Health and Wellbeing Board	28^th October 2020
Report author: Peter Roderick, Acting Consultant in Public Health, Vale of York CCG / City of York Council

York Tobacco Control Plan and Smokefree Playparks scheme

Summary

1. This report summarises the York Tobacco Control Plan, included as an appendix, and the council’s Smokefree Playparks scheme.

Background

2. A large amount of preventable ill health and early mortality in the city relates to smoking and tobacco use. The Health and Wellbeing Board has previously committed to partnership efforts to reduce smoking rates in York, and through the public health team in the council smoking cessation services are provided with the aim of giving residents the best chance of quitting through an evidence-based intervention from a stop smoking advisor.

3. In 2019, a number of partners in the city came together to form the York Tobacco Control Alliance, and after a year of operation the Alliance has produced a draft Tobacco Control Plan for York. This plan is included for endorsement at today’s Health and Wellbeing Board meeting.

4. In addition, as an early action arising from this work, members of the Health and Wellbeing Board are asked to note the council’s proposed Smokefree Playparks scheme, and consider other ways in which

Main/Key Issues to be Considered

York Tobacco Control Plan 2020-2025

5. The plan (attached) sets out the recent trends in smoking within our population, and the negative impact of smoking on a variety of aspects of life in our city. It puts forward a vision for smoking rates in York to reduce to 5% of the population in 2025, and lays out actions which are recommended to support this vision.

6. Smoking is the leading cause of preventable death worldwide, killing half of all lifetime users. Currently, 11.9% of the York adult population smoke (over 20,000 smokers), which resulted in over 700 deaths in the city between 2016 and 18, 1690 hospital admissions in 2018/19, and costs the economy (through healthcare costs and lost productivity) nearly £40m a year.

7. Smoking also increases the risk of severe symptoms and hospitalisation in those who become infected with COVID-19. Partners have actively supported the Quit for Covid campaign and actively promoted Public Health England’s ‘Today is the Day’ campaign which recognises that during the COVID-19 crisis, supporting people to live healthier lives has never been more important, and quitting smoking is the best thing you can do to protect your health.

8. The Tobacco Control Pan lays out a set of actions under three headings:

Priority #1: Prevent people from starting smoking, including Curriculum development and educational work, enforcement activity and work to tackle the trade in illicit tobacco, smokefree outside zones

Priority #2: Increasing the proportion of smokers attempting to quit, including promoting smoking cessation services in York, treating tobacco dependency in hospital settings, promoting cessation in primary, social and community care, Very brief advice, and work to reduce smoking in pregnancy

Priority #3  Increasing the success rate of smokers attempting to quit, including delivering high quality smoking cessation services, integrating universal smoking cessation services with specialist services, smokefree homes, vulnerable people, workplace policies

9. The plan includes as an appendix a position statement on e-cigarettes which has been produced by the public health team based on evidence and national guidance, and endorsed by the Alliance.

Smokefree Playparks Scheme

10. Smokefree legislation was introduced nationwide in 2007 for indoor public spaces, for example pubs and bars. Following the legislation, studies on the exposure of bar-workers to harmful tobacco smoke showed reductions of 80% to 90%. In the year following smokefree legislation, there was a 2.4% reduction in hospital admissions for heart attack. That meant 1,200 fewer emergency admissions in a single year. In the three years following the law’s introduction, there were almost 7,000 fewer hospital admissions for childhood asthma. The smokefree law, and the campaign that supported it, also helped to change attitudes and behaviour on smoking. An extra 300,000 smokers were inspired to make a quit attempt as the law came into force (ASH Briefing 2017: ‘10 years of smokefree legislation: the facts’).

11. As well as reducing exposure to second hand smoke, when smoking is no longer ‘normalised’ in visible settings this encourages smokers to smoke less and can trigger attempts to quit.  Children are also less likely to take up smoking if those around them don’t smoke. Research has shown that even preschool children who observe their parents smoking have already learnt that smoking is appropriate or normative in social situations (Brenner 2018). Evidence suggests that if young people don’t start using tobacco by the age of 26 they will almost certainly never start (Breathe 2025).

