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NPHS Staff Conference 2008 Targeting Stop Smoking Wales Services Gareth Davies, Mererid Bowley. Development within SSW. PID Organisational Development Service Delivery and Operational Matters Human Resource Management Core model Accredited training Data Targeting Services.
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NPHS Staff Conference 2008Targeting Stop Smoking Wales ServicesGareth Davies, Mererid Bowley
Development within SSW • PID • Organisational Development • Service Delivery and Operational Matters • Human Resource Management • Core model • Accredited training • Data • Targeting Services
On tobacco, the OTPH1 says“It will be one of the most perplexing mysteries for future historians to understand how societies with high levels of scientific expertise, analytical inclinations, communication abilities, demonstrated interest in health for people in the aggregate, and repeated claims to be concerned about the health and well being of children could have allowed money and power to blind the entire society to the importance of health”.
Smoking Kills2 Smoking kills 13+ people per hour For every 1000 20 year old smokers
Beyond Smoking Kills3 Smoking costs the NHS £2.7 billion annually “There is a terrible gap in life expectancy between the richest and poorest in British society. Smoking is by far the biggest single factor, accounting for half the difference.”
Contacts Smoker contacts service Attends assessment session? No contact only Yes Attends at least 1 treatment session? No contact only Yes Treated smoker
Treated Smokers TS Lost to follow up at 4 weeks Self assessment made at 4 weeks? No Lost to follow up at 4 weeks Yes Failed quit attempt Self assessed as quitter at 4 weeks? No Failed quit attempt Yes CO validation attempted at 4 weeks? Self reported 4 week quitter No Self reported 4 week quitter Yes Failed quit attempt CO validation successful at 4 weeks? No Failed quit attempt Yes CO verified 4-week quitter
SSW deprivation analysis SSW data Geo data WIMD data WHS data ONS data Smokers Deprivation
Contacts, males, aged 16+, by WIMD fifth (excl. health): 2007/08Data sources: SSW, WAG, ONS
Contacts, females, aged 16+, by WIMD fifth (excl. health): 2007/08Data sources: SSW, WAG, ONS
Treated smokers, males, aged 16+, by WIMD fifth (excl. health): 2007/08Data sources: SSW, WAG, ONS
Treated smokers, females, aged 16+, by WIMD fifth (excl. health): 2007/08Data sources: SSW, WAG, ONS
Self reported quitters, males, aged 16+, by WIMD fifth (excl. health): 2007/08Data sources: SSW, WAG, ONS
Self reported quitters, females, aged 16+, by WIMD fifth (excl. health): 2007/08Data sources: SSW, WAG, ONS
CO validated quitters, males, aged 16+, by WIMD fifth (excl. health): 2007/08Data sources: SSW, WAG, ONS
CO validated quitters, females, aged 16+, by WIMD fifth (excl. health): 2007/08Data sources: SSW, WAG, ONS
Self reported and CO validated quit rates, aged 16+, by WIMD fifth (excl. health): 2007/08Data sources: SSW, WAG, ONS
Conclusions Smokers in the most deprived fifth are the most likely to contact and undertake treatment There is a clear gradient from the least to most deprived fifth in terms of contact and treatment Population quit rates and treated smoker quit rates do not follow the same pattern. This is consistent with findings elsewhere.
Explanations? Lay epidemiology4 – poor housing, occupational hazards and environmental dangers are more immediate threats. Environmental tobacco smoke at home and cessation resource use5 Cigarette consumption and household support/smoking status 6
Acknowledgements HIAT – Nathan Lester, Hugo Cosh SSW – Katie Tulloch, Emma Rogerson, Julie Bishop LKMS – Dinah Roberts
References 1 Foege WH (2002) Challenges to public health leadership in the Oxford Textbook of Public Health, fourth edition, volume 2, The methods of Public Health, OUP, Oxford 2 Department of Health (1999). Smoking Kills: a White Paper on tobacco, The Stationary Office, London 3 Action on Smoking and Health (2008). BeyondSmoking Kills: Protecting children, reducing inequalities, downloaded on 17/10/08 from http://www.ash.org.uk/files/documents/ASH_691.pdf 4 Lawlor D, Frankel S, Shaw M, Ebrahim S and Davey Smith G. Smoking and ill health: does lay epidemiology explain the failure of smoking cessation programs among deprived populations. Am J Pub H 93(2): 266-270. 2003 5 Honjo K, Tsutsumi A, Kawachi I and Kawakami N. What accounts for the relationship between social class and smoking cessation? Results of a path analysis. Social Science and Medicine. 62(2):317-328. 2006. 6 Chandola T, Head J, and Bartley M. Socio-demographic predictors of quitting smoking: how important. Addiction. 99(6):770-777. 2004