Tobacco Free Lancashire

1. Tobacco Free Lancashire Sam Beetham – Young Persons Alcohol and Tobacco Team Nicola Turner – Teacher Advisor For Drug, Alcohol and Tobacco Education

2. Smoking Kills (1998) Smoking Kills defined its own evaluation criteria with three key aims and targets for children, adults and pregnant women in England. They were: • To reduce smoking among children (11-15 year olds) from 13% to 9% or less by the year 2010; with a fall to 11% by 2005. • To reduce adult smoking in all social classes so that the overall rate falls from 28% to 24% or less by the year 2010; with a fall to 26% by the year 2005. • To reduce the percentage of women who smoke during pregnancy from 23% to 15% by the year 2010; with a fall to 18% by the year 2005.

3. Beyond Smoking Kills (ASH, 2008) Recommendations • Prohibit all tobacco promotion including point of sale displays and pack branding. • Require all tobacco retailers to be licensed and improve enforcement of the minimum age limit. • Prohibit the sale of tobacco from vending machines. • Ensure all pregnant women are offered support from specialist stop smoking services as part of routine antenatal care. • Train midwives to provide appropriate stop smoking advice and referrals to all pregnant smokers. • Develop and evaluate new services and incentives to support the efforts of pregnant smokers to quit. • Promote smokefree homes and cars through national and local campaigns. • Evaluate the legislative option of prohibiting smoking in cars.

4. A Smokefree Future A Comprehensive Tobacco Control Strategy for England • To stop the inflow of young people recruited as smokers. • To motivate and assist every smoker to quit. • To protect families and communities from tobacco-related harm. DH, February 2010

5. School-based interventions to prevent the uptake of smoking among children and young people (NICE, 2010)

6. Recommendation 1 - Organisation-wide approaches- In consultation with young people and staff develop an organisation-wide smokefree policy which includes smoking prevention activities (led by adults or young people) and staff training and development Recommendation 2 - Adult-led interventions - Deliver interventions that aim to prevent the uptake of smoking as part of PSHE, PSHE education, activities related to Healthy Schools status or as part of the core curriculum (for example, science). - Schools should link with partners involved in smoking prevention and cessation activities in the wider community, such as NHS Stop Smoking Services or regional tobacco policy leads, to deliver the interventions.

7. Recommendation 3 - Peer-led interventions • Secondary schools should consider offering peer-led interventions to support their smokefree policy – which link to relevant PSHE education programme activities and any other relevant adult-led interventions. • Ensure the interventions can be delivered both in class and informally, outside the classroom. • Young people should nominate the peer leaders. • Peer leaders should receive training outside school delivered by adults who are experts. They should be in regular contact with the peer leaders while they are performing this role. • The interventions should be set up to ensure young people consider and, if necessary, challenge peer and family norms in relation to smoking, discuss the risks associated with it and the benefits of not smoking (environmental and economic).

8. Recommendation 4 – Training and development • Provide training for all those working in schools to prevent the uptake of smoking by children and young people. • Work with key partners (for example, the school nursing service, voluntary sector organisations and universities) to design and deliver training and smoking prevention interventions. Recommendation 5 - National context • Ensure school-based interventions to prevent smoking and to encourage young people to quit are part of a community-wide tobacco control strategy, with clear outcome indicators and involving key partner organisations. • Ensure schools deliver evidence-based smoking prevention interventions which are linked to their smokefree policy and consistent with regional and national tobacco control strategies. The interventions may be delivered as part of PSHE, PSHE education and work associated with Healthy Schools status, as well as being integrated within relevant curriculum subjects (for example, science).

9. Smoking, drinking and drug use among young people in 2009 Three in ten (29%) tried smoking at least once – decline from 53% in 1982 6% smoke regularly – decline from 13% peak in 1996 Girls smoke more than boys One in seven (15%) of 15 year olds say they smoke at least once a week – less than 0.5% of 11 year olds Mean consumption of regular smokers was 38.1 cigarettes a week NHS Information Centre

10. Smoking, drinking and drug use among young people in 2009 White pupils are more likely to smoke than pupils of Black or Mixed ethnicity Smoking is more likely among pupils in receipt of free school meals – an indicator of low family income Regular smoking is associated with drinking alcohol, drug use, truancy and exclusion from school NHS Information Centre

11. Smoking, drinking and drug use among young people in 2009 Factors associated with regular smoking Lessons about smoking Compared with pupils who said that they had been taught about smoking in the last year at school, those who did not recall such lessons were more likely to be regular smokers (odds ratio=1.32). NHS Information Centre

12. TSNW Survey (2009) - Tobacco • 24% claimed to smoke (3% reduction) 9% increase in those that claimed to have never smoked • Young females more likely than males to smoke • Majority started when they were 13 or 14 (45% combined). +4% increase 11 years or less • Slightly higher proportion 16-17 year olds buy from supermarkets/newsagents. 14-15 year olds rely on friends/family • +15% purchasing single cigarettes. +11% from other sellers • Fake cigarettes - 1% lower than North West as a whole

13. Background Project : East Lancashire Alliance to restrict the supply of illegal tobacco products project • This is a three year project involving Trading Standards, Young Persons Alcohol and Tobacco Team, School and Communities Partnership Team and East Lancs PCT and other partner agencies. • One area of activity is to identify through engaging with partners any gaps in tobacco education / information provision / training and support for agencies in East Lancashire including primary and secondary schools.

