BRADFORD AND AIREDALE TEACHING PRIMARY CARE TRUST MEETING OF THE BOARD OF DIRECTORS ON 25 SEPTEMBER 2007

Transcription

1 AGENDA ITEM NUMBER 11 TO NOTE BRADFORD AND AIREDALE TEACHING PRIMARY CARE TRUST MEETING OF THE BOARD OF DIRECTORS ON 25 SEPTEMBER 2007 BRADFORD DISTRICT TOBACCO STRATEGY UPDATE DIRECTOR RESPONSIBLE: Anita Sims, Director of Public Health Tel: (01274) Issue to be discussed Achievements made in implementing the Bradford District Tobacco Strategy and in addressing the targets for the numbers of smokers quitting through the tpct Stop Smoking Service Recommendation The Board is recommended to note the achievements made in furthering the aims of the Tobacco Strategy and in capacity building and service improvement to strengthen the tpct s ability to meet the PSA quit smoking targets. Relevant factors 1.0 Context National and Local Plans 1.1 The Health and Social Care Standards and Planning Framework (2004), set out key public service agreement targets for smoking prevalence:- To reduce adult smoking rates from 27% in 2002 to 21% or less by To reduce smoking prevalence among routine and manual groups from 31% in 2002 to 26% or less by To reduce smoking prevalence amongst year olds from 13% to 11% by 2005 and 9% by To reduce smoking amongst pregnant smokers from 23% to 18% by 2005 and 15% by The Health Act 2006 introduced a ban on smoking in all substantially enclosed public places, and in workplaces and public and work vehicles in England.

2 1.3 Bradford s current Local Area Agreement includes key indicators for smoking focussing on taking forward action plans for smoke free local authority premises and NHS premises, public places, workplaces and licensed premises. 1.4 Between 2003 and 2006 Bradford exceeded its stop smoking targets. In 2006/7 however, in common with many other areas, the target in Bradford was not met Projections from the SHA indicate that Bradford is at amber risk level for meeting the 2007/8 target. The targets for 2006/7 and 2007/8 are acknowledged to be challenging, not least because of the previous success rate we are left with the harder to reach groups of those who continue to smoke and because the baseline against which they were set was peak year for numbers of 4 week quitters. 2.0 Bradford District Tobacco Strategy (Appendix) 2.1 The Bradford District Strategy is based on extensive research over the past 40 years that has identified key elements of a comprehensive tobacco strategy. The aims of a comprehensive approach are to de-normalise smoking, protect nonsmokers from second-hand smoke, prevent new smokers especially children and young people from taking up the habit and promote quitting amongst adults and young people. 2.2 On this basis the following Department of Health recommended strands underpin the Bradford Strategy: - 1. Media education and information 2. Building Stop Smoking Services and strengthening local action. 3. Reducing exposure to second-hand smoke. 4. Reducing tobacco promotion. 5. Regulating tobacco. 6. Reducing supply and availability. 2.3 Additional objectives have been added in view of the importance of information about smoking to enable achievements of the other objectives, and to address the significant problem for Bradford of chewing tobacco. 2.4 The Strategy aims to promote the health of the people living and working in the Bradford Metropolitan District by reducing the use of tobacco and exposure to indoor tobacco pollution, particularly targeting populations in areas of greatest need. Its objectives are: - To reduce the levels of exposure to second-hand smoke in enclosed public places, workplaces, schools and the home. To reduce the level of tobacco use in the Bradford District with a focus on reducing the prevalence of smoking in manual worker groups and pregnant women in line with national and local targets..to ensure the provision of an effective Stop Smoking Service to help people stop smoking. 2.5 The Strategy is supported by an action plan, which is a dynamic document, constantly being reviewed and revised to take account of the current position, new evidence and emerging threats and opportunities. The Strategy and Action Plan can be found in the Appendix to this report.

