Agenda item

To receive a report from the Deputy Leader and Cabinet Member for Strategic Commissioning and Public Health and the Director of Public Health, setting out current patterns of smoking and measures to tackle this and tobacco control. The committee is asked to comment on and endorse this work.

Ms D Smith, Public Health Specialist, was in attendance for this item.

1.               Ms Smith introduced the report and, with Mr Scott-Clark, responded to comments and questions from Members, including the following:-

a)     asked if the 40% of adults with serious mental illness who smoked could be using tobacco as a form of medication, and if they could be helped to find alternative support, such as mindfulness, Mr Scott-Clark advised that mental health trusts had a stated aim of reducing smoking among patients as this had been proven to reduce aggression and anxiety. Statistically, people with mental illness had poorer health outcomes and lower life expectancy as their tendency to smoke made them vulnerable to contract and die of other illnesses. Addressing addiction of any sort would always form apart of good medical care;

b)       asked about research and current thinking on the safety of vaping, Mr Scott-Clark advised that Public Health England took the view that there was no evidence that vaping was safe in the long-term.  Clinicians supported the use of vaping as part of an attempt to quit smoking as it was seen as being safer than tobacco, and vaping could be used to administer some drugs, for example, for asthma.  However, while vaping could not be guaranteed to be completely safe, there was certainly no safe level of tobacco intake;

c)    insurance providers did not view vaping as a long-term alternative to smoking and would not reduce insurance premiums for vapers;

d)    concern was expressed that people quitting smoking might replace tobacco with some other substance, which could prove more damaging, but Mr Scott-Clark explained that it was hard to identify any causal relationship between giving up tobacco and turning to other substances. There was no evidence of a generation of young people who had never smoked but had adopted vaping as a habit.  He reassured Members that vaping shops operated under a strict national code of practice which stated that anyone who had not previously smoked should not be given vaping products containing nicotine;

e)    concern was expressed at the number of school children seen smoking outside school gates and the view put forward that what was needed to deter them was to show, perhaps as part of PHSE lessons, graphic images of the physical damage smoking could do.  Mr Scott-Clark set out the measures taken in recent years to reduce the attraction of cigarettes, including plain packaging featuring graphic images and cigarettes in shops being locked out of sight behind shutters. He added that the STP targeted the groups among which smoking was most prevalent, including the lowest paid and manual workers, and pregnant women.  The availability of illicit tobacco was a large problem in the South East and it was suggested that a report on this subject be submitted to a future meeting of the committee;  

f)     some people were more susceptible to addiction and this could be a matter of genetic predisposition. Clinicians supported this view and treated smoking as an addiction rather than a social issue.  Specialist services were commissioned to address addiction;

g)    education was a key issue, and it was known that, if a young person could get to the age of 16 without starting to smoke, they would be much less likely to smoke or use other substances in adulthood;

h)    concern was expressed that education of young people should be left to professional educators, and Ms Smith confirmed that the public health team was working with youth workers to encourage young people to quit.  However, some young people already addicted were resistant to this encouragement, and graphic images on packaging, with the hard-hitting message ‘Smoking Kills’ did not have the desired impact;

i)     a view was expressed that, alongside the figures for smokers and quitters, it would be helpful to acknowledge and show the number of people who had never smoked;

j)     concern was expressed about the number of medical staff, as well as patients, smoking outside hospital premises.  The NHS could be trying to treat one condition while the patient further damaged their health by smoking.  Mr Scott-Clark advised that several health trusts were working toward being totally smoke-free in the near future. He explained that the NHS could not use any patient’s lifestyles choices as a reason to refuse them treatment;

k)    health visitors would support expectant mothers not to smoke throughout their pregnancy and onwards through the child’s formative years, so a child had a chance to grow up in a smoke-free environment; and

l)     Mr Scott-Clark advised that the figures shown in the report for adult smoking prevalence across the districts of Kent were gathered from surveys and hence were not necessarily a reliable indicator of percentage of population.

2.         It was RESOLVED that the information set out in the report, and given in response to comments and questions, be noted, and local measures being taken to tackle smoking and tobacco control be endorsed.