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 smokefree 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
- Why is this a priority?
- What are the outcomes we want to see?
- What are the key actions we will take?
- How will we measure progress? (Key indicators/ potential indicators)
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.
Support the local maternity units to implement their in-house smoking cessation service and the development of the national smoking incentive scheme for pregnant women for the financial years 2024/25 to 2025/26.
Consider 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 2024/2025.
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 LBGTQ+, 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 smokefree homes, cars, and vaping products.
Support the government’s Stopping the Start proposals to ensure legislative changes are enacted.
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 Smokefree 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
Implement the governments ‘Swap to Stop’ scheme by submitting expressions of interest for pilot initiatives focussing on routine and manual workers, persons engaging with our substance misuse services and working with local housing associations.
New technologies such as vaping products are now viewed as an acceptable part of harm reduction approaches at a national policy level for adult smokers (13). 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 rising (6). 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.
Tackling the rise of youth vaping by working with partners to build a local picture and proactively listening to young people about vaping and understanding its appeal.
Supporting the government’s announcement on the ban on the sale of disposable vapes to benefit our young people and the environment.
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 e.g. mandatory provision of recycling bins for e-cigarette disposal.
Details of the public health outcomes can be found in the table below.
Public Health Outcomes Framework – top level indicators (14)
|
Reference |
Details |
|---|---|
|
C03c |
Smoking at booking (child and mental health services dataset) |
|
C06 |
Smoking Status at time of delivery (Public Health Profiles) |
|
C13a |
Smoking prevalence at age 15 years – regular smokers (Smoking, Drinking and Drug use survey among young people in England (SDD) survey) |
|
C13b |
Smoking prevalence at age 15 years – occasional smokers (SDD survey) |
|
C18 |
Smoking prevalence in adults (18+) – current smokers (Annual Population Survey (APS)) |
|
|
Smoking prevalence in adults in routine and manual occupations – current smokers (Public Health Profiles) |
|
|
Smoking prevalence in adults (18+) with serious mental illness (SMI) – (Public health Profiles) |
