Smoking and Mental Health HWb workshop 9th July 2015 Emily Clarke Assistant Manager Hertfordshire Stop Smoking Service Liz Fisher Head of Provider Services Tobacco Control Lead

What we are covering: Why this is so important Motivation and barriers to quitting What’s happening locally Hertfordshire Stop Smoking Service – what can we offer? Making a referral Better together – workshop discussion and next steps

Why Tobacco Control remains important Single most important cause of premature death and disability Kills 80,000 people prematurely in England alone and 1,500 people in Herts die every year Accounts for 50% of health inequalities between better and worst off Disproportionately affects most deprived groups 135,300 smokers in Herts Cost the NHS £55 million in

Smoking Still Kills Courtesy of ASH Obesity: 34,100 Smoking: 79,100 Alcoho l: 6,669 Suicide: 5,377 Illegal drugs: 1,605 HIV: 504 Traffic: 1,850 Leading cause of preventable death

All deaths in men and women aged 35 and over in England, 2013 Source: ASH (2015) Smoking Still Kills

Herts smoking prevalence

Smoking in People with Mental Health Conditions Source: RCP and RCPsych (2013) Smoking and Mental Health

Smoking and Mental Health Greatest impact on health inequalities High prevalence – no change over 20 years 70% in some groups years of life lost 42% of all tobacco smoked Misconceptions about wanting to quit and impact on mental health

Smoking and Mental Health Improved mental health reduces lifestyle risk behaviours Smoking responsible for most of the excess mortality in people with severe mental health conditions

Slide courtesy of Gay Sutherland

Slide courtesy of Gay Sutherland

Slide courtesy of Gay Sutherland

Tobacco – an NHS priority NICE PH48 NICE NICE PH45

Smokers who would find quitting difficult Source: RCP and RCPsych (2013) Smoking and mental health

What’s happening locally? CLeaR review on tobacco control NHS systems leaders’ commitment to tobacco control Herts smoking and mental health action group Implementing NICE PH48 – supporting HPfT to become Smokefree Implementing NICE PH45 – harm reduction approaches Mental health and smoking master classes Developing more specialist stop smoking services – behavioural sciences Included within the Quality Metrics for HPfT

What does a Stop Smoking Service offer? Medication (on prescription) Nicotine Replacement Therapy (NRT) x 7 Zyban & Champix Behavioural Support At least 5 weekly meetings with trained advisor or a 7 week group Carbon Monoxide Monitoring The service is FREE Ongoing Encouragement Periodic phone support in the first year (3, 6 and 12 months)

HSSS Referral Form

Better together: Raising the profile of smoking and mental health Improving the knowledge and motivation of stakeholders Identification of people with mental health conditions who smoke Offering advice to people with mental health conditions who smoke Offering intensive behavioural support and medication to service users Making Smokefree the norm in mental health settings

Thank you!

HSSS Contact Details For further information or to refer a patient/client: (secure address) Phone: or Fax: Text: (patients can just text ‘Smokefree’) Website: smokefreehertfordshire.nhs.uk All of the above are available to staff, patients and the public

Further reading Primary Care Guidance on Smoking and Mental Disorders: health.aspx RCP report: _key_recommendations.pdf _key_recommendations.pdf NICE PH48: NICE PH45: BI training: