Tobacco Control Strategy
Our vision, aims, principles, approach and priorities
Our vision
By 2030, cigarette smoking will be a much rarer sight on our streets and in our homes. Hundreds more young people will be protected from starting to smoke and breathing in second hand smoke. Thousands of our most vulnerable and dependent smokers will have accessed advice and support to quit smoking for good. Our aspiration is to achieve a smoke free generation by 2030.
Our aims
The aims we want to achieve are to:
- Prevent even more children and young people from taking up smoking and vaping
- Reduce the number of residents who smoke, particularly those who have the strongest dependence and face the most challenges in quitting successfully
- Create an environment that supports people to stop smoking for good
Our principles
- Outcomes-focused
- Emphasis on local action
- Innovation
- Advocate for change
- Equity
- Building stronger links
We want to put people at the heart of our strategy. We believe this will help to reduce the uptake of smoking in young people and ensure the current smokers take the lead in their quit pathway.
The strategy will endorse and present a borough-wide approach whilst simultaneously appreciating the need for targeted working to address the specific issues that are areas of concern.
We will look at new ways of working, being creative and working across the health and social care system to deliver on our aims in the tobacco control strategy. It is important to challenge attitudes, behaviours, terminology and how we deliver services as part of this process.
We understand that smoking, can go hand in hand with issues such as poor mental health, alcohol or substance misuse, or living with other major stresses in life. We will create stronger ties with services that can offer support with these underlying issues.
Our approach
- Reducing inequalities
- Prevention
- Partnership working
- Evidence base
- Personal responsibility and empowerment
Achieving the aims of the tobacco control strategy cannot be done in isolation, rather a collaborative approach across agencies will be required. This will include public, private, and voluntary partner organisations working together, and the involvement of the public through consultation and community engagement.
Decisions about services and programmes should be based upon the best available information and our strategy is based on our knowledge of local need as shown in the Joint Strategic Needs Assessment, (2017). This ensures we make best use of resources, providing the best possible services and support.
Tobacco control should not be seen as a life-style choice, smoking is an addiction and should be treated as such. In preventing the uptake of smoking and supporting people to quit, it must be seen in its widest context, considering the person’s environment, the geography within which they live and the life stage they are at.
Inequalities in smoking prevalence highlight the need to focus on smoking in order to address health inequalities, but also reinforces the need for targeting resources equitably. This will contribute to the fall in smoking prevalence for the whole population but would ensure a higher quit rate in deprived areas, those on low incomes and vulnerable groups.
Our priorities
One child a day in Cheshire West and Chester is born to a mum who has smoked throughout pregnancy. Smoking during pregnancy can lead to serious short and long-term health issues, including complications at birth, premature birth, low birth weight, certain birth defects, and sudden infant death.
Pregnant women who smoke are more likely to be under 20, un-employed and live in more deprived communities with high rates of smoking, this can make it much more difficult to quit long-term.
Objectives
Reduce smoking throughout pregnancy in line with national targets
Key actions
Continue to support the Smoking in Pregnancy task and finish group which brings partners such as the hospital trusts, local maternity services, local authorities and commissioned smoking cessation services together. This group will align work with the NHS Long Term Plan objectives for smoking in pregnancy and be implemented by 2023/24.
Investigate the options for financial incentive schemes to quit in addition to smoking cessation support. Produce a report with recommendations by the end of the financial year 2022/2023Consider changes in policy in relation to vaping products as a harm reduction measure in pregnancy within the context of existing guidance on nicotine replacement. Produce a report with recommendations by the end of the financial year 2022/2023
Children who grow up around adult smokers are more likely to take up smoking and most adults start smoking during their childhood, this cycle needs to be broken. Smoking rates are highest amongst children who have other vulnerabilities and health-risking behaviours in their lives.
Our smoking JSNA has also shown that certain groups have smoking rates that are at least twice as high as those in the general population these include: people who are unemployed or in manual occupations, people with mental health conditions, people who identify as LBGT+, hospital inpatients and people who are homeless.
Objectives
- Reduce smoking amongst adults(18+) in line with national targets
Key actions
- Embed high quality brief advice training in services that work with young people, for example within the 0-19 service, with particular emphasis on the needs of those who work with the most vulnerable individuals. This should include continuing advice on smoke free homes, cars and vaping products
- Support the implementation of the Khan Review recommendations into the national tobacco control plan review
- Continue to enforce the full range of regulations covering the sale and promotion of tobacco and vaping products. This should also include advice on how to report the distribution of illicit tobacco or vaping products, or illegal sales to under 18s
- Monitor the Universal Smoking Cessation service (Go Smoke free Cheshire) through key performance indicators (KPIs) and contract monitoring
- Work closely with health services associated with higher and further education settings to enable more students to successfully quit smoking with a level of support appropriate to individual needs
- Continue to develop a range of support to reflect the varying needs of all smokers, including those in priority groups
- Support smoke free workplaces, mental health units, hospital sites and prisons
New technologies such as vaping products are now viewed as an acceptable part of harm reduction approaches at a national policy level1. Vaping products are the nation’s most popular quit method and can protect against returning to the known health harms from cigarettes. However, public and professional opinions and beliefs about the acceptability of this stance vary. There has been a lack of clear information to help the public reach an informed decision and many people continue to smoke as well as vape (dual use).
Current best evidence suggests that regular use of vaping products amongst 11-17 year olds remains low but is rising2. The likelihood of trying or currently using vaping products increases with age and smoking status.
Objectives
Open a dialogue on novel tobacco and vaping products, such as e-cigarettes and shisha pens, and their place within the tobacco control strategy
Key actions
- Respond to new guidance from the Office for Health Improvement and Disparities (OHID) and the National Institute for Health and Care Excellence (NICE) as it is published. Work closely with partners across Cheshire and Merseyside to develop approaches to vaping products and new forms of tobacco that are based on local risk assessment, harm reduction principles, and the most up to date evidence.
- Set up data collection to help improve our understanding of vaping products use locally.
- Closely monitor the Medicines and Healthcare products Regulatory Agency (MHRA) latest guidance which paves the way towards medicinally licenced vaping products becoming available on prescription. Consider engaging with vaping shops to ensure compliance with relevant legislation
