Smoke-free homes and cars: protecting children and families Newsletter - June 2011

Transcription

1 co-ordinated by Smoke-free homes and cars: protecting children and families Newsletter - June 2011 On the 3rd of March 2011, I was delighted to chair a learning day organised by the Scottish Tobacco Control Alliance and REFRESH that brought together people from across Scotland keen to reduce the impact of second-hand tobacco smoke on children and families. The event participants agreed to contribute to a newsletter to capture much of what was presented and discussed. This is the result and I hope you find it both useful and interesting. Bronwen Cohen, Chief Executive of Children in Scotland Contents REFRESH p.3 Have attitudes to secondhand smoke changed? Children and young people s views Roy Castle Lung Cancer Foundation training NHS Greater Glasgow and Clyde smoke-free homes and cars initiative NHS Dumfries and Galloway p.5 p.8 p.9 p.10 p.13 Useful information p.15 Action on Smoking & Health (Scotland) (ASH Scotland) is a registered Scottish charity (SC ) and a company limited by guarantee (Scottish company no ). The harm caused by secondhand smoke With so many issues affecting young people today, I can understand why many organisations may find it hard to have smoking on their agenda. Yet children and infants are especially vulnerable to the adverse health effects of second-hand smoke (SHS) due to their smaller airways, faster rates of breathing and immature immune systems Exposure to SHS causes a variety of child ill-health including respiratory problems, reduced lung function, middle ear disease, asthma and wheeze, bacterial meningitis, damage to heart and circulation, and SIDS (cot death). The Royal College of Physicians of Edinburgh estimate that over 4000 new cases of respiratory infection, wheeze and asthma in Scottish children could be avoided every year by reducing the exposure of children to tobacco smoke. Recent polling for ASH Scotland shows that the public are aware that there are risks to children s health of exposure to tobacco smoke with a huge 88% saying that they think it increases the risk to a child s health. However research also shows us that many parents are not aware of the specific health risks and that health professionals and others want to learn more The STCA is funded by Cancer Research UK and ASH Scotland

2 about how they can reduce the harm to children caused by SHS. This is an area ASH Scotland is seeking to change through a range of work including the REFRESH (Reducing families exposure to second-hand smoke in the home) project. REFRESH has tested a new intervention to compare changes in SHS concentrations in the home before and after parents received advice on minimising their children s exposure to SHS; and measured the extent to which they changed their behaviour as a result. This Big Lottery Funded project, in partnership with Aberdeen and Edinburgh Universities, aims to reduce children s exposure to SHS in the home and is designed to be delivered by professionals working with children and families particularly in deprived communities. Studies have shown that smoking in the home hasn t increased since the 2006 public places smoking ban. Research also shows that it is in the areas of most disadvantage where smoking rates, and corresponding rates of death and disease, remain highest. This is also where exposure to SHS for children is highest. Smoking is a major cause of health inequalities in Scotland and remains an area of huge concern to those working in public health. Across Scotland 40% of primary school children live with a parent who smokes, 27.4% are exposed to second-hand smoke in their home, 9.5% are exposed at someone else s home, and 6.5% in a car. 19% of children were exposed to SHS at levels dangerous to arterial health. The challenge ahead is translating the knowledge that there is harm to the health of children to showing people how they could change their behaviour to protect children. I would like to emphasise that this is not necessarily about getting smokers who look after children to quit. Rather it is about informing people about the harms caused by children breathing tobacco smoke and showing parents and carers that the best way of protecting their children from the harm caused by SHS is to not smoke around them. ASH Scotland is campaigning for a new comprehensive tobacco control strategy which aims to reduce smoking and exposure to secondhand smoke, which the SNP in their election manifesto committed to introducing. Such a strategy is needed to reduce the major impact smoking continues to have on our population. I hope that our new government will introduce this within the first parliamentary year and it will include robust targets to reduce smoking and exposure to secondhand smoke. Smoking remains our biggest killer and whilst a quarter of adult deaths are from smoking, behind every death there are probably 20 people suffering a disease caused by smoking, 15,000 young people start to smoke every year, and tobacco costs Scotland 1.1billion, we must tackle the huge toll tobacco takes on our families and communities. If we work together we can reduce the harm tobacco smoke does to our young people. Preventing this deadly addiction in the first place is fundamental, but protection from the harmful impacts of second-hand smoke is also vital if we are to keep our children healthier and safer. Article by Sheila Duffy, Chief Executive of ASH Scotland More about REFRESH The REFRESH project aims to develop knowledge on reducing second-hand smoke in the home which will lead to better practice and support mechanisms for smoking parents and carers and better health for Scotland s children. 2 Smokefree homes and cars newsletter - June 2011

