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Written Reply by Ms Grace Fu, Minister for Sustainability and the Environment, to Parliamentary Question on Disamenities from Secondhand Smoke
Mr Shawn Huang Wei Zhong: To ask the Minister for Sustainability and the Environment what are the further measures to be considered in 2021 to ensure that disamenities such as secondhand cigarette smoke that causes long-term medical problems does not affect other homeowners who are non-smokers in their own homes.
Answer:
The Government takes a multi-pronged approach to address the disamenities from secondhand cigarette smoke.
To tackle smoking at prohibited residential areas, the National Environment Agency [NEA] works with government agencies, Town Councils and community leaders to display visual reminders to remind smokers to be considerate and entrench positive social norms. Where feedback on unlawful smoking persists, NEA steps up surveillance and enforcement operations at the affected block. Since January 2019, for smoking offences in corridors, NEA has enhanced its surveillance capability with the use of thermal cameras which can detect objects emitting high heat and capture images of the smoking offence.
On the issue of smoking in homes affecting neighbouring units, the Government is working with the community to adopt a three-pronged approach: [a] engender greater social responsibility, [b] facilitate productive conversations between neighbours and [c] enhance the dispute resolution process to better address disputes arising from smoking in homes. For example, NEA has collaborated with the Housing Development Board [HDB], Health Promotion Board [HPB], Municipal Services Office [MSO], and Town Councils to develop and issue joint advisories to units where feedback on tobacco smoke is received. The advisory urges smokers to be considerate to their family members and neighbours, as well as advises them on the smoking cessation helplines available. We will continue to encourage and support ground-up efforts by community organisations and the grassroots to manage feedback on smoking in homes. In addition, NEA, as part of an inter-agency committee, is working with other agencies to study how community disputes including secondhand smoke in homes can be better addressed under the Community Dispute Management Framework through upstream measures to encourage mediation and conflict resolution between neighbours.
There are also cessation programmes available across healthcare institutions, workplaces and in the community, to support smokers in quitting the habit. For example, HPB’s ‘I Quit 28-day Countdown Programme’ encourages participants to take daily actions to remain tobacco-free and rewards participants who quit successfully. Smokers can call QuitLine [1800 438 2000] to receive customised smoking cessation counselling from Certified Quit Smoking Consultants or visit HealthHub for articles, tips and support. HPB is also leveraging digital platforms during COVID-19 to pilot online delivery of programmes such as smoking cessation talks at workplaces, and will continue to ensure easy access to smoking cessation programmes.
While we will continue to monitor our efforts and best practices overseas, mitigating secondhand smoke in homes ultimately requires everyone to play their part. I urge smokers to exercise social responsibility and refrain from lighting up where the secondhand tobacco smoke can affect those around them. Families and friends of smokers, as well as the general public, can help reinforce these social norms.
Journal Article
Rachael L. Murray,
Rachael L. Murray
Cancer Research UK Graduate Training Fellow
1
Division of Epidemiology and Public Health, UK Centre for Tobacco Control Studies
,
University of Nottingham
,
Clinical Sciences Building, Nottingham City Hospital, Nottingham
,
UK
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Linda Bauld,Linda Bauld
Reader in Social Policy
2
Department of Social and Policy Sciences, UK Centre for Tobacco Control Studies
,
University of Bath, Bath
,
UK
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Lucy E. Hackshaw,Lucy E. Hackshaw
PhD Research Psychologist
2
Department of Social and Policy Sciences, UK Centre for Tobacco Control Studies
,
University of Bath, Bath
,
UK
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Ann McNeill
Professor of Health Policy and Promotion
1
Division of Epidemiology and Public Health, UK Centre for Tobacco Control Studies
,
University of Nottingham
,
Clinical Sciences Building, Nottingham City Hospital, Nottingham
,
UK
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Published:
10 February 2009
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Rachael L. Murray, Linda Bauld, Lucy E. Hackshaw, Ann McNeill, Improving access to smoking cessation services for disadvantaged groups: a systematic review, Journal of Public Health, Volume 31, Issue 2, June 2009, Pages 258–277, //doi.org/10.1093/pubmed/fdp008
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Abstract
Background
Smoking is a main contributor to health inequalities. Identifying strategies to find and support smokers from disadvantaged groups is, therefore, of key importance.
