1. Addressing Tobacco Issues in South Tyneside Ruth McKeown, Director Public Health Mark Overton, Head Health Inequalities South Tyneside PCT

2. Smoking and Inequalities Major health inequalities –Smoking 5 times higher among manual workers –People on low incomes spend disproportionate amount of their income on cigarettes (15%) –Smoking higher among pregnant women under 20 –Smoking levels higher among people with mental health problems (up to 80%) –Ethnic minorities (Bangladeshi men 45%) Decline in smoking in recent years mainly among over 30s and higher social groups

3. Smoking Related Disease –17% of all heart disease deaths –80% of deaths from bronchitis and emphysema. –30% of all cancer deaths –80% of lung cancer deaths Smokers also face a higher risk than non- smokers for a variety of illnesses e.g. Crohn's disease, impotence, osteoporosis, asthma.

4. Smoking Related Illnesses In South Tyneside Lung cancer rates are 77% higher than the national average Circulatory Disease 21%

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6. Local success through the Gateshead and South Tyneside Smoking Cessation Service Local services established throughout region in 1999-2000 Service in South Tyneside has been operational from January 2000 Follow strong evidence base using national smoking cessation guidelines and standards The Service is operated by South Tyneside PCT across both Gateshead and South Tyneside

7. Service availability 94% of South Tyneside doctor practices Local hospitals- staff and patients Local maternity units Local largest workplaces (Councils) Half of local community pharmacies All local centres for families and carers of under 5s (Sure Start’s) Clients’ homes Various community centres for groups

8. Service results- 4 week quitters

9. Service results Service met all key targets to date - in 2001/2 recorded highest number of 4-week quitters per 100,000 in England Service follows up clients of Specialist Advisors for up to 12 months- 19% remained abstinent for 12 months in 2001 (not a single puff on a single cigarette!) Department of Health’s view ‘excellent’ Service selected as English best practice model by Department Health and in August presented at 12 th World Conference on Tobacco or Health in Finland

10. Service User feedback Survey undertaken March-May 2003 with 191 respondents. Rating of help and advice 68% excellent; 19% very good; 13% good Various comments such as- ‘The advisor has been a credit to the service….’ ‘After 40 years of smoking, I am now a non-smoker thanks to the support I have received’. ‘I think the Service was very good and I don’t think it could be any better’.

11. Future Targets National targets set to reduce smoking rates in young people, adults, manual groups and pregnant women. A key national target is to achieve 800,000 4-week quitters from 2003-2006 Local Delivery Plan targets (as set by South Tyneside HA) –2003/4 868 4-week quitters –2004/5 973 4-week quitters –2005/6 1079 4-week quitters –TOTAL 2,920 4-week quitters LPSA Targets 2003/2006 3533 4-week quitters 2003/2006 68 4-week Pregnant quitters

12. Summary Smoking is an inequality in health issue South Tyneside has one of the best cessation services in the country There is increasing evidence that comprehensive tobacco control programmes are the most cost effective way of making significant reductions in diseases: Programmes can deliver rapid benefit with increasing cumulative effect and reduce health care demand There is a need in South Tyneside and across the North East for greater tobacco control.

13. Recommendation Promote and support the local Smoking Cessation Service That Tobacco Control becomes a Local Strategic Partnership priority Support the Tobacco Control proposals: endorse the StHA bid lobby for smoke-free public places e.g. restaurants, shopping centres, pubs, workplaces, Customs House help workplaces have a properly implemented smoke-free policy support the local tobacco control alliance

14. Coal dust gave us pneumoconiosis and lung disease

15. Asbestos gave us asbestosis and mesothelioma

16. Tobacco gave us lung cancer, heart disease, stroke, vascular disease, obstructive airways disease, throat cancer, stomach cancer, bladder cancer …….

17. Tobacco is the leading cause of industrial disease in the North East