Skip to content

Devon Smoke Free Alliance -Action Plan 2018-2023-Updated March 22


Last Updated


This collaborative action plan has been created by the Smokefree Devon Alliance members. It describes the actions needed to achieve the ambitions set out in the Smokefree Devon Alliance strategy for 2018 – 2023.

The plan outlines actions to deliver against our three priority areas as well as having a focus on supporting and developing a strong partnership approach to tobacco control through the Alliance.

1: Protect children and young people from tobacco and encourage Smokefree pregnancies

2:  Reduce health inequalities caused by smoking and support vulnerable groups to be Smokefree

3:  Create and support Smokefree organisations, particularly NHS organisations


Identify gaps in the Alliance membership and invite new members to fill these gaps

AllContinuousNew members continue to be sought and renewed representation from existing partners confirmed.

Current areas for improvement include licensing, fire and rescue service, district council representation and representation from Torbay broadly.

March 22 Membership renewal message sent out to confirm personnel changes and check for relevance.

Priority 1: Protect children and young people from tobacco and encourage Smokefree pregnancies


Continue good communication and collaboration to support smokefree pregnancies in Devon, and the rollout of the long-term plan aspirations of treating tobacco dependence (TTD).

Identify barriers, share good practice and plan to implement pathways and approaches to smoking cessation in pregnancy that are evidence-based and sensitive to local settings.

Public Health Devon, LMNS prevention group,

Public Health Midwifes in each local acute trust,

South West Academic Health Science Network, Devon ICS, Devon CCG

Target of 40% pregnant smokers offered model by March 2021March 2022 –  Treating Tobacco Dependence (TTD) system wide steering group is now in place with all trusts represented. TTD implementation held by this group and the associated locality steering groups.

Inpatients: By 2023/24, all people admitted to hospital (MH & Acute inpatients) & pregnant people & their partners who smoke will be offered NHS-funded tobacco treatment services. Fully ‘in-house’ model adapted from existing pathways. For pregnant people and their partners, with a new smoke-free pregnancy pathway including focused sessions and treatments – including a requirement for 40% coverage in 2021/22 revised to 100% offer by end Q1/ June 22

First face to face appointment

The 1st appropriate contact point/s for the delivery of the TTD intervention/s or identified elements if delivered separately

CO monitoring:

CO testing & recording forming part of standard pathway delivered to all pregnant women / persons at booking appointment or within an identified booking window and at 36 weeks (ideally all contacts).

VBA provision: 

Delivered in conjunction with all CO monitoring being undertaken.

Provision / offer of NRT at maternity contact:

Stop smoking treatment with NRT offer being routinely available to all pregnant women / persons at booking or within an identified booking window.

Monitoring and follow up:

Inline with In-House provision, CO testing, engagement and treatment is monitored and activity is targeted to ensure all pregnant women / persons are supported to take up offer of treatment (ideally done from within the local maternity system).

Antenatal Education Sessions

Ensure tobacco control messages e.g., smoking cessation, smokefree homes promotion, is part of parent education sessions delivered and that pathways to Stop Smoking Services are clear

Public Health Devon, Public Health Torbay, Childrens Services2022 and beyondMarch 2022 – :  This work is still paused. (Torbay ) pending recovery for system and COVID 19 pressures. Antenatal provision is on the LMNS prevention workstream but has been deprioritised due to capacity issues. This will be reviewed on a bimonthly basis.

Torbay: Having conversation around antenatal education for targeted communities with 0-19 service and hoping for midwifery involvement but paused currently, Links into Early Help – early in pregnancy, holistic programme.

Public Health Nursing Service

Ensure training in smoking cessation brief intervention to all staff, offer support for staff to quit, ensure referral pathways are embedded, explore data collection and reporting to Alliance. Integrate with TTD work within NHS trusts.

Public Health Nursing Services, Public Health Teams, specialist stop smoking services in Devon and Torbay, maternity teams March 2022 – :Training re brief advice and smoking cessation is a requirement for all staff to take at least once, normally on induction but looking to see if this can be renewed/updated on a more regular basis.

Training is also being provided to PH nursing staff to raise awareness of the risks of Smokefree Tobacco and use of vaping.

Illegal Tobacco

Operation CeCe – multi-pronged approach to disrupt illegal tobacco, working with HMRC

Trading StandardsOngoingThis project is running from January 2021 for 15 months

So far almost 10,000 packets of cigarettes, 61 kg (1234 pouches) of HRT and 234 tubs – est. street value £79,850.00.  More premises identified and further visits / action days to be arranged

Illegal Tobacco

Carry out a survey in schools to identify where young people are sourcing their tobacco – linking with the Schools Health Education Unit survey. Explore if this can also be completed in Torbay

Public Health Devon

Trading Standards

Public Health Torbay

2021 roll outMarch 2022 The Childrens and Families task group is looking into this area but had difficulties to engage schools. However, schools have raised concerns over vaping, and this could be a way to gain schools support/involvement. Community Safety partnership officer is supporting the work in this area in the Southwest of Devon.
Illegal Tobacco

Undertake enforcement work around illicit tobacco and promote this work / information through communications in order to generate intel.