3 3.0 Capacity Building and Service Improvement 3.1 In order to address the gap in performance against the targets described in 1.3 above the tpct has taken the following steps to build capacity, increase the numbers of smokers setting a quit date and increase the numbers of successful 4 week quits. The steps taken are described below and are linked to the key elements of the tobacco strategy Support local education and media campaigns The tpct Communications Team, in partnership with the Council s communications officer, have achieved a steady stream of media coverage over the last few months focussed on the implementation of the smoke-free legislation. This has included press coverage, radio interviews and plasma screen transmission Build local Stop Smoking Services; strengthen local action The Tobacco Control Team has been expanded to increase the human resources available to: - Increase client stop smoking support 4 wte stop smoking specialists were appointed in August 2007 Support the smoke-free legislation: 1 WTE Senior Health Promotion Specialist was appointed (on a job-share basis) in December 2006 and April 2007 to lead a multi-agency approach to smoke-free public places, workplaces and homes. 1 WTE Health Promotion specialist was appointed in October 2006 to build and provide workplace stop smoking support opportunities. Increase productivity of practice based services: 1 WTE Practice liaison Stop Smoking specialist was appointed in May 2007 and Sept 2007 to provide support and capacity building for practice based services. 1 WTE administrator has been appointed to support data collection and administration needs for practice based services. Increase the availability of community-based stop smoking groups: 13 sessional workers have been recruited and trained to provide stop smoking courses at community based venues and out of normal office hours. Other capacity building activity: A Nurse Prescriber Protocol has been implemented to increase access to NRT for pregnant smokers and stop smoking support is now provided at maternity units. An NRT Voucher scheme was developed and implemented in September 2007 to increase access to NRT provision for clients attending the specialist service and stop smoking courses provided by sessional workers. A Local Enhanced Service (LES) proposal is being developed to maximise the potential of pharmacists counter assistants providing Stop Smoking support in their practices.

4 Since January 2007 the service has provided information sessions and/or smokefree policy support for 65 businesses. 45 businesses went on to provide a stop smoking course for their staff, (approx 254 individuals have been through the 7 week course); the remaining 19 companies received Brief Interventions and Signposting for the staff. Brief intervention training for dental teams has been delivered. Within the period December 2006 to September 2007 approximately 100 dental team members have accessed training. Resources have been developed to support dental team training including a workbook which allows practitioners the option of using the workbook and completing a self assessment exercise in their own time and attending a shorter training module. A dental practice is piloting an intermediate level stop smoking service and a proposal has been developed to expand the pilot scheme. Social Marketing In order to increase the throughput of service users the tpct has commissioned a market research organisation to carry out a direct marketing campaign to encourage smokers to access the services. This commenced in August and early indications are very encouraging. The tpct, in partnership with the SHA and Leeds Metropolitan University, has recently selected a marketing organisation to undertake a major social marketing programme to increase the numbers of South Asian males accessing the Stop Smoking Service and another programme will shortly be developed to address male manual workers Reduce exposure to second-hand smoke Compliance with the smoke-free legislation has been very high in Bradford due to the multi-agency approach taken and the preparations made in terms of media coverage, communication with workplaces, workplace stop smoking groups and brief interventions training Promote Tobacco Regulations and Reduce availability and supply of tobacco products Work has continued in terms of media coverage but is hampered by the failure of the Bradford District to adopt the Proof of age scheme offered by West Yorkshire Trading Standards. Renewed efforts are shortly to be made by the DPH to gain agreement and commitment to, and funding for, this scheme via the Local Strategic Partnership Ensure robust data collections to inform objectives of Tobacco Strategy Data is now being collected monthly from practice based services and specialist advisors to enable trends to be tracked more closely. The service has increased its capacity to support this enhanced data collection (see 3.1 above) To reduce use of smokeless tobacco Information regarding smokeless tobacco has been developed, piloted and is now included within brief intervention training for dental teams. A proposal has been developed to include this information in all brief intervention training, supported by a stop smoking specialist (0.6wte) to work specifically with the Bangladeshi community with regard to tobacco use.

5 4.0 Achievements and Outcomes The Quarter 1 data for the service has shown a significant rise in 4 week quitters, with 2130 clients setting a quit date and 1037 quit at 4 weeks. This is the highest number for any Quarter 1 since the targets were introduced. The direct marketing campaign and increased groups in community venues had not commenced in Quarter 1, and the upward trend is therefore likely to continue in Quarter 2. The service s conversion % for 4 week quitters has increased from 44% to 48% for all services in this quarter.