Tobacco Control Strategic Plan for Hertfordshire:

Transcription

1 Strategic Plan for Hertfordshire:

2 Contents Page Foreword 1 Vision for Hertfordshire 2 The role of NICE Guidance and Standards 3 Priority 1: 5 To reduce adult smoking in every district to 18.5% or less by 2015 Priority 2: 10 To reduce smoking in young people so that less than 9% of 15 year olds report to be smoking by the end of 2015 Priority 3: 13 To reduce smoking in pregnancy so that less than 7% of pregnant women throughout their pregnancy by the end of 2015 Priority 4: 14 To protect young people from second-hand smoke by rolling out a comprehensive Smokefree homes and cars scheme Priority 5: All pubic sector workplaces to be completely Smokefree by

3 Foreword Effective tobacco control measures, including helping people to stop smoking, save more than they cost; this strategic plan draws together Hertfordshire s ambitions to reduce avoidable smokingrelated death and disability together into one document to ensure effective, co-ordinated action across the county. This plan has been developed by using the best available evidence in tobacco control and by consulting with a range of partners who have already contributed to the work of Hertfordshire s Tobacco Control. A detailed companion public health report which identifies the impact of tobacco on Hertfordshire has also been produced and informs the actions in this plan. Hertfordshire County Council has outlined Hertfordshire s strategic priorities to improve and protect the health of its residents and to reduce health inequalities between the best and the least well-off. These priorities are published in Hertfordshire s Health and Wellbeing Strategy and Hertfordshire s Public Health Strategy Along with Public Health, Hertfordshire s NHS Clinical Commissioning Groups and local NHS Commissioning Board also have a statutory duty to reduce inequalities. Teresa Heritage Executive Member, Public Health and Localism The Health and Wellbeing Strategy for Hertfordshire outlines the shared priorities to improve health and well-being, three of which include measures to reduce preventable ill-health and premature death (reducing the harm from tobacco, obesity and alcohol). Tobacco remains our biggest preventable killer. Hertfordshire County Council s Tobacco Policy was approved by Cabinet on 25 November This policy established the Council s position on tobacco and its commitment to reducing tobacco use and smoking prevalence. 1

4 Vision for Hertfordshire Healthy Lives, Healthy People, the national tobacco control plan contains three national ambitions to focus tobacco control work. Reduce adult smoking prevalence among adults in England to 18.5 percent or less by the end of 2015 Reduce smoking prevalence among young people in England so that less than 12 percent of 15 year olds smoke by the end of 2015 (from a baseline of 15% in 2009) Reduce smoking during pregnancy in England to 11 percent or less by the end of 2015 (measured at the time of delivery) An assessment of the data contained in the Joint Strategic Needs Assessment (JSNA) by the Health and Wellbeing Board in 2012 identified that the national ambitions were not stretching for Hertfordshire as a whole to make a difference to individuals and communities most affected by tobacco use. So more stringent ambitions were introduced by the Health and Wellbeing Strategy which seeks to achieve: 1. Reduce (adult) smoking in every district to 18.5 per cent or less by Reduce smoking in young people, so that less than 9 per cent of 15 year olds smoke by Reduce smoking in pregnancy so that less than 7 per cent of pregnant women smoke throughout their pregnancy by the end of Roll out a county-wide smoke free cars and homes scheme 5. All public sector workplaces are completely smoke free including grounds by 2015 These ambitions will be used as priorities and progress will be monitored through the Public Health Outcomes Framework. In particular we want to make sure that: Young people do not want to start smoking and young people under 18 cannot gain access to tobacco Young people are given early and age-appropriate help to stop smoking Fewer babies are born to parents who smoke and smoking at time of delivery prevalence continues to decline to reach less than 7% by 2015 There are fewer adult smokers who act as role models for younger people There are fewer people dying and suffering from smoking-related long term conditions Stop smoking services are available and amenable to meet the needs of different communities and populations, particularly those from disadvantaged areas and vulnerable groups Access to illegal and counterfeit tobacco is minimized through the work of Trading Standards and Her Majesty s Revenue and Customs (HMRC) Increasing numbers of smokers are aware of local stop smoking services and different routes to quitting or reducing smoking if they are unable to quit There is no exposure to second hand smoke in the home, car, work place or in public places. The public sector, local businesses, educational establishments and voluntary organisations are exemplars in tobacco control and have comprehensive Smokefree policies in place by 2015 The health inequalities gap between the better and worse off in Hertfordshire is narrowed so that areas with the highest smoking prevalence see the steepest decline 2

