Implementation of
‘Scotland’s Future
is Smoke Free’
Elspeth Russell
NHS Lanarkshire
Overview
• Setting the context
• Scotland’s Future is Smoke Free (2008)
• Local response to the national plan
• Reflection
Smoking Kills!
• Single most preventable cause of ill health and
premature death
• Quarter of all Scotland’s deaths attributable to smoking
• Maternal smoking is the most preventable cause of death
and illness in foetus and infants
• Conclusive evidence that exposure to second hand
smoke causes disease and death
Why people smoke
Social, economic, personal and political influences all play an
important part in determining patterns of smoking prevalence and
cessation. Although drug effects underpin the behaviour, family
and wider social influences are often critical in determining who
starts smoking, who gives up and who continues”
Jarvis, M. (2004) Why people smoke British Medical Journal, 328, 277-279
•
Evidence shows need for approaches which work across all
levels to discourage people from starting to smoke, help
smokers to stop, create an environment that is free of tobacco
smoke, change social climate around smoking
Scotland’s Future is Smoke Free (2008)
“We will continue to help smokers to quit but recognise
that, if smoking is to become a thing of the past, we need
to shift the focus towards preventing children and young
people starting to smoke in the first place.”
• Based on Towards a Future Without Tobacco (2006)
• Heavily relies on successful partnership working – the
NHS cannot achieve many of the actions on its own
• 3 year funding for health boards and local authorities
with one year additional funded for 2011/12
Scotland’s Future is Smoke Free (2008)
• Set new prevalence targets
• 4 key objectives
– Educate and promote healthy lifestyles
– Reduce the attractiveness of cigarettes
– Reduce the availability of cigarettes
– Reduce the affordability of cigarettes
• Many actions to be enforced through the Tobacco and Primary
Medical Services (Scotland) Act 2010
The Lanarkshire approach
•
Local examples of good practice but uncoordinated
•
Smoking Prevention Group formed and fixed term post appointed
•
Nine areas identified and prioritised which balanced national recommendations with local need
•
Where possible timetabled themed meetings after relevant national events
•
Virtual network formed – members joined relevant themed meetings only
•
Problem solving approach to themed meetings
•
Work plans progressed simultaneously due to tight timescales
•
Outcomes, outputs and key performance measures agreed and a work plan developed for delivery
between January 2010 and March 2012
•
Accountability to the Lanarkshire Tobacco Control Strategy Group
Smoking Prevention Action Plan:
Nine local work streams
•
Youth Involvement and Consultation
•
Training and resources
•
Curriculum development
•
Smoking Cessation services
•
Reducing second hand smoke exposure
•
Smoke Free policies
•
Enforcement and control
•
Campaigns and communications
•
Prevention programmes for key priority groups
Youth involvement and
consultation
• LANDED Peer Education Service
commissioned to facilitate youth involvement
in the workstreams
• Baseline consultation survey completed
• Brand for Youth Cessation service developed
Training and resources
• NHSL Stop Smoking Service and Landed
developed and co delivering a one day tobacco
awareness course to professionals working
with young people
• Central library lending facility set up for tobacco
resources
• Peer education workshop under development
Curriculum development: Smoke in your eyes
•
Review of local tobacco resources and national
evidence base and best practice
•
Virtual sounding board
•
Aligned to CfE outcomes from P4 onwards
•
Available on GLOW so easily updated
•
“ Scott & Hannah” storyline with illustrations
•
Process evaluation for all schools and detailed
evaluation with specific learning communities
Youth Stop Smoking Service
•
•
•
•
•
•
Text service launched
March 2011
Protocol in place for youth
staff
Flexible support following
assessment
Existing staff capacity,
aiming to utilise skills
Stop Smoking Service staff
have received Youth training
from Council partners
Will be reviewed after 6
months
Enforcement and control
•
Both Councils taken forward a range of
programmes to control tobacco sales
•
Met all national targets for test purchasing
•
Compliance with smoking in public places
ban in excess of 99%
•
Key priorities for future are to increase
public awareness of the new Act and
addressing smoking in vehicles which
come under the legislation
Second hand smoke
• Community consultation undertaken
• Models of best practice – Salford PCT
• 3 Healthy Living Centres commissioned to deliver a
community led programme using volunteer champions
• Focus on community settings including nurseries and
schools
• Staff training also developed and forms part of core training
programme
Smoke free policies
• Youth settings
– 4 pilots
– Survey of youth settings
• Good practice guidance to be developed
• NHSL No Smoking Policy
• Workplace no smoking policies
Workstreams under development
•
Communications and campaigns
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Key priority groups
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•
Social norms campaign in colleges stalled
Exploring potential for social norms within workplaces
Football clubs
Local media
‘
Mapping exercise from each Unit
Training modules and youth Stop Smoking Service now in place
Lack of evidence base
Key area for development 2011/12 working in partnership with
Community Learning and Development
Reflecting on delivery of
Scotland’s Future is Smoke Free
Some challenges…
–
Local Prevention Plan and funding runs to 2012 with only one year of funding thereafter
–
Need for more collaborative working nationally to build evidence base
–
Human Resource challenges – capacity, recruitment
–
NHS focus on HEAT and Efficiency Framework
Many opportunities…
–
Better engagement of partners in this agenda and increased focus on upstream activity
–
Funding for staff to develop a comprehensive programme, build capacity, and to ensure
robust monitoring and evaluation
–
Programmes developed provide opportunities to increase awareness and referrals to
cessation services thus contributing to HEAT
–
Provided impetus for Lanarkshire Tobacco Control Strategy
Thank you for listening
Questions?
Elspeth Russell
Assistant Health Promotion Manager
North CHP
NHS Lanarkshire
Law House
Carluke
Tel: 01698 377622
elspeth.russell@lanarkshire.scot.nhs.uk