EFFECTIVE TOBACCO CONTROL

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EFFECTIVE TOBACCO CONTROL

• KEY NATIONAL AND REGIONAL PRIORITIES AND THE KEY
  STRANDS OF ACTIVITY
• Ailsa Rutter
• Director of Fresh and
• Regional Tobacco Policy Manager

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SUMMARY OF PRESENTATION

• Brief overview of Fresh
• Outline of what needs to happen to reduce smoking
  international, national, regional and local
• The building blocks of tobacco control-
• The North East approach
• The headlines to our eight key strands of work

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• Brief overview of Fresh

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BACKGROUND TO FRESH

• Rationale quicker, bigger, bolder and more
  coordinated action required
• Evidence base- USA, Ireland, Australia- for
  Regional/State wide Programmes overseen by
  Offices
• Launched May 2005- funders, base
• Role
• Umbrella term
• Partnership- national, regional and local
• Work Programme

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BACKGROUND TO FRESH

• Key North East achievements
• Biggest regional response to smokefree
  consultation
• Highest compliance to smokefree law- excellent
  preparation with the local councils
• Coordination of key consultations- age of sale,
  smokefree regulations, picture warnings

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BACKGROUND TO FRESH

• Key North East achievements
• Sustained and increased media coverage each year
• Award winning media campaigns
• Local tobacco alliances across whole region
• Fresh local alliance toolkit developed and picked
  up country wide
• UKs first dedicated Regional Prisons working
  group

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BACKGROUND TO FRESH

• Key North East achievements
• Development and implementation of Smoking and
  Mental Health action plan
• Focussed work to develop evidence based action
  plans on key priority areas- through Regional
  Summits and consultations
• NHS SSS
• Health Care Commission

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BACKGROUNDTO FRESH

• Key North East achievements
• National influence- regional place on National
  Tobacco Programme Board
• Fresh one of five principle collaborators on
  Smoking Kills Revisited
• Model for work elsewhere- two other regions
  launching Regional Offices soon based upon Fresh
  model

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• Outline of what needs to happen to reduce smoking
  the key principles and objectives

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HOW CAN WE ADDRESS THIS? WHAT ARE THE PRINCIPLES?

• By following the lead set by the worlds first
  global health treaty (WHO Framework Convention on
  Tobacco Control) and by ensuring there is
  coordinated action taken at all levels to
• Help smokers to stop
• Prevent children from starting to smoke
• Protect people from exposure to secondhand smoke

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HOW CAN WE ADDRESS THIS? WHAT ARE THE PRINCIPLES?

• By adhering to the overriding principle to make
  smoking (and the Tobacco Industry) less
  desirable, less acceptable and less accessible
  (changing the social norms)

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HOW CAN WE ADDRESS THIS? WHAT ARE THE MAIN
ACTIONS?

• Price and tax measures to reduce the demand
  (single most effective measure)
• Non-price measures to reduce the demand
• Protection from SHS
• Regulation of the contents of tobacco products
• Packaging and labelling of tobacco products
• Education, communication, training and public
  awareness
• Treatment for tobacco dependence and help for
  quitting

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HOW CAN WE ADDRESS THIS? WHAT ARE THE MAIN
ACTIONS?

• Core supply reduction measures
• Illicit trade in tobacco products
  (smuggled/counterfeit)
• Sales to and by minors and
• Provision of support for economically viable
  alternative activities (for tobacco growers etc)

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HOW DO WE TACKLE THIS?

• We must follow the evidence base and learn from
  elsewhere.
• UK leading the world in integrated stop smoking
  services and comprehensive smokefree law and
  other measures to learn from elsewhere.
• We must work in partnership on this.
• Tobacco is a cross cutting issue requiring cross
  cutting action.
• We must recognise that there is much to be done
  still at all levels including the local level.

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WHAT ARE THE MAIN AREAS OF WORK IN THE NE?

• Develop infrastructure, skills and capacity
• Reduce exposure to second hand smoke
• Media, communications and education
• Help smokers to stop
• Reduce availability and supply
• Tobacco regulation
• Reduce tobacco promotion
• Research, monitoring and evaluation

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• The eight key strands- headlines of priorities,
  things coming up

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INFRASTRUCTURE, SKILLS AND CAPACITY

• Vital at all levels- leadership, plans based upon
  priorities, evidence base, identified leads,
  partnership approach, clear responsibility and
  accountability, skills, passion!
• What help?
• Fresh local alliances toolkit
• Skills training in media
• Fresh support to the alliances
• Practice sharing- SFNE Network, Summits, Planning
  Sessions
• National Support Team for Tobacco

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INFRASTRUCTURE, SKILLS AND CAPACITY

• Strategy is important- clear sense of direction
  of travel, focus
• Local Area Agreements- opportunity for tobacco
  control efforts within this
• What is coming up?
• Fresh Business Plan 2008/9- incorporating local
  plans
• National Consultation on new National Tobacco
  Strategy (Cancer Reform Strategy) very likely
  2008
• Smoking Kills Revisited 2008
• New Regional Tobacco Strategy 2009-2011