3 REFRESH (Reducing families exposure to second-hand smoke in the home) Introduction ASH Scotland, in partnership with the Universities of Aberdeen and Edinburgh is funded by the Big Lottery Fund research grants programme to manage REFRESH (Reducing families exposure to second-hand smoke in the home). This three year project aims to develop knowledge on reducing second-hand smoke (SHS) in the home which will lead to better practice and support mechanisms for smoking parents and carers and better health for Scotland s children. The REFRESH intervention The pilot intervention, led by the University of Aberdeen, compares changes in SHS concentrations in the home before and after mothers receive advice on reducing children s exposure to SHS and measures the extent to which they change their smoking behaviour as a result. The particularly novel element of the pilot intervention is the use of air monitors (Sidepaks) to provide real scientific data to parents on air quality and smoke levels (PM2.5) within the home. We hope the findings from the research will help us develop tools that can be delivered by community health workers in the home. The findings from the pilot intervention will be published in late autumn Continued over Outline of Pilot Intervention Visits Visit 1 Visit 2 (+24h) Visit 3 (+4 weeks) Visit 4 (+24h) Health and SHS exposure questionnaire Daily grid Saliva sample Set up SidePak Motivational interview Collect SidePak Change questionnaire Daily grid Saliva sample Set up SidePak Collect SidePak Feedback Enhanced PM2.5 levels shown to mother Extended interview Standard PM2.5 Feedback Smokefree homes and cars newsletter - June

4 Initial REFRESH desktop research findings Other elements of the REFRESH research have now been completed. In November 2010, ASH Scotland led work on a baseline survey of 388 practitioners who work with children and families in Scotland. Findings suggest that practitioners have a strong interest in SHS and the effects on children s health and a general desire to engage in the issue. There is however a lack of training and information on SHS in the home and how to raise the issue effectively with parents. There is also a lack of clarity on whose role it is to raise the issue of SHS exposure in the home. In March 2011, ASH Scotland led work on a mapping survey of smoke-free home initiatives in Scotland and England, which details work currently being undertaken. Most health boards in Scotland are engaged in smoke-free home initiatives. The report describes the variety of activities taking place and considers the policy and practice implications for future work in this area. Qualitative REFRESH research The University of Edinburgh is leading on qualitative research to help us better understand the issues faced by parents, practitioners and policy makers related to reducing children s exposure to SHS in the home. This work, which will take place from Autumn 2011, will include interviews and focus groups with practitioners and policy makers. It will explore what the current motivators and barriers are to delivering effective smoke-free homes interventions and discuss the implications of the findings of the fieldwork for their practice. REFRESH Critical Literature Review ASH Scotland is working to produce a critical literature review which will be available later in 2011 that will identify and critique the main findings from the literature on children and SHS exposure. It will examine the cultural and social barriers and motivators associated with smoking restrictions in the home and provide an overview of the effects of SHS exposure on children s health. REFRESH How to Guide The project team are currently developing a How To Guide for practitioners that will provide advice and information on raising the issue of SHS with families. This resource tool for professionals working with families and children will be peer-developed and will be available in Autumn Implications for policy and practice Using the findings from various strands of the REFRESH project as a basis, ASH Scotland will lead on generating a report of recommendations to influence policy and practice on SHS exposure in the home. This will be available in December Find out more: If you would like further information on the REFRESH project go to the Project web page: or April.Shaw@ashscotland.org.uk 4 Smokefree homes and cars newsletter - June 2011