5 We are advocates of and support evidence-based tobacco-control measures at regional and national levels All partners are committed to reducing the harm from tobacco and understand the association between smoking and health inequalities Our partners are skilled and have the capacity to deliver the tobacco control strategic plan using a public health approach to tackle inequalities and influence change through advocacy We have good quality data to inform our tobacco control strategic plan and we can measure success against reliable and accurate information We have a communication and marketing plan and resources to deliver consistent, coherent and co-ordinated communication on tobacco control throughout the county that reaches all our partners and communities Smokefree Hertfordshire An alliance of organisations working together to improve the health of people in Hertfordshire by reducing their exposure to tobacco, will be our key vehicle for delivering these ambitions. This strategic plan has been developed with input from key stakeholders and following a tobacco control workshop held in January It will be supported by an annual, multi-agency tobacco control action plan, to be produced by Smokefree Hertfordshire, the local. Local tobacco control action plans will also be developed jointly with each District and Borough council to reflect their strategic priorities but with local smoking prevalence, priorities and insights taken into account. Local Smokefree s may be convened to address particular issues; these will report individually to their local Health and Wellbeing Partnerships which cover the ten District and Borough Councils. The role of NICE Guidance and Standards The National Institute for Health and Care Excellence (NICE) are currently working on a tobacco quality standard expected to be issued in January 2015 We will ensure that our Strategic Plan and actions fit with these quality standards by making implementation of current NICE quality standards, guidance and pathways a core part of our approach. The principal sets of guidance are shown in the table below but there are others such as guidance on community engagement Standard or Guidance Type Number Behaviour change: individual approaches Smoking cessation in secondary care: acute, maternity and mental health services Tobacco: harm-reduction approaches to smoking Smokeless tobacco cessation: South Asian communities Quitting smoking in pregnancy and following childbirth School-based interventions to prevent smoking Identifying and supporting people most at risk of dying prematurely Preventing the uptake of smoking by children and young people Smoking cessation services (partially updated by PH45 and PH48) Smoking cessation: supporting people to stop smoking Chronic obstructive pulmonary disease quality standard Idiopathic pulmonary fibrosis: the diagnosis and management of suspected idiopathic pulmonary fibrosis Public Health Guidance Quality standard Clinical Guidance PH49 PH48 PH45 PH39 PH26 PH23 PH15 PH14 PH10 QS43 QS10 CG163 3

6 At a glance Smokefree Hertfordshire s Strategic Plan Hertfordshire Strategy Group Smokefree Hertfordshire: Hertfordshire s Smokefree Workplaces & Communities (Priority 5) Smokefree Cars and Homes (Priority 4) Reducing smoking in Pregnancy (Priority 3) Reducing smoking in children and young people (Priority 2) Reducing smoking in each district (Priority 1) Programme Co-ordination: Local Action Groups Communications and Marketing Plan 4

7 Priority 1: Reduce adult smoking in every district to 18.5% or less by 2015 Current smoking prevalence in Hertfordshire Area EAST & NORTH HERTS Smoking Prevalence (%) 2012 Stevenage 22.3 Welwyn Hatfield 20.4 Broxbourne 19.3 East Herts 15.2 North Herts 17.0 WEST HERTS 2012 Watford 14.3 Dacorum 17.4 Three Rivers 15.5 Hertsmere 20.8 St Albans District 16.2 Hertfordshire 17.7 England 19.5 Source: Local Profiles 2013 for England (2012 data) Smokefree Hertfordshire, Hertfordshire s will include the following membership and will focus on local partnerships in Districts and Borough Councils and with priority target populations and groups: Hertfordshire County Council, including Public Health, Health and Community Services, Community Protection and Young People s Services Local District and Borough Councils Local Officer tobacco control champions Public Health Manager Education Establishments (School and College PHSE leads; University of Hertfordshire) Clinical Commissioning Groups Children s Centres and Locality Stop Smoking Specialists East and North Herts and West Herts NHS Trusts (including maternity services) Hertfordshire Partnership foundation Trust Hertfordshire Community NHS Trust Primary Care/GPs The Local Pharmacy Committee and Community Pharmacies Local voluntary and community organisations Housing Associations Leisure facilities and sports teams Workplaces and local businesses Trading Standards and Her Majesty s Revenue and Customs (HMRC) Drug and alcohol services 5