14. Legal Drugs: The World of Alcohol and TobaccoA conference for Lancashire primary pupils and their teachers Planned Impact and Outcomes – Young People Through participation in workshops primary pupils (aged 9 -11) will: • Increase their knowledge about alcohol and tobacco and the related effects; • Address and clarify their attitudes towards alcohol /tobacco use; • Help enhance and develop the skills required to deal with difficult situations around alcohol / tobacco use.

15. Legal Drugs: The World of Alcohol and TobaccoA conference for Lancashire primary pupils and their teachers Planned Impact and Outcomes – School Staff • Through receiving a days training from a TACADE trainer to allow them to deliver structured alcohol and tobacco lessons effectively. • Through receiving resources which can be used within schools to allow for continuity of educational messages and to support the curriculum in school.

16. Legal Drugs: The World of Alcohol and TobaccoA conference for Lancashire primary pupils and their teachers • In total 199 pupils received alcohol and tobacco education / awareness raising sessions and 51 teachers/ members of school staff, 28 facilitators were also trained in delivering the alcohol / tobacco resources.

17. Legal Drugs: The World of Alcohol and TobaccoA conference for Lancashire primary pupils and their teachers • In order to assess whether the planned impacts/ outcomes of the conferences were achieved all pupils and teachers were asked to discuss and fill in a sheet 'What will you do when you go back to school?' • Suggestions on future action / activities to establish within individual schools were identified and recorded. • Develop and enhance the Scheme of Work for PSHE to include the resources for alcohol and tobacco & other resources e.g. the website and perhaps other TACADE resources. • Revise policies on drug, alcohol and tobacco • Information workshop for parents

18. Legal Drugs: The World of Alcohol and TobaccoA conference for Lancashire primary pupils and their teachers • These pledges were then followed up, by letter and pro-forma, three months after the conferences. A total of 51 questionnaires were sent out, 25 were returned (49%) • From the responses received, the schools were asked if their identified actions / activities had been either achieved, ongoing-planned or not commenced. • 92% of schools had continued to work on smoking issues on their return.

20. Lookout Tobacco • Health Centre • NRT, Smoking in pregnancy long term effects of smoking, what’s in a cigarette, are you addicted ? • Cosmos Lane • How to stop smoking, anti-smoking campaigns, second hand smoke, media, fire risks • Library • Who can you talk to , problem page, facts about tobacco, risks of smoking, the law

21. Lookout Tobacco • Shop • Laws around selling tobacco, buying single cigarettes, health warnings, comparing costs, counterfeit tobacco • Community Centre • Why do young people choose to smoke/ not smoke, local help and support, long term effects, smoke free ban, the law and advertising • School • Young peoples tobacco use, school rules, where to find help, environmental issues, health and sport, peer pressure.

22. Teacher Consultation Delivering tobacco education within Science curriculum • Year 7 - 50% • Year 8 – 61% • Year 9 – 39% • Year 10 – 44% • Year 11 – 44% • 33% of the schools questioned said they were not delivering within science Delivering tobacco education within PSHEe curriculum • Year 7 – 94% • Year 8 – 88% • Year 9 – 72% • Year 10 – 67% • Year 11 – 44% • All of the schools questioned said they were delivering within PSHEe

23. Impact of smoking in school – comments from school staff • Makes it difficult for them to concentrate, they sometimes get irritable and distracted. • Late for lessons, staff waiting time by chasing them around the school during break / lunch times. • Going off site is a safety issue. Carrying lighter and cigarettes against school rules.

24. How does school normally respond to pupils smoking on school site? • 83% pastoral response • 28% detention at lunchtime • 44% detention after school • 33% verbal warning • 17% written warning • 72% parental letter • 11% fixed term exclusion (none permanent) • 39% signpost to another service (school nurse) • 28% would refer to another service (NHS Helplines,GP, Young Addaction)

25. How does school normally respond to pupils smoking on school site ? 44% said they would respond in other ways including: • Smoking or be associated with smoking leads to 5 consecutive lunchtime detentions. Parents are contacted within 1 hour of incident. • PCSO involved. • Referred to Head Teacher, placed in behaviour support room for a number of days. Meeting with parents. • No services will help pupils. PCT school nurse some assistance this is quite frustrating.

