1. www.hertsdirect.org 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

2. www.hertsdirect.org 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

3. www.hertsdirect.org 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 2013-2014

4. www.hertsdirect.org 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

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

6. www.hertsdirect.org Herts smoking prevalence 2010-2013

7. www.hertsdirect.org Smoking in People with Mental Health Conditions Source: RCP and RCPsych (2013) Smoking and Mental Health

8. www.hertsdirect.org Smoking and Mental Health Greatest impact on health inequalities High prevalence – no change over 20 years 70% in some groups 16-25 years of life lost 42% of all tobacco smoked Misconceptions about wanting to quit and impact on mental health

9. www.hertsdirect.org 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

10. www.hertsdirect.org Slide courtesy of Gay Sutherland

11. www.hertsdirect.org Slide courtesy of Gay Sutherland

12. www.hertsdirect.org Slide courtesy of Gay Sutherland

13. www.hertsdirect.org Tobacco – an NHS priority NICE PH48 NICE NICE PH45

14. www.hertsdirect.org Smokers who would find quitting difficult Source: RCP and RCPsych (2013) Smoking and mental health

15. www.hertsdirect.org 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

16. www.hertsdirect.org 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)

17. www.hertsdirect.org HSSS Referral Form

18. www.hertsdirect.org 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

19. www.hertsdirect.org Thank you!

20. www.hertsdirect.org HSSS Contact Details For further information or to refer a patient/client: Email: stopsmokingservice@hertscc.gcsx.gov.uk (secure address) Phone: 0800 389 3 998 or 01442 453071 Fax: 01442 453070 Text: 80818 (patients can just text ‘Smokefree’) Website: smokefreehertfordshire.nhs.uk All of the above are available to staff, patients and the public

21. www.hertsdirect.org Further reading Primary Care Guidance on Smoking and Mental Disorders: http://www.rcgp.org.uk/clinical-and-research/clinical-resources/mental- health.aspx RCP report: https://www.rcplondon.ac.uk/sites/default/files/smoking_and_mental_health_- _key_recommendations.pdf https://www.rcplondon.ac.uk/sites/default/files/smoking_and_mental_health_- _key_recommendations.pdf NICE PH48: https://www.nice.org.uk/guidance/ph48https://www.nice.org.uk/guidance/ph48 NICE PH45: https://www.nice.org.uk/guidance/ph45https://www.nice.org.uk/guidance/ph45 BI training: http://www.ncsct.co.uk/pub_training.phphttp://www.ncsct.co.uk/pub_training.php