–        Record activity by the amount of illegal tobacco seized and the number of “cease and desist” letters sent to illegal tobacco sellers.

Trading Standards, DCC Comms Team  Several Illegal tobacco warrants being generated and test purchasing days being arranged for Plymouth and Taunton – aiming to cover more areas of interest as opportunity arises.

Work to ensure good data continues to be available to support the strategy and action plan.

– Link up with MatNeo LifeQI data reporting

– Collate and report data on declined referrals to stop smoking services from maternity


Public Health Devon,
Public Health Torbay, MatNeo collaborative including PH midwives, LMNS, Healthy Lifestyle Services

March 2022 – OSS provides monthly report to NDDH,  RD&E & TSDFT on referral number and outcomes.

Smokefree Places

Continue to advocate/implement smokefree places which protect children, including play parks and school gates.

–        Consider smokefree places most relevant to prevent modelling of smoking to children – are we consistent across Devon & Torbay?

District Councils,

Public Health teams, Early Years teams, Education teams

OngoingEDDC – would find more advice helpful

March 2022 – Early Years; – Publicity sent to all Early Years settings to raise awareness of smoke free play spaces.

Smoke Free Early Years Settings policy updated to include the changes in the EYFS 2021 Framework.

National No Smoking Day (NNSD) promoted via the Early Years Digest.

Childrens Centres display “Don’t Smoke Where We Play” Play posters. and signpost parents to Stop Smoking Services. Awareness raising training for Early Years Staff on Devon Smoke Free Alliance Website.

March 2022, The training and the website needs to be updated and repromoted

Priority 2: Reduce health inequalities caused by smoking and support vulnerable groups to be Smokefree

Stop Smoking Services

Ensure consistency of stop smoking services across the County for individuals to access, which provide an evidence-based service and access to nicotine replacement therapy or stop smoking medications.

–        These services will support individuals to use e-cigarettes as a quit aid should they wish to.

–        Recorded via S1 and uploaded to HSCIC

Public Health Teams, Healthy Lifestyle Services, GPs, Pharmacies, LPC, LMCContinuousMarch 2022 , All individuals accessing One Small Step (OSS) now receive direct supply Nicotine Replacement Therapy (NRT), this supports quit attempts, particularly amongst vulnerable groups.  There is a parallel product offer across Devon / Torbay – and probably Plymouth – regardless of current disparities in Formulary alignment.

The use of E-cigs is recorded on OSS data collection system. Some face-face provision is now available in Barnstaple, Exeter, and Newton Abbot. Data on the use of E-cigarettes will be available regularly.


Targeted approach to national tobacco control campaign uplift to reach target communities.

–        Healthy Lifestyle Teams to share local campaign resource packs with Smokefree Devon Alliance members

AllJanuary and  October each yearMarch 2022 National No Smoking Day promoted via DCC, OSS, Early Years, GPs and spread to all partner agencies.

The event is also promoted by “ASH” nationally. Difficult to gain data to show how many people quit on NNSD and if they maintained the quit.

EDDC promoting Stoptober to staff, members and public [newsletters & tweets]

Substance Misuse Services

Develop the relationship between substance misuse services and smoking cessation services, inc. developing referral pathway

Healthy Lifestyle Services, Substance Misuse ServicesOngoing 
Mental Health Conditions

Continue to work collaboratively to develop the referral pathway and embed smoking cessation advice and support for people living with mental health conditions in Devon ICS, particularly those living in the community.

–        Work to ensure data on the number of people with a mental health condition supported to quit smoking is collected across Devon and Torbay by healthy lifestyle services.

–        Links with TTD work as part of the long-term plan (see below)

DPT / TALKWORKS, Healthy Lifestyle Services, ICS / Health Inequalities GroupOngoingOSS: Smoking Very Brief Advice training delivered to all Talkworks teams. Referrals increased by 600% to OSS from pre project to end of Q2. Monthly project review meetings and referrals and referral data shared with Talkworks. OSS delivered training to perinatal team.

OSS and DPT collaborated on Stoptober/National No Smoking Day

Mental Health Needs equality across the service and community.

TTD steering group is the referral pathways will have option to refer to community pharmacies; There is support for TTD for in-patients, but this is often not followed through on discharge- need to be picked up within community services.  DPT raised concerns on continuity of support.

P SHeward,  will be picking up the “Equally Well” work  which includes smoking, via health checks and screening.  Referrals  into OSS as well.

Routine and Manual Workers

Build relationships with large routine and manual employers to encourage referrals into the specialist service (as well as support the development of Smokefree policies)

Healthy Lifestyle Services, District CouncilsOngoingEngaging with employers has been challenging through the pandemic, there has been a reluctance to engage and pressures on workforces has left little/no capacity to prioritise collaborative working.
Vulnerable Groups

Continue to expand relationships with stakeholders relevant to vulnerable groups, so that services are accessible and made available to smokers within these e.g. gypsy and traveller groups, LGBT, homeless population, individuals who are long term unemployed, individuals with learning disabilities, offenders, people accessing domestic and sexual abuse services, people in social housing

Healthy Lifestyle Services, Public Health teamsOngoingAs per substance misuse services above.  Torbay has specialist adviser aligned to those with complex needs, especially homeless population.  Ongoing project with homeless hostel to provide vaping devices and stop smoking support to residents to generate quit attempts and harm reduction.

