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|Topic title||Smoking and Tobacco Control (2015)|
|Topic owner||Tobacco Control Strategic Group|
|Topic author(s)||John Wilcox, Insight Specialist - Public Health|
|Topic quality reviewed||June 2015|
|Topic endorsed by||Tobacco Control Strategic Group|
|Topic approved by||Tobacco Control Strategic Group|
|Current version||July 2015|
|Replaces version||Smoking (2012)|
|Linked JSNA topics|
|Insight Document ID||87638|
Smoking causes 80,000 deaths in England each year, more than any other preventable cause. Nottingham has significantly higher rates of lung cancer, COPD and heart disease and other conditions compared to England due to smoking. It is estimated that each year smoking costs ‘society’ in Nottingham approximately £88m. This includes £3m per year to Nottingham City Council for additional social care costs and £11.0m to the NHS for treating smoking related illness.
Adult smoking prevalence has decreased in the city over the last decade. But according to the local Citizen’s Survey 27.4% smoked in 2014, which is the similar to the prevalence in England in the early 1990’s, and significantly higher than the current national prevalence of 18%. The represent a significant heath inequality which is indicative of the positive correlation between smoking prevalence and deprivation. There is also a positive correlation between smoking prevalence and deprivation within the city. Aspley, St Anns, Bulwell and Clifton wards have a smoking prevalence significantly higher than the city average and almost double the England average.
The high smoking rates during pregnancy in the city (18.5%), compared to England (12.5%), are of particular concern. Smoking in pregnancy increases risk of complications, which affect mothers and babies health, and increase risk of miscarriage and maternal death. Children who grow up in families and communities with a high proportion of smokers are more likely to become smokers themselves. Over 80% of adult smokers took up the habit before the age of 20. Second-hand smoke continues to be a significant cause of morbidity and mortality in children and 22.3% of households in the city still allow smoking in the home. Smoking prevalence amongst young people in England has decreased significantly over the last decade with only 8% of 15 year olds smoking regularly. Model based estimates, local survey data, and the strong correlation between child and adult smoking, suggests that smoking prevalence amongst young people in Nottingham, particularly in the most deprived areas, is likely to be higher than the national average.
High rates of smoking are a significant cause of people with mental health problems dying younger than the general population. Smoking rates are reported to be as high as 80% amongst local mental health inpatients and 57% amongst patients with enduring serious mental illness smoke. Research suggests smoking may contribute to stress and anxiety and stopping smoking is associated with an improvement in symptoms. Other groups with particularly high rates of smoking include adults who are unemployed, adults with alcohol and drug misuse problems, adults from Eastern European Countries and adults from certain LGBT groups.
The majority of smokes use manufactured or hand rolled cigarettes of which a proportion is illicit or counterfeit. Illicit or counterfeit tobacco brings crime into our communities and makes smoking more affordable and accessible to everyone including children and young people, ensuring people start young and continue the habit into adulthood. Shisha smoking is also an issue of concern due to the increase in businesses selling shisha tobacco to be smoked in bars, restaurants and at home. Local research and intelligence suggests this tends to be smoked more by young Asian people as a social activity, and awareness and knowledge of the health effects appears to be low.
Usage of e-cigarettes has increased significantly in recent years so that 22.9% of smokers and recent ex-smokers use e-cigarettes and 14.9% use them daily. Available evidence suggests that smoking e-cigarettes is likely to be less harmful than smoking tobacco, and that they may help people to cut down the amount they smoke and potentially help with quitting smoking. However they are currently unregulated products, of variable quality, with safety concerns and are not recommended as a smoking cessation aid by NICE.
Action to reduce smoking is coordinated through the city’s Tobacco Control Strategic Group which brings together partners from the NHS and city council to identify and oversees the city’s priorities for action which will be set out in a new strategy from September 2016. The chapter describes the current range of interventions to reduce smoking from across the partnership. It is estimated that through current tobacco control interventions there will be a return of £2.90, £6.95, £13.23 and £41.95 per smoker across all services over 2 years, 5 years, 10 years and Lifetime respectively, for each pound spent on the current programme.
Smoking in pregnancy is significantly higher in the city than the England average and the gap is widening.
Develop a multi-agency smoking in pregnancy pathway and enhance interventions to reduce smoking in pregnancy and support women who want to quit based on the latest evidence in the Healthy Child Programme Rapid Review.
Kate Thompson, Smokefree Coordinator, Environmental Health, Nottingham City Council. Kate.email@example.com