Agenda item

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Director of Public Health, setting out and seeking the committee’s endorsement of work to reduce the number of smokers in Kent, including a needs assessment and review of support services.  

Ms D Smith, Public Health Specialist, was in attendance for this and the following two items.

1.               Ms Smith and Mr Scott-Clark introduced the reports for this and the following two items and highlighted the following key points:-

Stop Smoking Services:

a)    statistics for quits cited in the stop smoking report were based on self-reporting and were therefore estimates, although more was known about the numbers seeking to quit and the methods they sought to use;

b)    Kent generally had a good rate of smoking quits, 51%, and this compared well to the national average;

Smoking in Pregnancy:

c)    work being undertaken had so far produced a number of successes and it was planned that this work would be rolled out across the county;

Illicit Tobacco in Kent:

d)    the public health team was working together with trading standards colleagues to tackle the supply of illicit tobacco in Kent; and

e)    it was known that this supply was closely linked to organised crime.

2.               They then responded to comments and questions from Members, including the following:-

a)    smoking was not the only way to ingest tobacco but other forms of tobacco such as chewing tobacco and snuff were not mentioned in reports about smoking.  These methods still involved nicotine and still caused cancers. Smoking was by far the most prevalent method of taking tobacco into the body. Other methods could be looked into as part of future work but were not expected to be as significant an issue as smoking.  Vaping had been identified by Public Health England as being 95% as safe as smoking, and other chemicals in cigarettes were more responsible than nicotine for causing cancers. NHS England supported the inclusion of vaping as part of a programme to stop smoking; 

b)    concern was expressed that children, girls in particular, were still taking up smoking, many of them at school. The cost of tobacco products must surely be difficult for children to afford.  Campaign work should target young people and dissuade them from starting to smoke.  Illicit cigarettes were often very cheap, and suppliers would target children   Although work was being done with schools to address the problem, one good way to stop children from smoking was to dissuade their parents from smoking, using campaigns such as smoke-free school gates; 

c)    the costs per head of quitting services delivered in Kent and Surrey varied due to the amount of therapy each quitter was given, some requiring more than others, and the number of quitters coming to the services to be served within the finite resources and funding available.  Surrey received less funding per head than Kent and, as a result, operated a smaller overall service than Kent. Stop Smoking services were a major indicator of health inequalities across the south east;

d)    asked how a health visitor would approach the task of talking to a pregnant woman about giving up smoking, it was explained that a mother would be asked if she was aware of the dangers smoking posed to her unborn child, and a health visitor would then seek to increase her knowledge and understanding of the dangers, using facts and figures.  Advisors were trained to national gold standard to do this effectively. Anyone not responding to a referral to a clinic appointment would receive an offer of a home visit from a health visitor, which would normally be taken up, as many women found a home visit more convenient than attendance at a clinic.  The ‘What the Bump’ campaign, to raise awareness of the dangers of smoking in pregnancy, would be included in future campaigns to raise its profile;

e)    the report and the work going on to address smoking prevalence were welcomed, but the point made that anyone feeling that they desperately needed a cigarette would not care at that moment about its damaging effects. People needed to be educated to reduce their dependence on cigarettes. Smoking was an addiction rather than a lifestyle choice and needed treatment to address it;

f)     some Members of the committee related their own experiences of smoking in the past and their reasons for giving up.  For some it was the realisation that they were putting their health at risk, for example with an increased risk of heart attack, while for others it was the advent of parenthood and concerns about giving children as healthy a start as possible;

g)    the role of a pregnant woman’s partner in supporting her to give up smoking had not been mentioned, but it would be very difficult for her to give up if her partner continued to smoke. Health visitors had noted when checking a woman’s carbon monoxide readings that having another smoker in the house would raise her reading. Support was available for partners wishing to give up. An example was given of a family recording high carbon monoxide readings, where it was realised that those levels were being caused by a faulty boiler in the family home. The family was then supported in getting this fixed;

h)    a question was raised about the attainability of the targets set out in the report for the reduction in the number of smokers by 2022, and if this high target wasn’t tempting failure.  Pilot programmes had been set challenging targets, but these targets were achievable if work were to start promptly now;

i)     asked how passive smoking would be addressed, it was explained that smoke-free school gates, parks and play areas, and smoke-free homes, sought to reduce the extent to which children could breathe in second-hand smoke;

j)     a popular belief was that smoking relieved stress but in fact it actually caused stress by causing blood levels to fluctuate dramatically.  Observation of smokers with mental health problems had shown that their levels of aggression dropped when they gave up smoking; and

k)    it was hoped that current projects and successful work could be continued and made more sustainable by achieving ongoing funding for the health visiting service and other areas of work, which had yet to be secured.

3.                     The Cabinet Member for Adult Social Care and Public Health, Mr Gibbens, thanked Members for their comments and asked that they consider supporting their local smoke-free school gates campaign using their Member grant money.    

4.            It was RESOLVED that:-

a)     the contents of the report be endorsed and Members’ comments, set out above, be noted;

b)     the proposal of the Smoking Plus model and Kent’s ambition of achieving 45,000 fewer smokers by 2022 be supported;

c)      the needs assessment and review of the stop smoking services currently being undertaken be acknowledged; and

d)     a further paper be submitted to the next meeting of the committee on the outcomes and recommendations of the Stop Smoking review, which would propose an effective model of smoking cessation provision to meet the needs of smokers wanting to quit.