Methods
A systematic review was carried out of studies identifying and supporting smokers from disadvantaged groups for smoking cessation, and providing and improving their access to smoking-cessation services. A wide range of electronic databases were searched and unpublished reports were identified from the national research register and key experts.
Results
Over 7500 studies were screened and 48 were included. Some papers were of poor quality, most were observational studies and many did not report findings for disadvantaged smokers. Nevertheless, several methods of recruiting smokers, including proactively targeting patients on General Physician's registers, routine screening or other hospital appointments, were identified. Barriers to service use for disadvantaged groups were identified and providing cessation services in different settings appeared to improve access. We found preliminary evidence of the effectiveness of some interventions in increasing quitting behaviour in disadvantaged groups.
Conclusions
There is limited evidence on effective strategies to increase access to cessation services for disadvantaged smokers. While many studies collected socioeconomic data, very few analysed its contribution to the results. However, some potentially promising interventions were identified which merit further research.
Introduction
As in most industrialized countries, smoking prevalence in the UK is considerably higher among less affluent groups. In 2007, smoking prevalence was 36% for men and 25% for women in routine and manual occupations, compared with 15% for men and 18% for women in managerial and professional groups.1 Although smoking has declined considerably since the 1970s for all groups, there has been no significant narrowing of the gap between manual and non-manual rates.2
Smoking is one of the main contributors to health inequalities in industrial countries3 and a recent analysis of causes of death in England and Wales by the Office for National Statistics argued that smoking played a key role in the relationship between deprivation and mortality.4 Among men, smoking is responsible for over half of the excess risk of premature death between the highest and lowest socioeconomic groups.5 For these reasons, addressing smoking-related inequalities in health has become a policy priority in the UK and targets have been established nationwide to reduce smoking rates among more deprived groups. In England, the key target concerning smoking is to ‘reduce adult smoking prevalence in routine and manual groups to 26% or less by 2010’.
Significant health gains are likely to be achieved by reducing the proportion of current smokers and if more of these smokers are drawn from disadvantaged groups, then this could make a significant contribution to reducing inequalities in health.6 A number of government policies have therefore been implemented to encourage smokers to quit smoking, with considerable emphasis on those in lower socioeconomic groups.7
Delivering evidence-based smoking cessation services to less affluent communities was one of the key government strategies to help reduce smoking in disadvantaged groups. Following the publication of the 1998 White Paper, Smoking Kills,7 smoking cessation services, now known as National Health Service [NHS] stop-smoking services, were established in the UK. The services were initially set up in 26 deprived areas known as Health Action Zones in 1999 and rolled out to the rest of the country from 2000.8 NHS stop-smoking services now exist in all parts of the UK and provide free at the point of use access to behavioural support from a trained adviser [one-to-one or group] in a range of settings, plus access to appropriate pharmacotherapies which are available on prescription. This intensive specialist support has been demonstrated to increase the chances of quitting four-fold over the use of willpower alone.9 From their inception, disadvantaged smokers were one of the key target groups for the services, the others being pregnant women and young people.10
However, there are a number of barriers to reaching and supporting more disadvantaged smokers in their quit attempts. Health services in the UK are traditionally more accessible in the more affluent areas—a phenomenon known as the ‘inverse care law’,11 and those living in disadvantaged communities may be less willing to seek help from statutory health services.12 Hence, one of the challenges for these services and for other interventions that can help smokers to quit is improving access for disadvantaged groups.
Recent research in England suggests that, at the national level,