5 Have attitudes towards smoking and secondhand smoke really changed? When I was asked in March this year to talk to health and social care professionals attending the Action on Smoking and Health (ASH) Scotland Event on Smoke-Free Children and Cars, it was a welcome opportunity for me to talk about issues related to secondhand smoke and children s health in a frank and open way. As an active researcher in the smoking behaviours of parents with children, the topic I was asked to talk about was Changing attitudes to smoking, smoke-free cars and homes, and my role was to give my personal view as to how things may have changed in Scotland since the introduction in March 2006 of legislation restricting smoking in enclosed public places. I have a particular interest in the health of women with children and the health of babies and young children, so while I touched in my talk on adult smoking and secondhand smoke exposure in cars, I drew more on my own involvement in research on adult smoking and the secondhand smoke exposure on children in home settings and how this has changed since Since the introduction of the legislation, much of the research and related health care practices around secondhand smoke have focussed on the exposure of young children living in home environments, which of course are not covered by the 2006 legislation. So have attitudes changed? And if so, what does this mean for the health of children? I am going to start with the good news, and one of the biggest positive changes for me, evidenced in research and also in day-to- day conversations, is people s understandings of second-hand smoke. When I first researched this topic with parents of young children (and professionals) back in 2003, people were uncertain about what second-hand smoke actually was, whether or not it was really harmful, and if it harmful to children, what those health effects actually were? Research I completed in 2009 with the Roy Castle Lung Foundation found that while some people are still rather hazy about health effects, knowledge is greatly improved, and very few people have never heard of the term [1]. What this means is that health and social care professionals feel that they are pushing at an open door with parents, so they are more likely to raise secondhand smoke with parents and feel comfortable giving advice. As this is about the children s health and not the adult s smoking, even the health care practitioners and people who work with children who smoke themselves feel motivated to give advice. So significant gains in children s health can be made just by asking adults to modify their smoking behaviour and this success appears to be going from strength to strength. Further good news (particularly for practitioners) is that if you work with one family, you may actually be reaching many more. Looking at interviews with people collected after 2006, we found that parents are learning from parents and this is changing social norms across families and social networks and they work together to provide a smokefree environment for their children [2]. Dr Jude Robinson, Senior Lecturer in Health Sciences, Health and Community Care Research Unit, University of Liverpool As parents (and grandparents) are more receptive to key messages, many report voluntarily imposing smoking restrictions to protect their babies and children, and more and more parents are saying that they only smoke outside. This community-based approach is essential as many children spend time in the homes of adults who are not their parents. To support these reported changes, post-legislation research in Scotland found that the exposure of children of non-smoking parents, or living in families where only one parent smoked, had been eliminated or greatly reduced since 2006 [3]. However children living with two smoking parents were still exposed to tobacco smoke in their homes, and for these children, little had changed. So this is where I turn to the bad news about the continued exposure. It is important to continue to link the continued exposure of young children to the levels of smoking, there have been some really encouraging trends, with levels of smoking declining in Scotland from 30.7% in 1999 to 24.3% in 2009, and currently UK levels are estimated to be around 21% [4]. However these encouraging Smokefree homes and cars newsletter - June

6 figures, showing a steady and seemingly unstoppable decline do not cause complacency for people working in tobacco control. This still means that one in five adults smoke and in some areas we know that smoking levels are higher. Smoking is linked to occupation, and in Scotland, 59% of people who are not working due to short-term ill-health are smokers, 51% of people who are unemployed, 48% of people who are permanently sick and disabled and 36% of people who are looking after their home and family, and so this includes some parents [4]. Giving these figures it is unsurprising that smoking rates are also highest in areas with multiple disadvantages, so in the most deprived areas smoking levels are as high as 43% compared to less than 10% in the most affluent areas. So people who smoke are also likely to live in disadvantaged areas, with associated poor housing, problematic schooling and limited employment opportunities. This makes smoking a difficult issue for health and social care professionals to tackle, as smoking is part of a picture of multiple disadvantages and there may be competing priorities in child health [1]. Smoking also varies by sex and gender, as in Scotland 26% of men smoke compared to 23% of women, and when we look at age and sex together, to look at the smoking rates of the younger age groups most likely to having children together, the figures rise again, as 33% of men smoke and 29% of women. These are just statistics though aren t they? And we could explain this by saying that many of the men and women in these age groups may not have children, or be involved in the care of children, so there is no real link between percentages of adult smokers and the health of children? Yet one of the findings from research carried out in the 1980 s and the 1990 s in the UK, and has been supported since, is that women with children are more likely to smoke than women who do not have children [5-8]. We also know from researching smoking in pregnancy that 20% of women report smoking when they first book in with a midwife, and 20% are smoking at the time of the first visit after the birth of their baby [9]. This figure rises as income falls, and nearly 30% of pregnant women smoke in poor areas compared to less than 6% in more affluent areas, and this has implications for the long-term health of the children born to these mothers. Children of parents who are in low income are often cared for in the homes of friends and relatives, and so these homes may not be smoke free. Research to date has identified Nearly 30% of pregnant women smoke in poor areas compared to less than 6% in more affluent areas, and this has implications for the long-term health of the children born to these mothers. reluctance by some parents to acknowledge that their smoking could be harming their children [10] and believe that as children get older they are able to tolerate higher levels of tobacco smoke [11]. Parents and carers may prefer to stay and watch young children rather than smoke outside, as often they may fear the child may hurt themselves, or become distressed if they are left. So smoking near children relates to unsafe living conditions, non-opening windows, doors that don t close and unsafe outside areas [12]. High levels of smoking in the wider community may also mean that parents have easy access to cigarettes, smoke more, and have a higher number of visitors who smoke in their homes, compared to people living in more affluent areas which again makes it more likely that their children will breathe in smoke at home [13]. Studies of mothers and fathers smoking have highlighted gendered differences that can also impact on the levels of control people have over smoking activities in the home. For example even if mothers give up smoking, or are non-smokers, fathers and/or other resident adults or visitors may continue to smoke in their homes and some pregnant women do not, or cannot, always avoid smoky places. Research of data collected with people after 2006 suggests that little had changed for many women, as although they comply with the legislation, and avoid smoking in public places as they don t want to experience the shame of being a smoker, they still smoke in their homes [14]. Home is increasingly seen as a safe place for women, and their roles as carers and homemakers means that they 6 Smokefree homes and cars newsletter - June 2011