OSS continues to support vulnerably housed individuals with the option of providing vapes

Harm reduction (cut down to quit) pathway in place for vulnerable groups

March 2022 OSS attends face-face fortnightly breakfast club at Gabriel house Exeter, to engage with homeless.

OSS attends fortnightly multi agency outreach morning in Buckland, Newton abbot to engage with residents in social housing.


Environmental health teams to continue enforcement of smokefree legislation, including smokefree public places, smoking in cars etc

Environmental Health TeamsContinuous 
Vulnerable Housed and Homelessness

Continue support using vapes for this client group

Public Health Teams, Healthy Lifestyle ServicesOngoing


March 2022 Homelessness health needs assessment has been commissioned by ICS, being conducted by Pathways. Jane Bullard (Paul Sheward) will bring this back to Alliance and try to ensure smoking included.

Priority 3: Create and support Smokefree organisations, particularly NHS organisations

Collaborative and Supportive Approach to Smokefree Action

Continue to support a cross agency approach to becoming Smokefree, involving all acute, community and mental health trusts in the ICS area.

–        Establish resources and examples that can support smokefree journeys

–        Share best practice

–        Improving treating tobacco dependence services so they work better as a system

–        Support successful roll out of the long-term plan funding


Smokefree NHS Policy Task and Finish group:

CCG / Devon ICS, Public Health teams, acute and mental health trusts, PHE

OngoingMarch 2022 Links made with Smoke free alliances in other counties to share good practice (Oxfordshire)

Sharing Good Practice across Devon Plymouth, Exeter, Torbay and North Devon NHS trusts.


Review stop smoking medication and nicotine replacement therapies included on various formularies and attempt to standardise across the ICS

Task and Finish group:

CCG, Public Health Teams, Healthy Lifestyle Services, acute and mental health trusts

September 2021Pharmacotherapy sub-group to be established as a sub-group of the alliance for formulary and PGD conversations within trusts.

Devon, Torbay and Plymouth LAs to try to align formularies as much as possible – stop smoking services collaborating.

E-cigarette / Vaping Policies

Continually provide updated information on e-cigarettes/vapourisers to encourage a consistent approach to vaping policies across organisations

AllContinuousFebruary 22 – Early Years and Childrens Centre policies updated to include E-Cigarettes and Vaping references.

Smoking and Vaping – Healthy Schools (

Making Every Contact Count (MECC)

Embed making every contact count into a range of commissioning strategies

All to considerOngoingEDDC worked to roll out MECC pre-pandemic, to staff, members & community representatives

March 2022 OSS delivering E-MECC lite, uptake has been high. Recent cohorts have included the Fire service, COVID testers, and Police. OSS on SW steering group panel.

Royal Devon and Exeter NHS Trust (RD&E) RD&E, OneSmallStepOngoing 
Northern Devon Healthcare NHS Trust (NDHT)  Ongoing.
Torbay and South Devon NHS Foundation Trust (TSDFT)TSDFT, Torbay Healthy Lifestyles TeamOngoing 
Devon Partnership Trust (DPT)


DPT Smokefree Steering GroupOngoingMarch 2022 DPT proudly achieved a Smoke Free environment across all its inpatient sites in 2018.
However, particularly over the last two years where operational focus has been pulled elsewhere, we are keenly aware that things have slipped and are not currently where they were or where they need to be.
The NHS Long Term Plan, and the recent update to NICE Guidelines has further highlighted this, but also given opportunity to review, renew and re-implement a Smoke Free DPT.
Treating Tobacco Dependency is still in it’s infancy, with ICS rollout, driven by National plans requesting this service to land in year 3 (2023/24).
At DPT we felt that we needed to take action now, given the lower life expectancy, comorbidities, and prevalence of smoking in individuals who suffer with mental health illness.
Our ambition is to deliver  a Pharmacy Technician led service for our inpatient wards, that involves delivery of smoking cessation behavioural support and pharmacotherapy to aid a quit attempt, with an onward referral upon discharge.
Year 3 will be used to implement a community service for ‘high risk mental health’ individuals. (Provided a definition for this category is provided by then)”
Devon County Council (DCC)

DCC to review current Smokefree policy and bring it in line with other organisations within the county, as well as the Public Health England advice on e-cigarettes

Public Health DevonOngoingTask and Finish group to review the Devon Smoke free policy and align it with policies across county.

Planning for the next Smoke Free Strategy 2023-2028/30.

Local Authority Tobacco Control Declaration

Ensure all local authorities in Devon continue to uphold the commitments outlined within the Local Government Declaration on Tobacco Control

All local authoritiesOngoing 

Last updated: March 22