8 Action Outcome Lead Partners Outcome Measures Establish local Smokefree s/ partnerships Local tobacco control alliances putting in place regulatory and whole system approaches to reducing the harm from tobacco Tobacco will continue to be de-normalised Strategy Group List on previous night s established CLeaR (national accreditation for excellence in local tobacco control) achieved Routes to get people into smoking cessation and harm reduction services will be developed Smoking cessation and harm reduction approaches to tobacco use are aligned. Regional and national tobacco control measures will be supported and delivered locally Establish Communications and Marketing Capability Regular use of insight to get campaigns and marketing to the right audiences Established communication pathways with professional and voluntary and community organisations and Hertfordshire County Council s Communications Team Hertfordshire Marketing plan and social segmentation plan in place Increased involvement of alliance partners to achieve this strategic plan Continue enforcement of tobacco control legislation Regulation of the age of sales (including test purchasing) Regulation of tobacco trading and counterfeit/ non duty paid products Point of sale restrictions on tobacco Regulation of advertising and sponsorship Hertfordshire Trading Standards, HMRC District/Borough Councils Community Safety Partnerships Coverage of restrictions Test purchasing outcomes Remedial actions with retailers who are non-compliant with tobacco legislation Test prosecutions 6

9 Action Outcome Lead Partners Outcome Measures HMRC integrated within our tobacco control alliance and to inform and use local intelligence to drive down the availability of illegal tobacco. Reduction of availability and access to illegal tobacco Effective control of illegal tobacco HMRC Hertfordshire Tobacco Control Intelligence reports on illegal tobacco availability Reports on seizures of illegal tobacco Stop smoking services are accessible to everyone but are prioritised to ensure target populations are helped to quit smoking (which includes: black and minority ethnic groups, mental health service users, routine and manual workers, prisoners and offenders young people and the homeless) 300 stop smoking services available across a variety of channels and times and targeted for communities Health Equity Audit conducted in 14/15 Hertfordshire Tobacco Control Referral, uptake and quit rates by key target populations and groups Stop s in Hertfordshire exceed Contractual Quality Standards Action plan in place focusing on findings of Health Equity Audit Risk register established to ensure targets are delivered in 14/15 Develop harm reduction approaches to smoking in line with NICE guidance PH45 and good practice, prioritising those at greatest risk of smoking related health inequalities Ensure people can cut down to quit or temporarily abstain from smoking Hertfordshire tobacco harm reduction guidance developed Hertfordshire Tobacco Control Uptake of harm reduction and harm reduction services Action plan in place Referral, uptake and quit rates- focusing on findings of Health Equity Audit 7

10 Action Outcome Lead Partners Outcome Measures Develop approaches to include e-cigarettes in harm reduction and smoking cessation Support development of e-cigarette policies by employers, local authorities and others Support people to safely and effectively use e-cigarettes as part of reducing the harm from tobacco and stopping smoking People who use tobacco can be supported to use e-cigarettes as alternatives to tobacco Hertfordshire HR Departments Action on Smoking and Health (ASH) Shift smokers from tobacco use to e-cigarettes Ensure young people do not access e-cigarettes as a route to tobacco use. Hertfordshire-wide e-cigarette policy developed for use by employers and local authorities Develop Hertfordshire Guidance for Sisha and smokeless tobacco products People who use Sisha and smokeless tobacco/ niche tobacco products are supported to use safer forms of nicotine Young people do not start to use smokeless tobacco Hertfordshire Tobacco Control Strategy Group Hertfordshire Trading Standards Audit of current use of Sisha and smokeless tobacco products in Hertfordshire Action plan in place to support users of Sisha and smokeless tobacco to using safer forms of nicotine Communication action plan in place highlighting the dangers of Sisha and Smokeless tobacco use with higher risk communities Intelligence on the enforcement of legislation on Sisha and niche products, including the licensing of Sisha bars in Hertfordshire. 8