7 are busy, many are bored and under-stimulated and some who stay at home during the evenings as the children are asleep, are underoccupied and smoke more than they would like. So while attitudes to smoking and secondhand home smoke have changed very much for the better since 2006, and this change has impacted positively on the health of children, we also know that health care legislation does not always impact equally on all people within a population 15, 16]. Current research suggests that some women and men may be reluctant or unable to modify their home smoking, and this continues to have implications for the health of the children who live, visit and are cared for in these settings. [1] Robinson J Understanding the real-life pressures of trying to keep children smoke-free. Report to the Roy Castle Lung Foundation. HaCCRU Research Report 118/09. July [2] Robinson J, Ritchie D, Amos A, Greaves L, Cunningham-Burley S Volunteered, negotiated, enforced: Understanding the intergenerational transmission of new non-smoking norms around children. Sociology of Health & Illness, 3(1): [3] Akhtar, P. C., Currie, D. B., Currie, C. E., & Haw, S. J. (2007). Changes in child exposure to environmental tobacco smoke (CHETS) study after implementation of smoke-free legislation in Scotland: national cross sectional survey. British Medical Journal, 335, 545. [4] The SHS Team. (2010). Scotland s People: Annual report from the 2009 Scottish Household Survey. Edinburgh: The Scottish Government. [5] Graham, H When Life s a Drag. London: HMSO. [6] Graham, H Gender and class as dimensions of smoking behaviour in Britain: Insights from a survey of mothers Social Science & Medicine, 38(5), [7] Graham, H Disadvantaged lives and women s smoking: patterns and policy levers. MIDIRS Midwifery Digest, 13(2), [8] Graham, H Why Social Disparities Matter for Tobacco-Control Policy. American Journal of Preventive Medicine, 37(2), S183-S184. [9] NHS National Services Scotland. (2009). Births in Scottish Hospitals. Retrieved 12th May isdscotland.org/isd/4028.html [10] Robinson J, Kirkcaldy AJ Imagine all that smoke in their lungs : parents perceptions of young children s tolerance of tobacco smoke. Health Education Research, 24(1): [11] Robinson J & Kirkcaldy AJ You think, I m smoking and they re not : Mothers attitudes to the risks of passive smoking. Social Science and Medicine 64(4): [12] Robinson J & Kirkcaldy AJ Disadvantaged mothers, young children and smoking in the home: mothers use of space within the home. Health & Place, 13(4): [13] Robinson J Trying my hardest : Mother s accounts of smoking and caring for children. International Review of Qualitative Research, 2(2): [14] Robinson J, Amos A, Ritchie D, Greaves L, Cunningham-Burley S, Martin C Waiting until they got home : Gender, smoking and tobacco exposure in households in Scotland Social Science and Medicine, 71: [15] Thomson, G., Wilson, N. and Howden-Chapman, P. (2006), Population level policy options for increasing the prevalence of smokefree homes, Journal of Epidemiology and Community Health, 60, 4, [16] Greaves L, Vallone D, Velicer W. (2006). Special effects: tobacco policies and low socioeconomic status girls and women. Journal of Epidemiology & Community Health, 60: ii1-ii2 Smokefree homes and cars newsletter - June