12. This has led to a number of areas adopting voluntary smokefree zones in key outdoor places not covered by current smoking legislation, for example Barnsley’s Smokefree town centre and Wakefield’s Smokefree play areas.

13. The council are proposing that after consultation, from the start of 2021 CYC-managed play area are designated as smokefree zones. This would be indicated through communication and publicity, and through appropriate signage at each play area. The arrangement would be governed through a voluntary code and would not be enforceable; however experience from other areas suggests that the power of social norms (e.g. highlighting local public support for smokefree zones in areas children play) and appropriate signage leads to a large drop in levels of smoking in those areas.

Consultation

14. The Tobacco Control Plan has been written by a number of different organisations and a number of different departments in the council, and all have been consulted in its contents. Partners involved in the York Tobacco Alliance include CYC, North Yorkshire Fire and Rescue Service, North Yorkshire Police, York Teaching Hospitals Trust, Tees Esk and Wear Valley NHS FT, Vale of York CCG, York against Cancer, and Community Pharmacy North Yorkshire, as well as a number of others on our mailing list.

15. The Smokefree playpark scheme will be introduced after a public consultation hosted on the council’s website and advertised through media, ward committees, Friends of Parks groups, and through targeting specific groups e.g. current smokers, parents and uses of play area, and other partners. The intended timescale for the consultation will be:

Opening:                                            November 2020

Duration:                                            Four weeks

Analysis of results:                            December 2020

Decision and implementation:          January 2021

Options      

16. Options for the Health and Wellbeing Board are:

a) Endorse the Tobacco Control Plan and note the Smokefree Playparks Scheme

b) Decline to note and approve these items

Analysis

17. Declining to approve these items would mean a missed opportunity for the Board  to support multi-agency work to improve the health and wellbeing of the York population.

Strategic/Operational Plans

18. This proposal is in line with the Council’s Plan 2019-23, to ensure Good Health and Wellbeing through a broad range of opportunities to support healthy lifestyles. The York Health and Wellbeing Strategy 2017-2022 specifically commits to ‘make sustained progress towards a smoke-free generation in York’. This proposal also aligns with the Council’s Health in All Policies approach whereby public health encompasses not just a set of services or work done by a single team, but runs through all city policies and practice and aims to improve the wider determinants of health.

        Implications

· Financial

The Smokefree playparks scheme includes a small investment in signs which will be part of routine capital investment in the city’s play areas

· Human Resources (HR)

There are no HR implications

· Equalities

People in routine and manual occupations in York are twice as likely to smoke as those in other occupational groups. This is one of the major causes in the life expectancy and healthy life expectancy gap between the poorest and most affluent member of society. Supporting and enabling people to quit and protecting children from the harms of smoking with disproportionally benefit people from lower socioeconomic backgrounds, and decrease health inequalities.

· Legal

There are no legal implications

· Crime and Disorder

There are no crime and disorder implications

· Information Technology (IT)

There are no IT implications

· Property

There are no property implications

        Risk Management

19. There are no risks identified associated with the recommendations below

        Recommendations

20. The Health and Wellbeing Board are asked to:

i. Endorse the York Tobacco Control Plan 2020-2025

Reason: So that local partnership efforts to tackle the rate of smoking in the city are supported, and the health of the population improved

ii. Note the Smokefree Playparks scheme

Reason: To support efforts to de-normalise smoking and make it invisible to the current generation of children in our city’

Reason:

Contact Details

Author:	Chief Officer Responsible for the report: Fiona Phillips, Assistant Director of Public Health, City of York Council
Peter Roderick Acting Consultant in Public Health Public Health City of York Council 01904 551479
	Report Approved	ü	Date	15.10.2020
Wards Affected:					All	ü
For further information please contact the author of the report

Annexes

Tobacco Control Plan for York