Smoking: Regional Tobacco Control
Action to cut smoking rates and reduce tobacco use needs to take place
locally, nationally and regionally if we are to have the most cost effective
policies in place.
• Some levers can only be effectively implemented regionally
• Value for money can be found through supra-local activity
• Making a long term impact on norms requires interventions at every level
History of regional tobacco control in England
The first locally commissioned comprehensive regional tobacco control
programme was set up in the North East in 2005 with funding from all Primary
Care Organisations and additional funds subsequently from the Strategic
Health Authority. Similar programmes were launched in the North West in 2008
and the South West in 2009. All English regions had some level of tobacco
control delivery from 2005-2010 with central funds from the Department of
Health. Such central funds ended in 2010 across the country and investment in
the regional function has only remained in the original three regions with local
authorities providing funding.
The regional programs have had a powerful impact, particularly in places that
have an appropriate level of investment, as recommended by NICE. In the NE,
for example, smoking prevalence significantly declined at a time when UK rates
were relatively static.
North East smoking prevalence compared to national average
35%
30%
25%
20%
North East Prevalence
15%
England Prevalence
10%
5%
0%
2003
2004
2005
2006
2007
2008
2009
What can been achieved at regional level
Analysis undertaken by NICE has shown that tobacco control at a regional level
is very cost effective. Interventions that can be best delivered at a regional level
include tackling illicit tobacco and the delivery of cost effective communications
and marketing campaigns. In addition to these issues, regional tobacco control
has also played a vital role supporting regional and local activity, sharing good
practice, encouraging the development of effective interventions and
coordinating networks.
“Regional structures have played a vital role in supporting local delivery
of tobacco control, and today they play a key role in agreeing and
monitoring local priorities.”
Department of Health, 2011
Regional Action on Illicit Tobacco
The ongoing North of England Tackling Illicit Tobacco for Better Health programme was
the first of its kind in the world. Similar work has also been undertaken in the South West
with good results. The programmes have taken a comprehensive approach to tackling
the demand for and the supply of illicit tobacco in communities through the development
of partnerships between health and enforcement colleagues, groundbreaking social
marketing campaigns, generating and sharing intelligence, and delivering enhanced
enforcement against the illicit tobacco trade.
Results from North of England Tackling Illicit Tobacco programme
40%
35%
30%
25%
2009
20%
2012
15%
10%
5%
0%
Smokers admitting to buying
illegal tobacco
16 to 24 year old smokers
admitting to buying illegal
tobacco
Average proportion of tobacco
consumption which was illicit
Similar activity in the South West has also produced strong results. In the SW:

Smokers admitting to buying illegal tobacco dropped from 20% in 2010 to 16% in 2013

Proportion of all adults classified as ‘very uncomfortable’ with illegal tobacco increased from
31% in 2010 to 49% in 2013.

Illegal tobacco share of the market dropped from 11% in 2010 to 7% in 2013

Proportion of smokers who are ‘often offered illicit tobacco’ dropped from 12% in 2010 to 8%
in 2013
There is a strong evidence base to
demonstrate the effectiveness of
regional tobacco control delivery in
reducing smoking rates. Localities can
achieve greater impact and return on
investment by working across larger
footprints and having an overarching
collaborative programme in place to
enhance local delivery.
This 'overview' is an introduction to
regional tobacco control delivery.
It is supported by separate handouts
on the following:
 Smoking: cost
 Smoking: children
 Smoking: health inequalities
 Smoking: quitting
 Smoking: illicit tobacco
 Smoking: working together
May 2014