8 Children and young people s views and experiences of smoking in the home and car Neneh Rowa-Dewar Children are often the object of concern in second-hand smoke (SHS) research, practice and policy, yet few studies have taken account of their views and experiences. My PhD study aims to do just that by exploring children s experiences and views on SHS and their role in negotiating smoking restrictions within the home and car. Perspectives on SHS exposure within the home and car were gathered from 38 boys and girls aged between 10 and15 who had members of their family that smoked. They participated in individual/paired interviews and small focus groups which involved the drawing of floor plans of the voluntary smoking restrictions within their homes. Eleven participants were recruited from an advantaged area and 27 from a disadvantaged Edinburgh area. Nearly all participants reported that their parents attempted to protect them from SHS exposure, either by not smoking in the home and the car, only smoking in certain areas or not smoking when children were present (particularly very young children). It should be noted that the reported stringency and effectiveness of such restrictions differed between the participants from the advantaged and the disadvantaged areas. Children from the advantaged areas reported their parents maintained virtually smoke-free homes except for some minor temporal exceptions such as in one room late at night or by the kitchen door. In contrast, only one participant in the disadvantaged area lived in a smoke-free home. However, all families imposed restrictions on smoking in children s bedrooms and many had restrictions in living-rooms and kitchens. Sometimes, however, the restrictions consisted of parents asking children to move away while they smoked within the same area or leave the room temporarily while they smoked: I ve got asthma and I need to sit in another room from my Dad when he smokes. Cos I cough and that. Like I ll be sitting next to him and I know he s gonnae smoke a fag cos he takes it out of his pocket or something and he s always got an ashtray next to him. And as soon as he blows it out I go to the next room and when he s finished he gives me a shout cos I ve had like quite a lot of problems with my asthma when I run and that I ve always got a problem with my chest and that. Ryan, 14, disadvantaged area Children actively resist parental smoking Children are often portrayed as the passive victims of parents smoking both in the media and academic literature. However, the 32 nonsmoking children actively attempted to resist their family members smoking (and to some extent their own exposure to SHS). The majority of the participants had at some point requested that their parents stop smoking and a few suggested that their parents had stopped briefly as a result. Participant s non-verbal attempts to stop their parents smoking were more persistent and imaginative than their verbal attempts. Attempts to resist exposure to SHS varied widely and included walking away from parents when they smoked, binning, breaking and hiding cigarettes, or in one case fitting a smoke alarm: My Dad [smokes] but always in the utility room by the back door. We make him [laughter]! Cos he used to smoke in the bathroom so we fitted a smoke alarm. Jack, 12, advantaged area As illustrated by this quote, many of the children were aided in their resistance by a non-smoking parent. Perhaps unsurprisingly, the six children in the disadvantaged area who reported that they smoked did not report resisting parental smoking or SHS exposure. Three of them reported smoking with their parents permission and the older two discussed smoking with their parents. While most children dislike and resist their parents smoking, they also resist the increasing stigmatisation of smoking parents. Unlike other smokers, they say their parents do not smoke much, maintain stringent smoking restrictions and are trying to quit. Most importantly, they say their parents always take measures to protect children (particularly babies), despite them not always being effective. Children are not passive and actively resist their parents smoking, sometimes alongside a nonsmoking parent. There is a clear information gap about effective smoking restrictions in the home, yet most parents take measures to protect children s health - which should be supported and encouraged while the end point remains a smokefree home and car. 8 Smokefree homes and cars newsletter - June 2011

9 Reducing Children s Exposure to Secondhand Smoke: Train the Trainers Programme - Lisa Gill As an organising partner of the Smoke-Free Homes and Cars; protecting children and families event in March 2011, The Roy Castle Lung Cancer Foundation offered a gift of training worth Twelve free training places were taken by delegates from Greater Glasgow and Clyde, Dundee, and Ayrshire for the first delivery of Reducing Children's Exposure to Secondhand Smoke Train the Trainer course. This training was delivered in May at Glasgow Caledonian University. The second delivery of training took place in Aberdeen and will support the work in Aberdeen City CHP to develop a Grampian Smoke-free Homes and Cars Project. The training provided delegates with the skills to undertake brief interventions aimed at reducing children s exposure to secondhand smoke, skills to adapt and deliver the training to suit local need and a comprehensive resource pack containing trainers information and lesson plans. With 24 individuals trained and capable of delivering a half day brief intervention programme around reducing children s exposure to secondhand smoke, we feel the Foundation has made a significant contribution to making Scotland s cars and homes smokefree. We intend to follow-up delegates in six months time to evaluate how they have disseminated the training in their localities. We will feed these findings back to ASH Scotland to circulate amongst interested colleagues. For further information about this or other training delivered by the Roy Castle Lung Cancer Foundation please contact: Lisa Gill, Training and Youth Advocacy Lead: lisa.gill@roycastle.org Delegates who attended the training commented on what they liked best: Attending the training along with partners who intend to deliver the training with locally Discussions about incorporating this into my daily work Lots of good practical advice Hearing others professional experiences Smokefree homes and cars newsletter - June

