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Tobacco and health in Wales. Hugo Cosh, Public Health Wales Observatory. 29th January 2013. Prevalence trend. Smoking prevalence has fallen considerably since 1970s; currently the best estimate is 23% of adults
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Tobacco and health in Wales Hugo Cosh, Public Health Wales Observatory 29th January 2013
Prevalence trend • Smoking prevalence has fallen considerably since 1970s; currently the best estimate is 23% of adults • Fall has slowed in recent years; target of 16% by 2020 (Tobacco Control Action Plan for Wales) is big challenge Source: General Lifestyle SurveySource: Welsh Health Survey Tobacco and health in Wales
Prevalence trend by occupational group • Around 45% in ‘never worked and long-term unemployed’ group and no sign of falling • 14% in managerial/professional occupations Source: Welsh Health Survey Tobacco and health in Wales
Prevalence by area • Generally highest in deprived areas • Four areas of Wales with prevalence over 30% (avg population 30,000) Tobacco and health in Wales
Prevalence by age • Continuing high smoking rates in younger men (25-44) • Approx 1 in 6 girls smoking weekly at age 15, compared to 1 in 9 boys Source: Welsh Health Survey Source: Health Behaviour in School-Aged Children survey Tobacco and health in Wales
Smoking in pregnancy • Around 1 in 6 mothers in Wales smoke throughout pregnancy – highest of UK nations • Prevalence highest in women in routine/manual occupations and those under 20 a) smoked throughout b) gave up before or during pregnancy Source: Infant Feeding Survey Tobacco and health in Wales
Second-hand smoke • 2007 ban has halved exposure in adult non-smokers • Children remain vulnerable to exposure at home (39% live with at least one smoker) and in cars (20% exposed to second-hand smoke on most recent car journey) Source: Welsh Health Survey Tobacco and health in Wales
Smoking-attributable mortality • In 2010, smoking is estimated to have caused 5,450 of 30,550 deaths (nearly 1 in 5) in Wales residents aged 35+ • Of these 5,450 deaths, 2,480 were from cancer • Estimated that around a third of the overall inequality in mortality is caused by smoking Tobacco and health in Wales
Mortality trends • Overall rates of death from smoking are falling • Lung cancer mortality (below) rising in women, but peak of smoking prevalence came later in 20th century than men Males Females Tobacco and health in Wales
Smoking-attributable hospital admissions • An estimated 27,690 admissions in 2010 were due to smoking, around 5% of all admissions in Wales residents • Rates are falling slightly over time Males Tobacco and health in Wales
Cessation (1 of 3) • A high proportion of smokers say they want to quit (70% in 2010 according to Welsh Health Survey) • Quit rates for Stop Smoking Wales are comparable with England’s but number using the service has not risen Numbers using Stop Smoking Wales Quit rate (self-reported, at four weeks) Tobacco and health in Wales
Cessation (2 of 3) Smokers in most deprived areas more likely to seek support from Stop Smoking Wales than smokers in least deprived areas, but treatment levels are similar Rate per 1,000 estimated smokers: a) given an appointment b) attending treatment Tobacco and health in Wales
Cessation (3 of 3) • Was not possible to obtain Wales-wide data on community pharmacy activity but around 350-400 offering level 2/3 enhanced services • Spend on NRT via pharmacy route where known Abertawe Bro Morgannwg UHB: £274,466 (2011) Aneurin Bevan HB: £34,194 (2011) CwmTaf HB: £31,355 (2010) HywelDda HB: £35,027 (2010/11) • Pharmacy quit rates where known (CO validated, 2010/11) BetsiCadwaladr UHB: 46% CwmTaf HB: 53% Powys THB: 44% Tobacco and health in Wales
Examples from California & Singapore • Falls in smoking prevalence achieved through sustained and bold intervention: • California: from 27% in 1985 to 13% in 2009 • Singapore: from 20% in 1984 to 13% in 2004 • Of 25-cent tax on cigarettes, 5 cents were dedicated to tobacco control by the landmark 1998 California Tobacco Tax and Health Protection Act. • Question of applicability of California/Singapore experience to the Wales context Tobacco and health in Wales
Acknowledgements Project Board Project team Project manager: Hugo Cosh Team: Gareth Davies, Ioan Francis, Elinor Griffiths, Leon May, Cath Roberts, Claire Tiffany, Margaret Webber Nathan Lester Mezz Bowley Cindy Marsh Cath Roberts Jane Wilkinson Also thanks to… Rose Allgeier, Joanna Arthur, Susan Belfourd, Dee Hickey, Ciaran Humphreys, Louise Megrath (Public Health Wales), Salah Sharif (NHS Information Centre) Tobacco and health in Wales
Find out more... Google ‘Tobacco health Wales’ PDF (bilingual) Technical guide Downloadable data Powerpoint slides Tobacco and health in Wales