1. Smoking and health inequalities Study Aims 1.Collation and dissemination of existing evidence 2.Extend the knowledge base 3.Identify opportunities for intervention

2. Smoking and health inequalities Methods Phase 1 Phase 2 Phase 3 desk research, interviews with experts

3. Smoking and health inequalities Methods Phase 1 Phase 2 Phase 3 postal and telephone Survey of 30 national agencies that work with low income groups

4. Smoking and health inequalities Methods Phase 1 Phase 2 Phase 3 In depth interviews with policy makers and service providers of key agencies

5. Smoking and health inequalities Phase 3 Aims Build trust and confidence Identify factors that encourage change Identify opportunities for collaboration Agencies Interviewed Government departments and agencies Social services and welfare organisations ‘Total institutions’

6. Smoking and health inequalities Government led approaches 4 models of tackling smoking among low income groups -Pilot projects in key settings -Smoking targets in broader programmes -Guidance to alliances -Approved Code of Practice on smoking (ACoP)

7. Smoking and health inequalities Government led approaches (contd.) Unrealistic, under-resourced, unsustainable and un-implemented Question marks over: -mechanisms for identifying and sharing good practice -Innovation and experimentation vs. evidence based practice

8. Smoking and health inequalities NGOs and social services Barriers Smoking – not a primary priority Other more urgent priorities Fear of alienating client group Conflicting loyalties about the rights of poor people to smoke Drivers Framing the issue in their terms Focusing on consumers demands Offering a helping hand Offering options -Information provision -Standards of professional development -Policy changes

9. Smoking and health inequalities ‘Total Institutions’ Barriers Long standing smoking culture Lack of information Confusion over funding Lack of leadership Drivers Identifying relevant evidence Recognising the importance of organisational structures Building support – partnerships with key agencies

10. Smoking and health inequalities Recommendations Improved provision of basic information Tailored information to specific audiences – staff working with low income groups Standard settings – improved professional development Brief interventions in non health care settings Partnerships with national charities working with low income groups Task force on smoking and health inequalities