10 NHS Greater Glasgow and Clyde: reducing children s exposure to secondhand smoke Addressing children s exposure to secondhand smoke in the home and car is a priority for NHS Greater Glasgow and Clyde. Our aim is to increase public awareness of the dangers of SHS in the home and car; to increase the number of secondhand smoke brief interventions carried out by key health professionals who work with families of children under the age of five years; to increase the number of children living in smokefree homes and travelling in smokefree cars and to reduce the health impact of secondhand smoke exposure. Brenda Friel, Health Improvement Senior (Tobacco Control) within NHS Greater Glasgow and Clyde Our overarching message is that smoking should, as far as possible, be taken outside of the home and car. The work we are doing is being implemented across six local authority areas and ten Community Health (Care) Partnerships within the Greater Glasgow & Clyde area. We have a training programme Reducing Children s Exposure to Secondhand Smoke The training is targeted at key health professionals who have direct contact with parents and carers of children under the age of five years and are in a position to provide follow up. The training has been evaluated and reports that if the correct professionals are trained they are in a better position to raise the issue of secondhand smoke and support changes in behaviour. The main target is health visitor groups. A copy of the full report is available at Over 500 have attended the training across Greater Glasgow and Clyde. Resource development has been important. Leaflets and posters have been developed to distribute to parents and carers. Focus groups were conducted to explore views on proposed promotional materials including key messages. A respondent from the training evaluation considered the leaflet to be a non threatening way to raise the subject of SHS with families. A copy of the leaflet can be downloaded from: I liked the idea of just having a leaflet, being able to bring the subject up and say just have a wee look at it, I ll maybe speak to you next time I m out or something like that, rather than going in too heavy and just being able to leave the information and maybe broaching it the next time. 10 Smokefree homes and cars newsletter - June 2011

11 In addition to obtaining views on proposed promotional materials we wanted to explore current knowledge, attitudes and perceptions of SHS, some focus group quotations are below Encourages them to smoke they get used to being around it. Female smoker 4 children over 5 We are making the choice to smoke and they haven t. They are having to take it whether they like it or not. Female smoker, 2 children over 5, 2 children under 5 Focus Group We go on about the kids not being well...having coughs an that...but it s probably us that s causing it. Female smoker, 2 children over 5, 2 children under 5 It s something you grew up with you did it before you had kids. It s trying to break a habit that s being going on for a long time Female smoker, 2 children over 5, 1 child under 5 I signed up not to smoke anywhere in the house. Since then (3 weeks ago) I ve been smoking outside in the garden. Female smoker, 2 children over 5, 1 child under 5 Smoking in cars campaign The University of Aberdeen carried out a study for Greater Glasgow and Clyde to measure levels of secondhand smoke in cars where people smoked. The study measured fine particles present in secondhand smoke. These particles go deep into the lungs affecting lung and heart health especially towards children. A doll was placed in a car seat, tubing attached to the doll s nose which connected to a monitor. The monitor measured the fine particles present in the car. A fine particulate measurement of 35 and over is considered unhealthy. The study reported that the average level during smoking journeys was 95, more than half of smoking car journeys reported a peak level of over 250 and the highest recorded level was 886. The study also reported that opening windows and having the ventilation on had little effect in bring the particles down to a safe level. Following on from this we organised a media campaign to publicise the results. Glasgow Evening Times agreed to publish a feature on the study and vendors distributed car window stickers. A press release resulted in uptake of the article by all the main newspapers and was reported on numerous websites. The car window sticker was also distributed via local press, petrol stations, health-centres and local events. More over Smokefree homes and cars newsletter - June

