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The level of need in the population

Background papers: Lifestyle and wider determinants :: Smoking and tobacco control [Update in progress] :: The level of need in the population

Smoking prevalence

Nationally, the prevalence of smoking among adults dropped from 24% in 2005 to 21% in 2008.[1] Smoking prevalence in Medway in 2010 was recorded at 24.9% higher than the national average. Smoking prevalence in Kent was higher than the national figure at 24.9%. The variation in prevalence across the Medway area is significant and varies between 16.2% in Rainham Central and 39.8% in Chatham Central (see Appendix -> Health and social care maps). There were around 54,344 smokers in Medway in 2010.

Figure 1: Smoking prevalence among over 18s in Medway and in England
Figure 1: Smoking prevalence among over 18s in Medway and in England

A Health Equity Audit (HEA) carried out in July 2011 by the Kent Public Health Observatory [2] on the Medway Stop Smoking Service found that groups I, E, K and J had a good level of uptake. Smoking prevalence is highest in Mosaic group I,K,N and O and these groups make up 31% of the Medway population. Although the service is doing well at attracting smokers from Mosaic Group I and K, it is likely that there is a potential to target more smokers from group N and O.

The mosaic groups that are not well represented in Figure 21 are A, C and L, however smoking prevalence in these groups is lower than the England average so the number of smokers to target will be lower. Smoking prevalence is strongly linked to deprivation. 45% of men and 40% of women in the most deprived 15% of households are current smokers.[3]
Routine and manual (R/M) smokers form the largest group of smokers among the general population and as stated, have higher smoking rates than other occupational groups in the general population (31% in R/M men and 27% in R/M women compared with 21% and 20% respectively in the general population).[4]

Age


• Those aged between 18 and 34 are setting the most quit dates. Those that are most successful in quitting are the older population aged 60 plus.
• Those aged 20 to 34 reported the highest prevalence of cigarette smoking (32% among 20–24 year olds and 26% among 25–34 year olds) while those aged 60 and over reported the lowest (12%).
• Low Income Diet and Nutrition Survey 2007 [3] found that older adults were much less likely to be current smokers than younger adults. Among men, the prevalence of current smokers was 54% for men aged 19–34, 58% for those aged 35–49, 52% for men 50–64 and 22% for men aged 65 and over. It is a similar pattern for women.

Figure 2: Numbers of Medway residents quitting smoking by age group in 2010/2011
Figure 2: Numbers of Medway residents quitting smoking by age group in 2010/2011

Gender


• Males are more successful at quitting than females. Medway have been more successful at getting both men and women to quit and are better than the South East Coast and England average.

Figure 3: Numbers of Medway residents quitting smoking by gender in 2010/2011
Figure 3: Numbers of Medway residents quitting smoking by gender in 2010/2011

Young people


• In recent years the proportions of young people smoking has declined. In 2006, the proportion of 11 to 15 year olds who said that they had smoked at least once in their lives was 39%; this fell to 33% in 2007 and 32% in 2008.[5] The survey defines regular smoking for this age group as usually smoking at least once a week. The proportion of this age group who were regular smokers was 9%in 2006, and 6%in both 2007 and 2008. Girls are more likely to smoke than boys and there is an increase in the prevalence of regular smoking with age.
• In the south east 7% of young people between 11 and 15 years old smoke with more girls smoking than boys.[5] This is despite the increase in age at which it is legal to buy tobacco to 18.
• Three in ten (29%) of pupils have tried smoking at least once. This proportion is the lowest measured since the survey began in 1982, when more than half of pupils (53%) had tried smoking. In the south east 35% of young people self-report ever smoking a cigarette, compared to 29% nationally. More girls have tried smoking at least once (36%) than boys (33%).
• There are approximately 37% homes within England in which dependent children are living with smokers and potentially exposed to second-hand smoke.[6]

Smoking in Pregnancy


• The number of maternities has been fairly steady in Medway and is currently around 3500 per year.[7]
• The prevalence of smoking during pregnancy is high among the Medway residents compared to the England Average of 14%; it is currently around 20% in Medway.
• This level equates to approximately 700 Medway resident mothers still smoking at the time of delivery each year. It also indicates that around half the women who smoke are stopping smoking during pregnancy.

Prisoners


• The prevalence of smoking is much higher in the offender population than in the general population, for example it is estimated that at least 80% of prisoners smoke compared to 24% of the population of Medway.
• The health needs of children and young people in the secure estate are noticeably higher than for those in contact with the YJS than they are in the community. Contact with the youth justice system (YJS) will produce positive health and well-being outcomes for children and young people. Early identification and attention to these needs should be considered integral to work to reduce youth crime and anti-social behaviour.[8]


References

[1]   Office for National Statistics. General Lifestyle Survey 2008: Smoking and drinking among adults 2010; Office for National Statistics.
[2]   Spencer S, Jolley J. Health Equity Audit - Stop Smoking Service: NHS Medway 2011; Kent & Medway Public Health Observatory. http://www.kmpho.nhs.uk/lifestyle-and-behaviour/smoking/?assetdet957414=216973 .
[3]   Food Standards Agency. Low Income Diet and Nutrition Survey 2007; http://food.gov.uk/science/dietarysurveys/lidnsbranch/
[4]   Department of Health. Service delivery and monitoring guidance, 2011/12 2011;
[5]   Diment E, Harris J, Jotangia D, et al. Smoking, drinking and drug use among young people in England in 2008 2009; The NHS Information Centre. http://www.ic.nhs.uk/webfiles/publications/sdd08fullreport/SDD_08_%2809%29_%28Revised_Oct_09%29.pdf .
[6]   Action on Smoking and Health. Secondhand Smoke: the impact on children 2011; Action on Smoking and Health. http://www.ash.org.uk/files/documents/ASH_596.pdf .
[7]   Office for National Statistics. Births by area of usual residence of mother, England and Wales 2010;
[8]   Department of Health. Healthy Children, Safer Communities -- A strategy to promote the health and well-being of children and young people in contact with the youth justice system. 2009; Department of Health, Ministry of Justice, Home Office and Department for Children, Schools and Families. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_109772.pdf .