Contact: Berni Lee, Consultant in Public Health, Shropshire Council / Rachel Robinson, Executive Director of Health, Wellbeing and Public Health, Shropshire Council

The Board received the report of the Consultant in Public Health and the Public Health trainee – copy attached to the signed Minutes – which provided a brief summary of the Khan review into making smoking obsolete which concluded that the government target for smokefree 2030 would be missed by at least 7 years.  The report also outlined the burden of smoking and smoking-related ill health and health inequalities in Shropshire.  It summarised the current tobacco control efforts in Shropshire and highlighted the recommendations contained in the Khan report.

The Public Health trainee gave a presentation – copy of slides attached to the signed Minutes – and highlighted the implications of the Khan Review for Shropshire.  She reported that smoking was the biggest single cause of illness and death nationally and that although the numbers of people smoking in the UK (14%) had come down since the 1970s and 1980s due in part to tobacco control, the numbers were still significant.

The Public Health trainee drew attention to the smoking burden in Shropshire and how that compared to the national average and to the Council’s 15 nearest neighbours.  Smoking prevalence in Shropshire was similar to the national picture, however hospital admissions were higher in Shropshire than the national average and higher than other local authorities and perhaps not performing as well as it might.

Whereas smoking in Shropshire was similar to what it was nationally, it could be seen that for some particular groups it was a health inequality issue and that the smoking prevalence in those particular groups was high in Shropshire and higher than the national average.  This suggested that there were some particularly at-risk groups in Shropshire who were really affected by the health inequalities related to smoking.

The Public Health trainee looked at what smoking really costs us as a society not just in terms of health and social care, but in terms of productivity and loss of earnings.  Shropshire were currently spending around £14-16m so this was a significant issue for Shropshire.  She then went into more detail around the Khan review of the smoke free 2030 ambition set out by government in 2019 that had been published earlier in the year.  The main headline from the report was that the target was going to be missed by at least seven years and for those who were most deprived in society, that target would not be met until 2044.

The Public Health trainee drew attention to the main recommendations of the review which focussed on strengthening tobacco control and the critical recommendations contained within the pictorial illustration of what the review was all about. The critical recommendations were ‘must do now’ recommendations that would have the most impact.

The Public Health trainee informed that Board of the work currently being undertaken within Shropshire to tackle smoking and smoking related inequalities which fell into four main areas, the first being tobacco control led by trading standards including enforcement activities which disrupted the supply chain of illegal tobacco and particularly identifying, detecting and preventing the sale to minors.  The second area was the tobacco dependency treatment programme, which was part of the NHS long-term plan, the third point was the new national scheme for community pharmacies to provide follow-up post-discharge community support.  The final area was local authority level support, including the social prescribing service.  There were also plans in place to operate a new service looking at behavioural support for those discharged from mental health inpatient treatment.

Concern was raised about the recommendation of offering vaping as an alternative as it was felt that the impact and consequences of vaping were not yet know and that schools were reporting a significant rise in the number of quite young children now vaping rather than smoking.  In response, the Public Health trainee reported that Public Health England were very clear that vaping was not risk free and that research was emerging about the potential risks of vaping and research that she had seen had shown that vaping was about a third as dangerous as smoking as there weren’t as many chemicals and toxins present in vaping smoke compared to cigarette smoke.  Vaping was considered as a very good quit tool and not a ‘cool’ tool and concern was expressed about how vaping was being made to look attractive to children.  More work was therefore needed around this messaging.

RESOLVED:

To note the contents of the report and to receive updates going forward.