12 NHS Greater Glasgow and Clyde: reducing children s exposure to secondhand smoke continued... Name the teddy competition We wanted to do some work to promote the secondhand smoke message with primary one children. We agreed to host a competition to give the teddy, we feature in our resources, a name. Schools across Greater Glasgow and Clyde, (six local authority areas), were invited to participate. Five local authorities participated and so far involved 146 schools, 241 classes and 5114 pupils. A story, Jenny and the Bear was read out to the pupils by the class teacher. The story incorporates messages around secondhand smoke which incited discussion with the class. At the end of the story the children are asked to give the teddy a name. A shorter version of the story was illustrated in a booklet which was then given to each child to take home. This included a home extension activity at the back of the booklet to ensure that parents engage with the resource. The activity links in with the health and wellbeing experiences and outcomes of the Curriculum for Excellence, the Scottish Government strategy to increase literacy and explores themes around a favourite toy, rewarding positive behaviours and consideration for others. This is currently being evaluated and if effective in conveying the secondhand smoke message will be repeated subsequently. Future activity We want to continue our work across Greater Glasgow and Clyde in terms of training, to further promote the dangers around smoking in the cars, further distribute car stickers and encourage more schools to use the Jenny and the Bear resource. In addition we would like to progress work with the Royal Hospital for Sick Children (Yorkhill). We would like to explore how to take the training forward in this setting and how we can gain greater compliance with the NHS Greater Glasgow and Clyde No Smoking Policy. Brenda Friel has been a supporter of and regular contributor to STCA activity for over seven years. 12 Smokefree homes and cars newsletter - June 2011

13 Provided brief advice training to professionals working with the target group. Provided awareness sessions to pupils in primary schools in order to encourage dialogue with parents. Findings indicated that: Those who received the training had increased their knowledge of children s exposure to SHS in the home and they also felt more confident to discuss the issue with their clients. NHS Dumfries and Galloway - Susan McKie and Jill Brodie At the Smokefree Homes and Cars Conference in March, the Smoking Matters service, NHS Dumfries and Galloway, gave a short presentation on our experience of developing a Smokefree Homes (SFH) project and partnership working. The key findings that we focussed on were: the need for the formation of a steering group from the initial planning stages how the partnership increased the capacity of the project by making use of existing mechanisms for delivery i.e. partners delivering brief advice as part of their normal work routines how meetings need to be kept to a minimum and be focussed and effective as all teams are time restricted that one person should take the lead role in coordinating and communication how smoking became part of/moved up partners working agendas that we developed relationships for future partnership working. Clients were approached through existing relationships with people, which provided a positive introduction to the Smoking Matters service. When professionals raised the issue of SFH, many clients had shown a willingness to make their home smoke free and some had requested to be referred into the stop smoking service. There were a high number of children in the targeted areas who were exposed to second hand smoke in the home. Before the awareness sessions only 47% of pupils were aware of SHS and 69% had never discussed the issue at home. Three months after the awareness sessions 81% were aware of SHS and 52% had never discussed it at home. The Smoking Matters service now offers SFH training as part of it s mainstream work and the Smoking Prevention Officers have included the pupil awareness sessions into their education programme. Susan McKie Tobacco Control Officer Smoking Matters Service NHS Dumfries and Galloway susanmckie@nhs.net Since the conference we have completed our evaluation of the pilot project and found positive results. The pilot targeted two areas in Dumfries and Galloway with the highest smoking prevalence with the aim of raising awareness of children s exposure to second hand smoke in the home, and used a two-pronged approach: Smokefree homes and cars newsletter - June

14 Earlier this year, Belmont Primary School turned an initial visit from Smoking Matters into a whole week of healthy events By Christine L. Smith, Belmont Primary School Teacher When the P5 children of Belmont Primary School in Stranraer responded enthusiastically to a visit from Abbie Wallace of Smoking Matters, I knew we could take her work further. Abbie s visit to outline the dangers associated with smoking really captured the interest of the children and they loved all the artefacts and props she used. As a follow up, I used this experience as a stimulus for the children asking them to create individual leaflets which highlighted the risks and dangers associated with smoking. I was so pleased with the children s efforts I sent copies to Abbie who was also delighted. In turn, she used some of the children s phrases and graphics in a poster to advertise the Smoking Matters service in Dumfries and Galloway. The children were thrilled, and in a bid to extend the project Abbie organised a day of activities throughout the school. This was scheduled to coincide with National No Smoking Day on 9 March, with the theme being carried on over the week by class teachers. The lower school classes completed Smoke Free Me Booklets during the week and the upper school had related input during their health and wellbeing lessons. In addition, four workshops were organised with the four classes from the upper school involved. Over ninety children, split into eight groups, spent the morning completing associated tasks to increase their awareness of the dangers of smoking, second-hand smoke and healthy lifestyle choices, spending around fifteen minutes at each action station. Abbie led a body-mapping exercise where the children identified all the places in the body which can be affected by smoking. Children also completed a game on the X-Box which encouraged movement and exercise. In the computer suite, Irene Johnstone, NHS D&G s Healthy Weight Worker had activities designed to get the children thinking about healthy food choices. In addition a local fire officer showed the children a film about the dangers cigarettes pose in relation to house fires and discussed the issue with them. The children absolutely loved the events and activities and responded positively to each workshop. The whole experience enabled the children to realise that choosing not to smoke is only one of the choices faced when opting into a healthy lifestyle. The children of Primary 5 also brought the whole theme together with their This Afternoon assembly, a parody of ITV s This Morning, where Max and Holly, the hosts, introduced a series of special guests who outlined the no smoking message in an informative and entertaining way. The assembly which was for the whole school assembly was such a success, the children repeated the performance to parents, families and friends later in the month. Primary School classes in Stranraer responded enthusiastically to the smoke-free message 14 Smokefree homes and cars newsletter - June 2011