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REDUCE EXPOSURE TO SECOND HAND SMOKE

• Job not done on this
• Continuing focus on this is vital to denormalise
  smoking further

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3. MEDIA, COMMUNICATIONS AND EDUCATION

• Bread and butter of tobacco control
• Will remain a vital component to all work at
  national, regional and local level
• The addictive nature of tobacco use, and tobacco
  companies ongoing efforts to find ways to market
  their products, despite bans and restrictions,
  confuse the public, pour scorn on evidence means
  we will be fighting tobacco industry marketing in
  whatever form for many years to come.
• Planning day 25th January

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3. MEDIA, COMMUNICATIONS AND EDUCATION

• Education- context important
• Best evidence on what prevents children starting
  to smoke
• Changing the adult work in which they grow up in,
  aspire to
• Good evidence on what works and doesnt
• Current NE Mapping Exercise
• Keen for piloting on youth advocacy- Durham
  delegation

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4. HELP SMOKERS TO STOP

• Wider tobacco control vital to keep driving
  smokers to quit
• 70 want to quit smoking
• This is an addiction and people need help
• UK leading the world in NHS SSS
• NHS support
• Highly cost effective use of NHS resources
• Implement NICE guidance- County Durham and
  Darlington taking lead

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4. HELP SMOKERS TO STOP

• Be realistic about the contribution of the
  services- not prevalence reduction services- at
  best 0.2 contribution annually
• Set realistic and meaningful targets- ownership
  of these targets
• Improve primary care systems- GPs need to be
  better at brief advice- routinely to all smokers
  and referring them to NHS SSS- need QOF to be
  rebalanced

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4. HELP SMOKERS TO STOP

• Important to have all partners promoting benefits
  of SF lifestyle, signposting to NHS support,
  giving effective brief advice
• Acute sector- stop before the op, advice on SHS
• Role of local government, voluntary and private
  sectors
• Key priority groups for health inequalities-
  routine and manual worker smokers, pregnancy,
  mental health
• Current Fresh consultation on Reducing smoking
  pre-conception, during pregnancy and post natally

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5. REDUCING AVAILABILITY AND SUPPLY OF TOBACCO
PRODUCTS

• Age of sale 1st October welcome realistic
  expectation
• Some compliance monitoring necessary- politically
  
• Negative licensing plans- long term positive
  licensing aspiration
• Vending machines- likely national consultation-
  Fresh keen for outright ban

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5. REDUCING AVAILABILITY AND SUPPLY OF TOBACCO
PRODUCTS

• Cheap tobacco is a huge problem for the North
  East
• Will cover in more detail later

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6. TOBACCO REGULATION

• The current situation is back to front most
  harmful are least regulated and vice versa
• Will be covered later this morning

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7. REDUCE TOBACCO PROMOTION

• Major progress made in the UK with comprehensive
  bans on tobacco advertising and promotion
• BUT

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7. REDUCE TOBACCO PROMOTION

• Point of sale an issue- power walls etc- should
  all products not be under the counter?
  Consultation likely 2008
• Need for generic plan packaging? Discarded
  cigarette packets free massive industry
  advertising- perpetuating the norm

• Internet- very difficult
• Cross border advertising-
• FCTC protocol on this
• Promotion in the movies- emerging research on
  this and the influence on children
• International Summit Feb Liverpool- Fresh
  involvement

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8. RESEARCH, MONITORINGAND EVALUATION

• We need to know what impact we are having, public
  perceptions, monitoring for targets etc
• County Durham has done some innovative work in
  this area- public opinion surveys, vending
  machines survey, point of sale plans
• Fresh undertaken opinion surveys, media
  evaluation, qualitative work into smuggling, air
  quality monitoring/workers exposure- plans for
  further work around smuggling, NHS SSS, tobacco
  industry denormalisation
• Durham University work- ground breaking
• UKCRC success welcome tobacco research element

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8. RESEARCH, MONITORINGAND EVALUATION

• Monitoring crucial
• GHS 2006 out soon- new IHS should offer much
  better local data
• Need for improved QOF data quality from GPs
• Importance of monitoring on smoking and pregnancy
  
• New NHS SSS service and monitoring guidance

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ACHIEVING SUCCESS

• Will take long term, sustained, resourced and
  coordinated effort
• Issue is not going away- smoking remains crucial
  area for partnership action
• Even if hit PSA targets in 2010- NOT ENOUGH
• Where do we want to be?
• Long term goal?
• 10 prevalence 2020- nicotine use- not smoked
  tobacco??

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BIG TOBACCO QUOTES

• "Irrespective of how many children take up
  smoking in a year, no one's immortal - everyone
  dies sooner or later
• "We dont smoke that s. We just sell it. We
  just reserve the right to smoke for the young,
  the poor, the black and the stupid."