1. The effect of socioeconomic differences on smoking uptake in young people in a low prevalence smoking area Emma Regan And Linda Homan The effect of socioeconomic differences on smoking uptake in young people in a low prevalence smoking area Linda Homan and Emma Regan

2. The effect of socioeconomic differences on smoking uptake in young people in a low prevalence smoking area Emma Regan And Linda Homan Concerns regarding the high percentage of smokers in certain areas of Essex highest on the English Indices of Deprivation (IMD). ‘Overall in Essex it is estimated that 25.1% of the 20% most deprived communities smoke compared to only 17.5% in the remaining 80% of the population. The prevalence is estimated to be as high as 33.6% in the most deprived communities of Tendring.’ (EJSNA, 2013, p. 8).

3. The effect of socioeconomic differences on smoking uptake in young people in a low prevalence smoking area Emma Regan And Linda Homan Overall differences in life expectancy between HDAs and LDAs of 7.3 years for men and 4.9 for women (PHE, 2013). However, a closer look is more revealing.

4. The effect of socioeconomic differences on smoking uptake in young people in a low prevalence smoking area Emma Regan And Linda Homan Life Expectancy variations in Essex PCT Areas AreaOverall difference North East Essex13.3 years South East Essex8.6 years Mid Essex9.3 years. West Essex5.4 years South West Essex5.3 to 4.8 years

5. The effect of socioeconomic differences on smoking uptake in young people in a low prevalence smoking area Emma Regan And Linda Homan Method: The two phases involved focus groups and semi-structured interviews followed by a county wide survey carried out in the 14 districts of Essex.

6. The effect of socioeconomic differences on smoking uptake in young people in a low prevalence smoking area Emma Regan And Linda Homan The effect of socioeconomic status on: Family: There is a significance of living in a smoking household both in high deprivation areas (HDA) (Χ 2 = 9.96, df = 1, p = 0.001), and low deprivation areas (LDA) (Χ 2 = 37.24, df = 1, p <0.001). Mum smoking for HDA areas was 34.1% compared to half that for the LDA schools at 17%. Dad smoking was similar and 40.4% of HDA school pupils reported that dad smoked compared to 21.1% of LDA pupils Young people are 2.08 times as likely to smoke if they do not live with both parents compared with those who live with both parents.

7. The effect of socioeconomic differences on smoking uptake in young people in a low prevalence smoking area Emma Regan And Linda Homan The effect of socioeconomic status on: School / best friend / peer smoking: The results show that there is a significant association between the type of school and the incidence of smoking (Χ 2 = 7.64, df = 1, p = 0.007). Out of school friends smoking: young people are 5.0 times more likely to smoke if out of school friends smoke. Young people are 5.8 times more likely if school friends smoke. If best friends smoke, then the influence was strongest (6.5 times more likely to smoke).

8. The effect of socioeconomic differences on smoking uptake in young people in a low prevalence smoking area Emma Regan And Linda Homan Interesting proposals for Stop Smoking services and schools Key implications from the research  Young people from a smoking household are more likely to smoke regardless of socioeconomic status  Parent’s smoking behaviour was approx twice as high in HDA  Family smoking has MORE influence in LDA  Young people are twice as likely to smoke if they don’t live with both parents  If their best friend smokes they are 6.5 times more likely to take up smoking.  *64.6% of young people (regardless of socioeconomic status) thought that most people today smoke.

9. The effect of socioeconomic differences on smoking uptake in young people in a low prevalence smoking area Emma Regan And Linda Homan Preventing uptake and reducing prevalence KS 2, 3 & 4 PSHE lessons & risk management Highlighting perceptions and influences of family & friends Promotion of service for YP and parents at every contact Use of peers & YHC’s Encouraging schools to follow NICE guidance e.g. comprehensive school stop smoking policy In-house school or specialist stop smoking advisers able to work with both YP & families Specific smoking cessation programme for YP Targeting schools in HDA Targeting students in exclusion units/CSS PREVENTION CESSATION

10. The effect of socioeconomic differences on smoking uptake in young people in a low prevalence smoking area Emma Regan And Linda Homan Prevention - KS 3 (11-14 yrs) Tackling perceptions

11. The effect of socioeconomic differences on smoking uptake in young people in a low prevalence smoking area Emma Regan And Linda Homan Prevention – KS 4 (14-15 yrs)

12. The effect of socioeconomic differences on smoking uptake in young people in a low prevalence smoking area Emma Regan And Linda Homan Cessation

13. The effect of socioeconomic differences on smoking uptake in young people in a low prevalence smoking area Emma Regan And Linda Homan FFS toolkit

14. The effect of socioeconomic differences on smoking uptake in young people in a low prevalence smoking area Emma Regan And Linda Homan Limitations  Academies (often in HDA’s) can be reluctant to accept health & wellbeing support.  Disparity in school advisors role i.e. many do not work with families outside of the school setting  Schools in LDA’s have less capacity for family support workers  High adult smoking = higher YP smoking  SSSS constraints

15. The effect of socioeconomic differences on smoking uptake in young people in a low prevalence smoking area Emma Regan And Linda Homan Future work  Develop the prevention/cessation work to reflect more detailed aspects of the research findings  Follow up original research by providing bespoke prevention sessions to those schools in KS3 and assessing again in KS4.  Work closer with partners (e.g. the PSHE forum/risk avert initiative)  Develop the family quit programme and target parents in HDA schools to quit

16. The effect of socioeconomic differences on smoking uptake in young people in a low prevalence smoking area Emma Regan And Linda Homan Thank you! ANY QUESTIONS? Linda Homan – linda.homan@anglia.ac.uklinda.homan@anglia.ac.uk Emma Regan – emma.regan@acecic.nhs.ukemma.regan@acecic.nhs.uk