Topic Report: Smoking and tobacco control

Local stop smoking services (SSS) provide a highly cost-effective approach to help people quit smoking. SSS form a key part of improving health outcomes and reducing the health inequalities gap, as well as significantly improving people’s chances of quitting smoking for good. Most smokers say they want to quit but without support, 75% of quit attempts end in relapse within a year (source: Attempts to quit smoking and relapse: Factors associated with success or failure from the ATTEMPT cohort study. Addictive Behaviours).

To support people to stop smoking in Buckinghamshire, Buckinghamshire Council Public Health commissioned an integrated lifestyle service which offers free, evidence-based stop smoking support. SSS have been in place in Buckinghamshire since 2012. The service offers 12 weeks of behavioural support, as well as free access to quitting aids such as Nicotine Replacement Therapy (NRT) and E-cigarette starter kits.

During 2020/2021 the Buckinghamshire SSS supported 410 people to successfully quit smoking, the trend is shown in the chart below with numbers reducing nationally, although at a faster pace in Buckinghamshire. Over the last 10 years the absolute number of successful quits has reduced by 81% in Buckinghamshire compared to 74% nationally. However, it is important to note, as shown in the charts below, the proportion of successful quitters (from those who have set a quit date) has increased slightly nationally across the time period and fluctuated within Buckinghamshire but remaining above 50%.

Source: Statistics on NHS Stop Smoking Services in England.

Source: Statistics on NHS Stop Smoking Services in England.

As well as stop smoking support, the service can also offer support for a wide range of lifestyle issues (such as losing weight or getting more active). Nationally, in 2020/21 more women set a quit date than men however more men successfully quit (62% compared to 57% for women). There were also higher quit rates for men and women in those aged 45 and over (63% and 60% respectively). The dashboard is available at Microsoft Power BI.

Those using an e-cigarette alongside Nicotine Replacement Therapy (NRT) achieved the highest success rates for quitting.

The COVID-19 pandemic quickly changed the way people interact with SSS. More smokers wanted to access virtual support rather than visiting the service in person. To adapt to this, the local SSS started offering remote (phone or via video) appointments and posting out quitting aids directly to clients. Despite this shift in delivery, there hasn’t been a decrease in quit rates. Clients are finding the service easier to access as phone support is often more convenient.

The Buckinghamshire Tobacco Control Strategy – Towards a Smokefree Generation (2019 – 2024) sets out the local ambition for achieving a smokefree generation. This strategy aims to ensure that children and young people are discouraged from taking up smoking, all smokers in Buckinghamshire are supported to stop smoking, and the supply and demand of illicit tobacco is reduced. There is a particular focus on engaging those communities where smoking rates remain high.

The strategy recognises that everyone has a role to play in ensuring that tobacco-related harm is reduced within Buckinghamshire, whether in schools, the workplace, the community or within hospitals. The strategy provides a clear set of areas for action, that have been translated into an annual action plan that is developed via the Buckinghamshire Tobacco Control Alliance (TCA). The TCA consists of a wide range of stakeholders, including the NHS and Voluntary, Community and Social Enterprise (VCSE) sector. All partners work together to achieve a common goal, and the TCA meets to discuss progress and plans quarterly.

To support the themes within the Strategy there is a TCA annual action plan, with partners working together to tackle wider tobacco control work in Buckinghamshire.

Some of the work within the action plan includes:

• developing and promoting new local campaigns that promote smokefree environments
  • smokefree sidelines – no smoking at Youth football matches
  • smokefree parks & playgrounds
  • illegal tobacco campaign highlighting the dangers to local communities
• supporting the NHS to deliver the NHS Long Term Plan for Tobacco Dependency Services
• promoting mass media campaigns such as Stoptober (no smoking for October)
• sharing information on E-Cigarettes with schools and other professionals
• reviewing smoking policies at workplaces