Smoking Cessation Services: extending the reach in Northern Ireland - Gerry Bleakney
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Smoking Cessation Services: extending the reach in Northern Ireland - Gerry Bleakney Presented on Friday 6th June 2014.
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Smoking Cessation Services: extending the reach in Northern Ireland - Gerry Bleakney
- 1. Stop Smoking Services – Extending the Reach IPHI Workshop June 2014 Mrs Gerry Bleakney PHA Strategic Lead for Tobacco Control gerry.bleakney@hscni.net
- 2. Overview • Strategic Direction/targets • Service provision • Reach of services
- 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)
- 4. Source: Continuous Household Survey; 82/82- 09/10. Northern Ireland Health Survey 2010/11-2012/13. Smoking prevalence in Northern Ireland 2005/06-2012/13 2020 strategy target prevalence= 15%
- 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)
- 11. Stop Smoking Service providers by total number of providers at each location across Belfast LCG by super output area* multiple deprivation measure 2010 (MDM) Reproduced with the permission of Land and Property Services under delegated authority from the Controller of Her Majesty’s Stationery Office, © Crown copyright and database rights NIMA ES&LA 210.3
- 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
- 22. The Battle Goes On!!
Editor's Notes
- 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.