1. Mission (Im) Possible ? Prevention, Protection and Cessation with Young People Chris Chappell, Health Improvement Manager Blackwater Valley and Hart PCT Sarah Preece, Co-ordinator Smoke Free Hampshire and Isle of Wight

2. Introduction Adult smoking prevalence declined from 39% in 1982 to 27% in 2002. No change in smoking prevalence among young people. Huge impact on health of young people.

3. Rates of Smoking 1. How many young people start smoking every day? Answer: Approx 450 young people start smoking every day. (Ref: Smoking and the Young, Royal College of Physicians. London, RCP, 1992)

4. Rates of Smoking 2. What percentage of adult smokers start before age 15? Answer: 80% of adult smokers start smoking during adolescence and continue into young adulthood (Ref: Callum, HEA, 1998).

5. Rates of Smoking 3. What percentage of 15 year olds in England smoked regularly in 2002? Answer: 23%: 21% of boys and 26% of girls (Ref: Statistics on Smoking: England 2003, Department of Health).

6. Rates of Smoking (Prevalence of regular smoking by age) Office for National Statistics smoking amongst secondary schoolchildren surveys, 1996 from Nicotine Addiction in Britain, RCP, 2000.

7. Rates of Smoking 4. Have rates of smoking among young people gone up or down in the past 20 years? Answer: Rates have gone up and down over the past 20 years, but are now approximately the same as in 1982 (1982: 11% v. 2002: 10% of 11-15 year olds [9% boys and 11% girls] smoking regularly) (Ref: Drugs use, smoking and drinking among young people in England. Department of Health).

8. Rates of Smoking (Trends in Prevalence of regular smoking, 11-15 year olds) Drug use, smoking and drinking among young teenagers in 1999. National Statistics, 2000. Drugs use, smoking and drinking among young people in England in 2001. DoH press release

9. Smoking Habits 5. Why do young people start smoking? Answer: Peers smoking –Best friend / girl/boyfriend –Friends –Peers (e.g. classmates) Parental/sibling smoking Female sex Social deprivation Policies on smoking (protective) Advertising/films

10. Nicotine Addiction 6. How many cigarettes does it take to be addicted to nicotine? Answer: Teenagers have similar levels of addiction to adults ‘once you have smoked 4 or more cigarettes, you are likely to become a regular smoker’ (Ref: Leventhal & Cleary 1980). Symptoms of addiction can develop within weeks of the first cigarette (Ref: DiFranza, Tobacco Control, 2000).

11. Nicotine Addiction Answer: 50% of young adult smokers will still be smoking at 60 years old. (Ref: Nicotine Addiction in Britain, RCP, 2000). 7. What percentage of young adult smokers will still be smoking at 60?

12. Nicotine Addiction 8. Is giving up easier for young people than for adults? Answer: No: 58% 11-15 year old regular smokers say ‘difficult to go without smoking for 1 week’ and 72% ‘difficult to give up altogether’ (Ref: Drugs use, smoking and drinking among young people in England. Department of Health, 1999).

13. Giving Up Smoking 9. What percentage of young people want to give up smoking? Answer: Nearly half of adolescent smokers say that they would like to stop smoking. (Ref: Higgins, ONS, 1999).

14. Smoking Cessation 10. What research has been undertaken regarding effectiveness of smoking cessation and young people? Answer: 1.Nottingham - Teenage schools smoking study and CRUK Zone Project, using NRT – results? 2.Cardiff University Smoking Prevention in Schools – school smoking policies and peer-led intervention

15. Points for Consideration Cessation Smoking cessation services Definition of success Lack of targets/funding Best practice guidance Rates of cessation by age, social class, education Carbon monoxide or cotinine Teachers’ knowledge & attitudes Quit Breakfree

16. Points for Consideration Prevention Speed of nicotine addiction School policies Myelination Stress Influences Healthy Schools Scheme