Agenda item

Joint Report of the Corporate Director Adult and Health Services, DCC and the Director of Public Health, DCC.

The Board received a report on Tobacco Control presented by the Public Health Advanced Practitioner, Katie Bewick (for copy see file of minutes).

The Public Health Advanced Practitioner noted that smoking prevalence in County Durham was estimated to be 16.2 percent, which was higher than the regional and national prevalence.  She noted that in reducing prevalence there was a focus on key priority groups including pregnant smokers, routine and manual workers and people with severe mental illness.  She explained that in 2021/22, County Durham had the highest rate amongst North East local authorities, with 1 in 6 pregnant mothers smoking at the time of delivery.  It was explained that smoking prevalence rates were higher in adults with a registered severe mental illness, than the general population.

It was noted that in County Durham 31 percent of the population have a registered severe mental illness compared to the population prevalence of 14.3 percent and therefore it was a key priority group to support to stop smoking.  She explained that the number of smokers in routine and manual occupations had risen over the last three years and work was taking place to reduce demand and the supply of illegal tobacco products, increasing price and addressing the supply of tobacco to children.  The Board noted that a vaping communications toolkit had been developed to ensure there were clear, consistent communications across the North East and this would be followed up locally with a specific virtual event on 30 March, which would focus on vaping, with members of the Board invited to attend.

Councillor R Bell noted that the target as regards five percent, was very ambitious and asked, when looking at groups such as those with mental health issues, smoking while pregnant, and manual workers if there was any information on why rates were higher in those groups.  The Public Health Advanced Practitioner noted that the targets were not just for County Durham, they were national and noted that many of the issues were linked to health inequalities and other issues in addition to smoking.  It was noted there were stop smoking communications and service available, including ASH (Action on Smoking and Health), with guidance for Local Authorities and help to be able to embed at place. 

Peter Sutton noted the disparity in prevalence, as set out in the table within the report and asked if there was anything County Durham could learn from North Tyneside, or whether the issue was simply linked to deprivation.  The Public Health Advanced Practitioner noted arrangements that were in place as regards standardising across their Foundation Trust rather than local ‘stop smoking services’.  The Chair asked if higher prevalence in manual workers was linked to the ability to gain extra breaks as a smoker.  The Public Health Advanced Practitioner noted that there was a clear link to deprivation, less income, social housing, health inequalities.

Dominic Gardner noted that TEWV had been ‘smoke free’ since 2016 and noted that those with severe mental health issues typically died 10-15 years early than those without and noted that it was difficult to tackle at the in-patient stage and therefore it may be more useful to tackle within the community.  The Public Health Advanced Practitioner noted that many routes needed to be looked at.

The Programme Director - Children & Young People's Integrated Services, CDCP noted that looking at tackling smoking during pregnancy, it was useful to look to prevent smoking at an earlier point, therefore working in schools to stop girls from starting smoking.  The Public Health Advanced Practitioner explained that there was briefing advice in schools and colleges, including branching out into other areas, such as reproductive health, contraception and fertility advice.  She added it was a workstream within the Tobacco and Alcohol Health Working Group.

Rachael Stray noted a pilot scheme relating smoking when pregnant at the CDDFT, and a scheme in Manchester that had taken place.  She added that there was information out on ward and with maternity specific work too, with Midwives carrying CO₂ readings for example.  She noted that CDDFT was committed to reducing those health inequalities.

Andrea Petty noted that messaging was important not only in terms of health, but also linked to poverty, and that further information on the messaging would be useful for the Board.  The Public Health Advanced Practitioner noted the work of Fresh.  The Head of Integrated Commissioning noted that the ‘continuity of care’ pilot had made a big difference and noted that the relationship between midwives and pregnant women was very important, with Rachael Stray noting a hybrid model at CDDFT.

Resolved:

(a)That the contents of the report and support a renewed emphasis on tobacco control work to address the smoking prevalence across the County be noted.

(b)That the Board continue to support the work of the Tobacco Control Alliance to deliver on its actions, which include the recommendations from the Khan Report.

(c)  To champion Tobacco Control to become everyone’s business.

(d)To champion stop smoking advice and support to become a core part of all council directorates including, but not limited to, social care and housing.

(e)To support with the vaping agenda, ensuring that there is consistent communication and language used about vaping, using the ADPH communications guidance, ensuring that all communications are approved in advance by the Director of Public Health.