26. Pupil focus group • Impact on you and your friends: • Doesn’t impact – don’t care about health don’t care about what they can’t see – outer appearance that matters. • Calm, stressed, angry, annoyed when you don’t have a fag, chills us out, stops arguments • Most young people started smoking ages 10 -12 • Sources: • Mum buys, shops, random people in the street, school in singlesNot being asked for ID • Should still be 16 if you can get married and have sex at 16 • Information / Education: • People learn for themselves – own experience

27. Brief Intervention Training - evaluation comments • Very useful to learn about how we can train people in school to provide practical help to students. • Excellent information to take back to school and advise students who want to give up. • Really useful but not enough time. We need Level 2 training to be the next step in prescribing. • Very good. A really practical and hands on session. Session leader was very good. • Really useful, very informative, very inspiring presenter. • Fantastic – wonderful speaker – good information. • Need smoking intervention in school – not sign posting. Staff (school) are on overload and don’t have time to train on a service (specialist) that is already working well. Bring the girls in!

28. Niche and Counterfeit tobacco Delivered by Trading Standards officers at all Secondary Consortia Meetings (November 2010) • Increased my knowledge to add to smoking course in school. • Interesting and informative. • Very informative about products and the law. • Good to see the products so that we know what we are looking for. • Probably too much information. Don't expect we'd ever have the skills, in school, to really recognise illegal products. Would always refer to relevant agencies if we have suspicions. Law enforcement v education remit?

29. Resource boxes Content: • There are a range of materials purchased from : • GASP (a one stop shop for stop smoking and smoking education resources and tobacco control consultancy, nationally and internationally recognised). • HIT (an organisation providing training, consultation and information on drug-related issues.) • Locally developed materials.

30. Displays 3D illustrated box of stop smoking tips 3D interactive display of a giant cigarette and 15 of the toxic chemicals in tobacco smoke

31. DVDs Lots of visual tips on how to stop smoking CLEARING THE AIR… A play about smoking and the effects on our lives. Written by Dead Earnest for Pendle Council using funding from NHS East Lancashire and involved local schools and colleges. There is an information sheet highlighting the different issues contained within the resource boxes.

32. Interactive resources • CO monitors - detailed instructions on how to use included Shortness of breath pack – interactive pack for up to 38 pupils to demonstrates how smoking restricts breathing and what Chronic Obstructive Pulmonary Disease feel like Demonstrates the amount of tar in tobacco smoke of average smokers 15-20 a day

33. Leaflets and posters • A-Z of Poisons in Tobacco Smoke • Ten Top Reasons to Stay Smoke Free • What’s in tobacco smoke • Tobacco Industry – Poster • Kiss a Non Smoker – Poster • Like Snogging an Ashtray

34. Smoke Screen • Stop Smoking strategies resource for teachers / staff working with 11-18 year olds in schools, colleges, youth projects and other settings. Free Resources • North West Illicit Tobacco Fact sheet • Tobacco, Young People and the Law • Smoke Free Homes materials • Reduce the Risk of Cot Death • Give Me Room to Breathe

35. Links to curriculum • Included within the boxes are sheets which outline how the resources link to KS3 and KS4 Non Statutory curriculum • PSHE - Personal Wellbeing • PSHE - Economic Wellbeing and Financial Capability • Citizenship • Science

36. Powerpoint presentations • A series of presentations sourced from various national documents and local data: • Young peoples presentation • Social context of smoking presentation • Adult presentation • Impact of smoking on health – short and long term pictures • Tobacco products – South Asia

37. Other work • Smoking and the Law leaflet • Global Youth Tobacco Survey – 13 schools in Lancashire • Piloting of ‘Smoke and Mirrors’ resource – 13 schools • Piloting of TACADE ‘Up in smoke!’ resource – 6 schools • Piloting peer-led intervention project in one FE College • Repeat of TSNW Survey – April 2011

38. MAPPING EXERCISE TO IDENTIFY WHAT ALCOHOL, DRUG, TOBACCO EDUCATION IS DELIVERED IN LANCASHIRE’S FURTHER EDUCATION COLLEGES • All of the FE colleges consulted with were found to deliver alcohol, drug, tobacco education although to varying degrees. Information was mainly delivered through tutorial sessions. Staff were required to deliver alcohol, drug, tobacco education (although not all staff across the board). In the majority of the colleges it was a role for either personal tutors or other facilitators. • Eight out of the 10 colleges responded to the young people’s consultation exercise. In total there were 1,234 completed questionnaires received. • 57% of the young people questioned felt that they received enough relevant information about drugs, alcohol and tobacco in college. However, 43% of students felt that they did not receive enough.

39. MAPPING EXERCISE TO IDENTIFY WHAT ALCOHOL, DRUG, TOBACCO EDUCATION IS DELIVERED IN LANCASHIRE’S FURTHER EDUCATION COLLEGES Young people were asked to identify which drugs that they felt had most impact on college age students (this was an open ended question and therefore open to different interpretations by young people).

40. FE College Events • An informal / interactive session focusing on raising awareness around health and lifestyle impacts of smoking with students (16-18) i.e. using CO monitor to test levels of carbon monoxide. • To provide an educational resource for staff; the folder includes stop-smoking strategies offering a realistic approaches to the issues of smoking among young people. • To evaluate the effectiveness of a range of tobacco resources designed to educate young people. • To promote volunteer opportunities for young people to be involved in a No-Smoking Day ‘peer education’ project.

41. UCLAN Survival Kit