Report, presentation and strategy attached.

The chair agreed for this item to be considered before item 6, Havering’s Integrated Starting Well Plan.

Report presented by Kate Ezeoke-Griffiths and Natalie Naor.

The Tobacco Harm Reduction Strategy was developed this year in partnership with a range of partners. Tobacco is a major cause of ill health, early death, and inequality. The strategy is aligned with national policies as well as local policies, including the council’s corporate plan which aims to help residents stay well and lead healthy lives. This is a five-year strategy due to the government’s funding commitment for five years. The strategy covers tobacco reduction as well as vaping. The government aims to create a smoke-free nation by 2030. The government had introduced a Tobacco and Vape Bill to Parliament in the last few days. 

This strategy was a result of a Tobacco Harm Reduction Partnership including the NHS, the local pharmaceutical community, and other teams across the council. The partnership aims to oversee the development of the strategy, the implementation of the action plan, and the measurement of progress over time, using a set of indicators. The strategy has been informed by wider stakeholder events. The strategy has also been guided by a needs assessment which was conducted earlier this year. The vision of the strategy is to deliver a smoke-free future for Havering and improve the health and well-being of the local population as well as to achieve a smoke-free borough in line with the national ambition to reduce smoking prevalence to 5% or less. The prevalence of adult smokers in Havering is 12.4%. The prevalence is particularly high among mentally ill people, people in treatment for alcohol or drug misuse, and people in private or social housing or rental properties, and people in manual or routine occupations. Smoking is less prevalent among pregnant women, largely because of a specialist pregnancy service locally, which is now run by the NHS. The strategy focusses on groups with the highest prevalence of smoking: men, people with long-term or severe mental illness, and people in treatment for drug or alcohol misuse.

It was reported that vapes can be useful for quitting smoking but they are not advisable for people who do not smoke or for children, because the long-term impact is unknown. 25% of young people aged 11 to 15 nationally tried e-cigarettes in 2023. 9% of young people vape frequently. In Havering, 12% of pupils have experimented with vaping. The report authors welcome the new Tobacco and Vape Bill. Havering’s Trading Standards team are trying to increase the number of retailers who adopt the “challenge 25” approach.

It was reported that smoking costs Havering £256 million per year. People who are socially or economically disadvantaged are more likely to smoke and suffer the resulting income loss and harm to health. The strategy aims to help these groups. There is also an environmental impact to smoking, including deforestation and cigarette litter. There are four priorities to the strategy: prevention (raising awareness and providing training, working with trading standards and schools); supporting smokers to quit (expanding number of community pharmacies, creating specialist lead advisory service for priority groups); creating smoke-free environments (supporting Trading Standards with enforcement of legislation, working with social housing and property management companies, and working with health visitors to create smoke-free environments for babies and children); and regulation and enforcement (working with Trading Standards, raising awareness of the dangers of illegal items, developing reporting mechanisms).

Nine indicators have been chosen to measure progress. The main goal is a continued reduction in smoking prevalence, particularly amongst priority groups. An action plan is already being implemented, using a government grant received earlier this year. The majority of actions have already been implemented, but there are still a couple which are currently in progress. Completed actions include extending universal service, launching SMI service, training frontline staff, distribution of CO2 test kits, and creation of a communications plan. The goal by 2029 is a steady reduction in smoking prevalence in Havering, including amongst priority groups. The strategy also aims to reduce smoking and vaping among young people, and create a healthier Havering population by 2039.

The next step was to get approval for this strategy from the Health and Wellbeing Board, then get approval from the place-based partnership board, and then go to public consultation early in the New Year, before going to Cabinet for approval of the new strategy.

In reply to a question, resources have been provided to schools for use in lessons. There was also an intention for Trading Standards to engage with schools and provide them with information about reporting retailers.

It was observed that the indicators for measuring progress do not include a measurement relating to young people. In response, there was an intention to conduct a needs assessment around vaping amongst young people, and this needs assessment should provide measurements which can be used to monitor progress.

In response to a question regarding how the number of smokers in Havering is measured, data is currently being used from a national survey. However, there was also an intention to use GP data to provide a more detailed picture. Ward-level data will also be collected.

In response to a question about the influence exerted upon national policy setting, representatives from Havering participate in regional and national events to influence government. There has been mention of receiving further money from government for Trading Standards, but this money has not been received yet. There is a need to consider the possibility that free ports will facilitate the flow of more illicit products into Havering.

A training session was run in September for partners including the NHS and social care professionals.

It was observed that if smoking is to be banned outside hospitals as a result of national legislation, support will need to be given to smokers in hospitals.

In response to a question about how young people first gain access to smoking and vapes, the majority gain access from retailers who are selling these products to underage customers. These products are also promoted on social media by influencers.

A question was asked regarding the support available to smokers after they have left hospital. These patients will be referred to the specialist Stop Smoking Service, who will stay in touch with them and meet them in the community after they leave hospital.

The Health and Wellbeing Board APPROVED the Tobacco Harm Reduction Strategy 2024-29.