Targeting Tobacco An alternative approach

1. Targeting Tobacco An alternative approach Carolyn Baker

2. Why another smoking project? • The Targeting Tobacco project aims to contribute to reducing Tasmanian smoking rates to 15% by 2016. • The current adult smoking rate for Tasmanians (daily & occasional) is 21.7% and is declining .. Daily and occasionally smoking rates as defined in the Australian Health Survey 2011/12. BUT

3. Smoking rates are increasing for some • People in lower socio economic groups have higher smoking rates than people in higher socioeconomic positions AND • People facing multiple disadvantages have the highest smoking rates of all.

4. Australian National Preventative Health Agency 2013

5. Tobacco is a social justice issue 1 in 2 smokers will die from smoking Higher prevalence of smoking by disadvantaged groups means that people • start smoking earlier • smoke for longer • smoke more heavily • fewer attempt to quit Higher prevalence = higher level of health problems + impact on disposable income

6. Financial impacts of smoking In Australia among smoking households • 11% suffer severe financial stress • poorest households spend 20% of their income on tobacco • children twice as likely to go hungry • less income for housing/rent • higher absenteeism from work Sources: Siahpush, Borland & Scollo (2003); Siahpush,Spittal & Singh (2007); Siahpush, Yong, Borland, Reid & Hammond (2009); Scollo & Winstanley (2008)]

7. Benefits of quitting • Quitting smoking brings immediate financial benefits and reduces suffering from financial stress by 42%. • A pack-a-day smoker can save more than $5000 a year by quitting.   • Tackling Tobacco Program NSW indicates community sector clients (with an average income of $400 or less) spent around $64 per week on smoking. • Quitting smoking potentially enables people on low incomes to increase their disposable income Source: Cancer Council NSW (2012)

9. A vicious cycle Social disadvantage and deprivation Makes circumstances worse Creates vulnerability to smoking Smoking prevalence

10. Aim of Targeting Tobacco Project Reduce smoking-related harm amongst disadvantaged groups by Building capacity of social and community service organisations to • Make smoking care part of usual care • Support clients to quit

11. What we have done to date • State-wide survey of Tasmanian community service organisations in April 2014 • Investigated how social and community service organisations address smoking with their clients and staff. • To read the final report go to Quit Tasmania website http://www.quittas.org.au/resources-professionals/targeting-tobacco

12. Results Over 76 responses to the survey were received from 44 different community service organisations around the state. Half the respondents were actively engaged as either case workers 17 (24%) or support workers 19 (26%) Proportion of smokers working in the community services sector daily and occasional was estimated at 27% Community workers believed more than half their clients smoked

13. Smoking Policies Table 1. Organisation policies 85% of respondents stated their organisations had smoking policies Most policies covered smoking in buildings (90%) and vehicles (76%), Fewer policies exist around staff and client smoking on home visits, accompanied outings and in temporary accommodation.

14. Organisation Practices 47% respondents indicated their organisational practices did not include recording a client’s smoking status on their files 32% of community service workers never ask clients if they are interested in quitting or cutting down their smoking 39% never record quit smoking attempts 44% never include quit smoking plans as part of a service to clients 26% never refer clients for additional quit smoking support.

15. Attitudes to smoking • 74% of community service workers believed smoking ads to their clients’ disadvantage. • 75% of respondents believed smoking clients should receive support to quit smoking • 62% of respondents believe smoking care should be offered to clients by their organisation • 40% believed the organisation currently supported staff to be able to provide this assistance

16. Skills and confidence to address smoking Staff training on smoking cessation had occurred in 24% of organisations in the last 12 months While community workers were confident in discussing smoking with clients, the confidence levels of staff in knowledge about ways to quit using nicotine replacement therapy and its cost was low. This reduces the ability of staff to inform clients about current ways they can go about quitting and in turn restricts opportunities for staff to offer a meaningful brief smoking intervention to clients.

17. “what skills, support and resources are needed to better enable organisations to support clients and staff interested in quitting smoking?” • Training and education • Review community organisation smoking policies • Improve client documentation • Review smoking resources Literacy issues were identified as a weakness for many people accessing community services. Easy to read, visual materials would be of use in discussing smoking with clients.

18. The next 6 months • Quit Tasmania is offering free 1 hour briefings to community service organisations keen to update staff on ways to support staff and clients interested in quitting. • Sessions will be targeted to the population groups with whom organisations predominantly work • Briefings will be held August to December 2014. • A Targeting Tobacco Community Worker Kit of helpful resources is being developed

19. For more information • Carolyn Baker • Cancer Council and Quit Tasmania • Ph: 62428109 • Email: cbaker@cancertas.org.au • Visit: www.quittas.org.au