Ten High Impact Changes
10. Maintain and promote smokefree environments
A concerted effort is required to sustain the profile of tobacco control and maintain the momentum provided by the Smokefree legislation of July 2007 if the significant benefits are to be had from de-normalizing smoking are not to be lost.
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In the year April 2009 to March 2010, Hull City Council Environmental Health Department received 93 complaints regarding smoke free provision. All complaints were investigated and advice or informal action was taken. In four instances more formal action had to be taken with the service of fixed penalty notices. These were all paid within the specified time therefore there was no requirement for legal proceedings.
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In September 2009 the NHS Stop Smoking Service’s Smoke free families team expanded to support pregnant women, their partners and smokers with children under 5 years at clinics within Children’s Centres and generic service. The benefits of smokefree homes or zones were also explained and awareness raised.
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February 2010 saw the increased provision of staff and resources available to prisons to reduce prevalence of smoking amongst prisoners and staff and promote smokefree areas within the prison setting.
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Goodwin Development Trust have completed a six month pilot of Smokefree Zones Programme. Follow this Goodwin Development Trust won the tender to take the programme forward for a further year. A full time co-ordinator is now taking the programme forward.
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From December 09 to March 10 the Goodwin Development Trust Health Wardens provided information and guidance to 158 families and individuals about the health benefits to themselves and their families when smoke free zones are established in the home and car to eliminate the risks from second hand smoke inhalation. 44 smokefree zones were established in homes and 15 smokefree cars, all were provided with supporting promotional items to help maintain zones, raise awareness and promote compliance with friends and family.
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The Smoke-free legislation in Hull has been aided and enforced by a dedicated smokefree enforcement officer and a small number of Health & Safety Officers, based in Environmental Health.
The work has been both reactive and proactive, giving priority to respond to reports and complaints received from members of the public, colleagues and other agencies. The proactive work has included carrying out spot checks to monitor compliance and offer advice and guidance where necessary, targeting areas of the City or types of premises where non-compliance was thought most likely, this included multi agency visits to licensed premises which are on-going. In addition, awareness raising of the smokefree legislation, and promoting its success has been carried out at events held throughout the City, which included the Dove House Day and the Stay Safe event held in Victoria Square, Hull.
From April 2008 - June 09 there have been 145 reports in relation to the legislation, approx 117 of these have been complaints, and 28 requesting advice on various smoking related issues such as signage and shelters.
The majority of complaints relate to smoking in work places work vehicles and other enclosed public places such as pubs. A number, however relate to smoke drift or cigarette related litter causing a nuisance, which are not enforceable under the Smokefree legislation. These have arisen as a consequence of more people smoking outside and has been made worse by the lack of available designated smoking areas and lack of management of designated smoking areas.
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A limited extension for mental health units to comply with the legislation expired on the 1st July 2008, however, prior to this date a large majority of the units had already removed the use of the smoking rooms, and had taken steps to aid compliance by erecting smoking shelters.
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Commencing October 2008, further proactive work was carried out in Hull in the form of advisory visits specifically to licensed premises, to monitor compliance, and to offer further advice and guidance. Following the visits to licensed premises a flyer was distributed offering praise to licensee's and staff for their continued support, whilst also reinforcing specific areas of their responsibilities that have been an on-going issue, such as staff smoking when premises have closed, and managing designated smoking areas effectively.
The flyers also advertised the Hull and East Riding NHS Stop Smoking Service.
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In Hull, work focussing specifically on taxi drivers is ongoing, this includes visiting taxi ranks, where a number of drivers have been approached and witnessed smoking in their vehicles by authorised officers. In May 2008 and 2009, a flyer was issued along with licensing renewal letters again to reinforce the legislation and their responsibilities.
Despite the proactive work that has been carried out, issuing of fixed penalties is still on-going, with 14 fixed penalties being issued to date.
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NHS East Riding of Yorkshire is updating its Smokefree Policy for all Trust employees to ensure the optimum health and safety of its entire staff, ensuring that all staff are aware of the Policy and its contents.
The Policy sets out to protect all employees from the effects of secondhand smoke whilst working out in the community i.e. home visits. A policy letter will be sent to patients/clients prior to visits, requesting they do not smoke before and during a home visit by Trust staff. If this is not possible, the patient/client will be requested to provide a 'smoke free zone' in the home. Non-compliance of the policy could result in the service being withdrawn from the home and the patient/client will be asked to make alternative arrangements to continue their care.
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Within 2008/09 the region gained funding from the Department of Health to undertake a number of tobacco control related activities. The East Riding of Yorkshire Council's Food Services Team used this funding to undertake 30 tobacco retail test purchasing visits and 10 tobacco vending machine test purchases.
The remainder of the funding was used to undertake responsible / advisory retailer visits regarding acceptable forms of ID and check tobacco advertisements at retailers and detection of illicit tobacco using the HMRC detector.
The test purchase visits were conducted using 14 and 15 year old volunteers, who are required to look their age (i.e. minimal make up) and must be truthful at all times (i.e. give their correct age if asked). The purpose of these exercises is not to trick or catch out traders but to identify traders who are not carrying out basic every day checks which are necessary to ensure age-restricted products are not sold to people underage.
Available intelligence is used prior to the test purchasing visits to identify/target premises.
The total number of test purchases conducted during 2008/09 is as follows:
73 tobacco retail test purchase visits were conducted - 3 retailers sold to young people under the age of 18 years (4.1%) and 10 tobacco vending machine test purchase visits were conducted - 8 retailers did not prevent sales to young people under the age of 18 year (80%).
These findings are encouraging in respect of the retail test purchases as they demonstrate a high level of compliance. However, the findings in respect of vending machine test purchases, which are similar to regional findings are disappointing. These results will be fed back by the region and will form part of the national picture.
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Hull and East Yorkshire Hospitals NHS Trust has committed itself to adhering to a gold standard of smoking prohibition and politely requests that patients, staff and visitors do not smoke anywhere on its sites, either inside or outside. The Trust has an ongoing challenge to reduce the numbers of people smoking outside main entrances to its buildings and one area where this has been a continuing issue is the garden at the Women and Children's Hospital on the Hull Royal Infirmary site. Using funding from NHS Hull the Trust commissioned three large signs asking people to refrain from smoking in this area. While signage can only be a part of the overall solution it appears that this has had some effect in reducing the number of people who are using the garden when smoking.
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The Smokefree Zones programme in Hull has been running for a number of years, and has evolved to suit the needs of those delivering the programme and the families it is for. The overall aim of the programme is to raise awareness of the dangers of secondhand smoke and encourage families to stop or restrict smoking in their homes making them safer healthier places to live. The programme is delivered by Health Visitors who raise the issue at each contact with a family. A range of resources have been developed to give to families including: shopping trolley key, bibs, feeding spoons and beakers.
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