11 Action Outcome Lead Partners Outcome Measures Continue roll out of Making Every Contact Count with NHS trusts and primary care, and other priority agencies Ensuring every health and local authority service and voluntary and community organisations encourage people to quit smoking and adopt healthier lifestyles Hertfordshire Agreements with NHS Trusts in Place Achievement of target numbers by NHS trusts and other settings Brief Intervention training, including motivational interviewing techniques available to all voluntary and statutory agencies Increasing numbers of service users accessing stop smoking and lifestyle services Joint planning, training and referral pathways are developed between statutory and voluntary agencies so that service users are offered support to deal with a range of addictive behaviours and that smoking cessation or smoking harm reduction is seen as an integral part of an individual s package of care. Ensure drug and alcohol users can access Stop s Hertfordshire Tobacco Control Reciprocal referral pathway in place Referrals, uptake of services and quit rates 9

12 Priority 2: To reduce smoking in young people so that less than 9% of 15 year olds report to be smoking by the end of 2015 Action Outcome Lead Partners Outcome Measures Services in Hertfordshire reach the You re Welcome accreditation standard for young people Services are accessible and sensitive to the needs of young people Hertfordshire Accreditation of 50% of services by year 2 Children s Centres and Health Visitors contribute to the reduction of smoking in young people Parents of young children are actively encouraged to give up smoking so children do not start to smoke Hertfordshire Community NHS Trust (HCT) ensures Health Visitors advise and refer all smokers to and advise parents about the dangers of second-hand smoke Hertfordshire Uptake of smoking cessation and harm reduction approaches by users of Children s Centres Children s Centres have Smokefree policies and action plans in place Number of referrals received by agreed in their local Quality Requirements with Clinical Commissioning Groups Health Visitors adopt the Smokefree homes and cars scheme Yeah Butt programme is rolled out in schools and young peoples settings alongside peer support and mentoring programmes Young people are motivated to resist smoking Hertfordshire Tobacco Control Strategy Group Hertfordshire Number of schools using the programme Smoking status in health related behaviour questionnaire 10

13 Action Outcome Lead Partners Outcome Measures Smoking prevention programmes run through Youth Connexions Young people are supported to give up smoking Hertfordshire Tobacco Control Strategy Group Uptake rates among Connexions users Small project commissioning with third sector agencies Innovative ways of working with vulnerable young people on tobacco to get them not to smoke Hertfordshire Tobacco Control Strategy Group Measures will vary depending on project Develop more work in youth settings including whole school approaches as well as programmes aimed at vulnerable young people Enable young people to resist smoking patterns Smokefree policy templates and toolkits are developed for PHSE leads/teachers Hertfordshire Tobacco Control Strategy Group Smoking rates in health related behaviour questionnaire Roll out of Health Champions Programme Peer training for young people to develop interventions Hertfordshire Tobacco Control Strategy Group Number of champions working on tobacco control Smoking rates in health related behaviour questionnaire Targeted social marketing for young people Use Mogo website and associated ing to cover 12,000 young people Hertfordshire Tobacco Control Strategy Group Smoking rates in health related behaviour questionnaire Uptake of website and message numbers Roll out Peer mentoring programmes such as the ASSIST (A Stop Smoking in Schools Trial) Young people can resist smoking Hertfordshire Tobacco Control Strategy Group Uptake of programmes in schools Smoking rates in health related behaviour questionnaire 11

14 Action Outcome Lead Partners Outcome Measures Smokefree playgrounds Smoking becomes de-normalised and young people are not encouraged to smoke Hertfordshire Tobacco Control Strategy Group District Councils Number of authorities and schools making playgrounds smoke free Ensure targeted youth support service has smokefree training Vulnerable young people can access support Targeted Youth Support Services Uptake rates Test purchasing and investigate where they think there are breaches to the legislation relating to the sale of tobacco to minors Illegal tobacco sales reduce and are prosecuted Hertfordshire Trading Standards Number of test purchases which indicate breaches Remedial action plans in place with noncompliant retailers 12