15 PATH academically accredited stop-smoking support modules Partnership Action on Tobacco and Health Partnership Action on Tobacco and Health (PATH) is a joint initiative between ASH Scotland, NHS Health Scotland and the Scottish Government to reduce the prevalence of tobacco use in Scotland. It continues to support the implementation of Scottish and UK government policies on tobacco and smoking. Managed by ASH Scotland, PATH has taken a lead in a number of key developments to roll out and enhance evidence of good practice for stop-smoking services across areas of training, data collection, evaluation, prevention and cessation. For more information about brief advice and smoking cessation related training, visit the website: British Lung Foundation Children's Charter The BLF launched its Children's Charter in June last year. The main media element was the BLF's call that smoking should be made illegal whenever a minor was in the car. We chose this issue as it was easy to explain and in recognition of the increasing evidence base about the significant levels of second hand smoke that children were exposed to in this confined space. To date our petition has already gained over 15,000 signatories and it's not too late to sign it to show your support. Smoke-free Perth and Kinross As part of the wider Tobacco and Health Improvement partnership work in Perth and Kinross, a smoke free homes scheme is being piloted in North Perth areas where there is a high smoking prevalence. The scheme is guided by a multi-agency steering group that meets quarterly and has input from various professionals including Tayside Fire and Rescue, NHS Tayside Smoking Cessation service, Perth and Kinross Council, Fairfield Housing Cooperative and Perth and Kinross CHP. NHS Grampian NHS Grampian have produced posters and leaflets to back their smoke-free homes campaign. For more information contact Irene Fraser, Smoke-free Homes Co-ordinator , irenefraser@nhs.net Contact: Tracey Furness Smokefree Homes Project Worker Perth and Kinross Council Smokefree homes and cars newsletter - June

16 Smokefree Families Project Miriam Bell Our project is jointly funded by Liverpool Primary Care Trust and Liverpool City Council. We had a three month lead time to prepare the strategy and the project was launched on 15th February The aims of the project were to encourage parents to protect their families from second-hand smoke (SHS) by making a commitment to one of the following steps: Step1: Never Smoke around babies. Children and pregnant women Step2: Never Smoke around babies, children and pregnant woman and only smoke in one well ventilated room Gold: Make your home and car smoke free at all times. 2,009 - families signed up to a Smoke Free Families Promise (Target 1,500) 1,757 (87%) families signed up to the GOLD promise What has gone well? The project well exceeded its target by 509 families and has since been re funded to run for another 12 months. The Smoke Free Families (SFF) objective has been achieved. Parents have welcomed the information provided with a positive approach without parents being made to feel bad about smoking. People who smoked were happy to sign up to SFF and did not feel obliged to ask for stop smoking support. Delivering brief intervention to parents who did not understand the true effects of SHS was well received. Health professionals feel more confident in raising the issue of SHS through the SFF scheme. When following up clients, those who did not request stop smoking support at the time were contacted three months later and offered support again, either to sign up to SFF or if they had reconsidered the offer of stop smoking support. Excellent support was provided from Alder Hey Children s Hospital and the Liverpool Women s Hospital. Excellent response from parents in areas of low deprivation and high smoking prevalence, the target audience. Smoke-free Homes in Highland As part of it s smoke-free homes initiative, NHS Highland produced a newsletter aimed at young people to raise awareness of second-hand smoke. For more information contact: Denise May Smoking Prevention Officer (NHS Highland) denise.may@nhs.net The ASH Scotland Information Service has produced information briefings on a host of topics including, child exposure to second-hand smoke, smoking in cars and smoking and breastfeeding. Contact the Information Service for help and advice on accessing tobacco related information. enquiries@ashscotland.org.uk Action on Smoking & Health (Scotland) (ASH Scotland) is a registered Scottish charity (SC ) and a company limited by guarantee (Scottish company no ).