading Standards, NHS, Children Centres, education leads, District Councils, vol orgs and so on The Alliance actively supports national TC actions and campaigns Each district council has a senior officer and an elected member TC Champion; with district TC action plans in place, based on local need and priorities. Some of our 10 district councils have used the ‘district offer’ to focus on specific issues (e.g. oral tobacco in one district) Our first public health policy document was our Tobacco Policy – Herts CC equivalent to the LG declaration of support for TC and includes commitment to WHO FCTC article 5.3 NHS systems leaders in Herts have agreed to sign up to the NHS declaration of support and have agreed an action plan to deliver key ambitions to support this commitment (MECC; implementing NICE PH48; implementing Herts harm reduction guidance; focus on reducing smoking in mental health and smoking in pregnancy throughout primary and secondary care)
- JIM Tobacco Control and smoking cessation work together in a single team, so there are economies of scale in terms of knowledge and experience, provision of training, workforce development and partnership working The TC plans are developed in consultation with Alliance members and feedback on progress is given at quarterly meetings. We take a lifecourse approach to tobacco control – with preventing mortality in babies and children under 5 as a priority through to the treatment of long term physical and mental health conditions – this is reflected in the CCG contracts with our NHS partners who actively support our public health and TC ambitions and the drive on prevention and reducing NHS and social care costs Children Centres have tobacco control within their SLAs and the opportunity to deliver Local Stop Smoking Services, with 2 pilot sites already trained.
- TERRY The alliance has facilitated a joined up approach, especially in delivery of TC action plan and supporting national campaigns implemented locally (such as Stoptober) and local campaigns (such as ‘Wise up to Roll Ups’ and ‘Love Your Bump’) Hertfordshire Tobacco Harm Reduction Guidance (local implementation of NICE PH45) is being widely adopted by all our partners and is being implemented with a focus on specific groups such as people with mental health and long term conditions and within the NHS to support local ambitions to become completely Smokefree We are working with HPfT and both our CCGs on reducing smoking in people with severe mental health conditions – they have adopted this for their ‘Quality Premium’ 15/16 We recognise the value of supporting regional networks and national tobacco control actions - we have set up a local implementation group to ensure that the smoking in private cars legislation (illegal when person under 18 is present from 1 Oct) is coordinated across the county (Police responsibility) with the enforcement Smokefree workplace vehicles (District Council responsibility).
- JIM We know that the biggest impact on reducing smoking in children is by reducing smoking in the adult world around them. In addition to this we have a Young peoples delivery group: This group co-ordinates ASSIST ( an evidence-based peer led intervention for year 8 students) being delivered in schools with highest background population of smoking We developed a Smokefree schools toolkit (schools can self assess as being ‘Smokefree’, which includes a comprehensive package of support and referral to local stop smoking services rather than detention for students found to be smoking) Partnership with District Councils has resulted in ‘Young and Smokefree’ an interactive educational resource for schools Trading Standards coordinated work with HSSS, HMRC and the Police. Test purchasing on underage sales (recently there was 100% compliance with no sales of e-cigs to under 18s) Work with the DH on operation Henry - using a sniffer dog to trace counterfeit and non-duty paid tobacco) this resulted in some significant seizures. We are using our usual approach to develop resources for smokefree homes and cars and have already developed a suite of resources and an online pledge
- TERRY So while we try to keep all this working, our next big areas of action are: Continuing to develop the alliance – obviously Keep going with nuanced strategy – segment populations Audit and monitor how well our Harm Reduction Guidance has gone down and the impact this has on services (are fewer people going onto quit? Are there changes in prescribing practice?) Increasing footfall into services – this is imperative and national campaigns need to do better at driving smokers into local services. We are implementing babyClear in July 2015 – to improve routine CO monitoring and referrals and have redesigned services so that we have a named stop smoking specialist for every single pregnant smoker.