15 Priority 3: To reduce smoking in pregnancy so that less than 7% of pregnant women throughout their pregnancy by the end of 2015 Action Outcome Lead Partners Outcome Measures Ensure Making Every Contact Count is rolled out into every NHS Trust Pregnant women are pro-actively referred to stop smoking services using an opt-out protocol CCGs to commission the approach NHS Trusts Primary Care CCGs require every NHS Trust to implement Making Every Contact Count by 2016 Implementation plans in Trusts Referral numbers from NHS Trusts to stop smoking services Ensure maternity services especially midwives contracts require smoking status assessment, carbon monoxide measurement and offering smoking cessation support routinely Ensure maternity services, especially midwives, refer to Pregnancy Stop Smoking Specialists Pregnant women and their partners are given repeated opportunities to quit smoking with specialist support from s Specialist support is accessed easily for pregnant women and their partners Clinical Commissioning Groups Clinical Commissioning Groups Hertfordshire Stop Smoking Service NHS Trusts Hertfordshire Stop Smoking Service NHS Trusts Smoking status at the time of first ante-natal appointment and at the time delivery Smoking status during pregnancy and at the time of delivery Referral rates,uptake rates and quit rates increase from 13/14 Quit rates increase from13/14 Smoking status during pregnancy and at the time of delivery Referral, uptake and quit rates Increase referrals of pregnant women and their partners who smoke from a wide range of organisations Ensure Pregnant women can access Nicotine Replacement Therapy Referrals are received from GPs, Community Pharmacies, voluntary and community organisations and Children s Centres Chances of quitting are enhanced for pregnant women NHS Trusts Hertfordshire Tobacco Control NHS Trusts Community Pharmacies GPs Referral, uptake and quit rates Uptake and quit rates 13

16 Priority 4: To protect young people from second-hand smoke by rolling out a comprehensive Smokefree homes and cars scheme This is in addition to the work on young people above* Action Outcome Lead Partners Outcome Measures Ensure second-hand /passive smoking reduced through enforcement Second hand smoking is reduced in public places covered by the law Hertfordshire Trading Standards District Councils Enforcement rates Roll out Smokefree homes and cars campaign (e.g. Smokebusters) Ensure Hertfordshire Fire and Rescue Service can educate residents about risks of smoking in home Young children are not exposed to harmful second hand smoke at home or in the car People are encouraged to give up smoking while they have home fire safety checks. There are fewer smoking-related house - fires District Councils Hertfordshire Tobacco Control Strategy Group Community Protection/ Hertfordshire Fire and Rescue Service Campaign coverage Uptake of smoking cessation services Number of Smokefree homes and cars pledges received Population coverage Fewer smoking-related house fires Fewer smoking-related mortalities 14

17 Priority 5: All pubic sector workplaces to be completely Smokefree by 2015 Action Outcome Lead Partners Outcome Measures Employers are supported to develop policies on smoking at work Every workplace has a policy modelled on Hertfordshire County Council Tobacco Policy with HR and Healthy Herts All public sector employers All public sector employers are signed up to a tobacco policy 50% of them have Smokefree policies in place 50% of them have referral mechanisms in place, or provide smoking cessation support Employers are supported to develop referral routes to Stop s Employees obtain support easily All public sector employers Number of referral routes in place Uptake of services and quit rates Number of routine and manual workers who quit smoking increase Employers are supported to develop policies on e -cigarettes which does not treat them as smoked tobacco products Employees can use e-cigarettes as a way of moving from tobacco/harm reduction All public sector employers All local authorities develop policies by

18 References Hertfordshire County Council (2013) Healthier Herts: A Public Health Strategy for Hertfordshire Available at: Health%20Strategy% pdf NHS Commissioning Board: The functions of clinical commissioning groups (2013). Available at: Health and Wellbeing Board Hertfordshire (2013) Strategy Healthier People healthier Communities for a healthier and happier Hertfordshire. Available at: Hertfordshire County Council Cabinet Panel. Report of the Director of Public Health (November 2013). Available at: Department of Health (2011) Healthy Lives, Healthy people: A tobacco control plan for England. Available at: Action on Smoking and Health (ASH) CLeaR Excellence in. Available here: 16

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