1. Action research: smoking in a disadvantaged community in Nottingham Ann McNeill John Britton Marilyn Antoniak Graeme Docherty Laura Jones University of Nottingham Brendan Gough Nottingham Trent University Susan MacAskill and Martine Stead University of Stirling

2. Why this study? Nottingham City PCT and the Nottingham Strategy Action Group were concerned about smoking in Nottingham generally and Aspley Ward in particular Nottingham City PCT and the Nottingham Strategy Action Group were concerned about smoking in Nottingham generally and Aspley Ward in particular They have funded a 2 year study aimed at: They have funded a 2 year study aimed at: Understanding why smoking rates are so high in the Aspley Ward Understanding why smoking rates are so high in the Aspley Ward Working with the community to reduce smoking Working with the community to reduce smoking

3. The Aspley Ward Comprises: Aspley Estate Aspley Estate Broxtowe Estate Broxtowe Estate Bell’s Lane Estate Bell’s Lane Estate

4. What have we been doing? 1. Community mapping: Desk research Desk research Conducting short ‘street interviews’ with residents to gather a range of attitudes to smoking Conducting short ‘street interviews’ with residents to gather a range of attitudes to smoking 2. Intensive data collection to gather more in depth views on Aspley, smoking and potential interventions: 1. Focus groups with local residents 2. Interviews with ‘key informants’

5. Street interviews 100 people interviewed 100 people interviewed 31 smokers 31 smokers 27 had made previous quit attempts; 20 of them had used support 27 had made previous quit attempts; 20 of them had used support Most smokers were aware of the local NHS Stop Smoking Service Most smokers were aware of the local NHS Stop Smoking Service 10 ex smokers of whom 4 had used support to quit 10 ex smokers of whom 4 had used support to quit

6. What are important issues in relation to health for people living in the Aspley area? No response/don’t know 78 No response/don’t know 78 Healthy eating 6 Healthy eating 6 Smoking 4 Smoking 4 Alcohol 3 Alcohol 3 Other (healthcare, environment, Other (healthcare, environment, employment, education etc) 15 employment, education etc) 15

7. To what extent is your or other people’s smoking a problem for you? Smoking is a problem32 Smoking is a problem32 Common responses:  It effects everyone’s health  Smelly, costly and dirty Smoking is not an issue53 Smoking is not an issue53 Common responses  Acceptance /matter of choice  Better since smoking ban Don’t know/no response15 Don’t know/no response15

8. Key interviews Phase 1: June to September 2009 Phase 1: June to September 2009 15 interviews 15 interviews Phase 2: November 2009 to January 2010 Phase 2: November 2009 to January 2010 12 interviews 12 interviews Interviewees included health professionals, local community leaders, police and other local community workers and retailers Interviewees included health professionals, local community leaders, police and other local community workers and retailers

9. Focus groups Phase 1: July to September 2009 Phase 1: July to September 2009 10 focus groups conducted 10 focus groups conducted Phase 2: December 2009 to January 2010 Phase 2: December 2009 to January 2010 7 focus groups conducted 7 focus groups conducted 82 local residents of mixed ages, sex and smoking status were consulted

10. Common themes There was no cohesion across the ward as a whole, each estate independent of others There was no cohesion across the ward as a whole, each estate independent of others Lack of accessible local amenities and poor uptake of what is available Lack of accessible local amenities and poor uptake of what is available Little detailed understanding of available services Little detailed understanding of available services Word of mouth played important role Word of mouth played important role Feeling that local New Leaf service is somewhat rigid Cheap cigarettes identified as a problem

11. Issues for consideration Learned behaviour across the generations Perception of risks of smoking alongside other problems Sensitivity around closing local fag houses, more consensus around the problem of proxy purchasing More flexible approaches needed to attract and draw smokers into quitting, eg cutting down first? Role of community workers and figures seen as key

12. Next steps Developing a list of potential interventions which will be discussed for feasibility with key stakeholders at a strategy meeting next week Developing a list of potential interventions which will be discussed for feasibility with key stakeholders at a strategy meeting next week Smokers’ support group started Smokers’ support group started Implement new interventions in collaboration with community members Implement new interventions in collaboration with community members

13. Thank you Any questions?