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

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

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.

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 Midwifes in each local acute trust,

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

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 1^st 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).

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

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.

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.

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

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

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

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

Trading Standards

Public Health Torbay

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.

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

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

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?

Public Health teams, Early Years teams, Education teams

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

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

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

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]

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

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)

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.

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

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

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

Continue support using vapes for this client group

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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

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

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

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

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

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

Smoking and Vaping – Healthy Schools (healthyschoolscp.org.uk)

Embed making every contact count into a range of commissioning strategies

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.

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

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

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

Last updated: March 22