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Reductions to Stop Smoking and Tobacco Control (S04)


Portfolio: Health and Partnerships Portfolio


Tobacco Control – Contribution to FRESH No contribution to FRESH the regional office for Tobacco Control. There would be no capacity to undertake local campaigns and limited capacity to support national or regional campaigns in Darlington.

Ending of Wider Tobacco Control £28,500, FRESH North East


S4 - Reductions to Stop Smoking and Tobacco Control

Your Say

8 comment(s)

This table lists comments from the public about this proposal


Core HP4 (Public Health Stop Smoking Service)
Cut S04 (Stop Smoking and Tobacco Control)

Cut this service

Cut S04 (Stop Smoking and Tobacco Control)

Stopping smoking is down to will power (I am an ex smoker so know), campaigns etc. don't really help so t6he council should save the money. If some one wants to stop smoking they will.

Cut S04 (Stop Smoking and Tobacco Control)

Reference- Fresh and Balance funding We are writing in response to the recently published Borough Council budget proposals and specifically in relation to the potential cancellation of all funding to Fresh and Balance in 2017-18. We understand that there will be a meeting in relation to the budget proposals tomorrow. We absolutely sympathise with the Council, which we know is facing incredibly hard decisions with regards to public health and many other areas of business, due to wider local government funding cuts. We also of course appreciate all of the support you have given to Fresh and Balance over the years. However, it is important to stress that Darlington and the North East as a whole, suffers an appalling burden as a result of alcohol and smoking, with massive costs to local authorities, the NHS, the police, workplaces, families and communities. Alcohol and tobacco are also the leading causes of preventable illness and mortality in Darlington, representing the most immediate public health challenges facing not just adults, but also future generations, in the town. From a Darlington perspective: • Alcohol costs £41.09m per annum, in costs to the NHS, crime & licensing, social services and the workplace • Alcohol is a factor in an estimated 10,969 recorded and unrecorded crimes in Darlington every year • There were 2430 alcohol-related hospital admissions in 2013-14 • 198 people prematurely die from smoking every year • Tobacco use generates 18,000 GP appointments and 3,900 hospital admissions and outpatient visits per annum • The tobacco burden equates to a £3.6m cost to the NHS and an extra £1.3m to the council spent on social care costs – not to mention the cost to local people. In addition, alcohol and tobacco also drive health inequalities: people from more deprived groups suffer far greater harm from than people in higher socio-economic groups and this is particularly clear in communities across Darlington and the wider North East. Taking this huge burden into account, it is clear that continued investment in Balance and Fresh offers the most efficient and cost effective option for tackling tobacco and alcohol related harms in Darlington. Evidence shows that the most impactful way of tackling smoking and alcohol harm is to take action at a population level: since the two programmes were introduced (Fresh 2005 and Balance 2009) key impacts have been made on tobacco and alcohol: • Smoking has declined by more than a third from 2005 to 2014, with the biggest decline of any region in England from 1 in 3 adults regularly smoking in 2005, it is now down to 1 in 5 (19.9%). This is 165,000 fewer smokers. The North East approach of working together has been commended by the World Health Organisation, England’s former Chief Medical Officer Sir Liam Donaldson, the NHS Leadership Academy, and in two government strategies. The North East “locally together” approach has been recently praised by Public Health England as the model for the rest of the country. • Smoking related mortality in the NE is declining faster than the national average. • The North East is the only region in the country to experience a decrease in the rate of alcohol-related hospital admissions and it has significantly narrowed the gap with the rest of England. • Leadership, expertise and advocacy on both tobacco and alcohol creating a social movement and some of the highest levels of public support nationally. In addition, Darlington would continue to generate significant efficiencies through commissioning regional programmes. For example, hugely impressive economies of scale are achieved across the North East, particularly around PR, where the annual returns on investment have regularly exceeded 30:1 achieving unpaid media coverage of over £3million per year; and through award winning mass media campaigns, where buying power is substantially cheaper at a regional rather than local level. Taken as a proportion of Balance and Fresh’s budgets, Darlington has as one example benefitted from two world class alcohol and tobacco media campaigns per year – in four separate bursts of activity - reaching significant numbers of the target population, for approximately nine pence per capita of the local population. That simply would not be possible through isolated investment at the local level. As noted earlier, we appreciate the difficult choices facing the council, in the light of unprecedented funding cuts. However, we genuinely believe that working together as a region makes us stronger and more cost effective for the people of Darlington. In the absence of investment in evidence-based programmes, which have been shown to deliver excellent results for the local authority, the concern is that we will see rates of smoking and risky drinking creep up again, with more lives lost, more illness, more pressure on local services and greater costs in the long-term. Finally, if Darlington Council does withdraw all funding from Fresh and Balance the whole future of the model is potentially at stake as for a decade now it has covered the whole region. We would ask you to consider whether continuing to fund the two programmes, even at a substantially reduced level, would be possible in order to maintain the significant progress made in addressing the two most important public health issues for the people of Darlington.

Cut S02 (DAAT and substance misuse)
Cut S04 (Stop Smoking and Tobacco Control)
Cut S13 (Social Fund Budget)

There are three proposals as part of the MTFP as follows: • Terminate the funding provided to First Stop Darlington by the Drug, Alcohol and Tobacco (DAAT) Team for the Substance Use Homelessness Service. This is a discretionary service, currently contracted to March 2018 (subject to annual review) and the proposal is to end it a year early, on the 31st of March 2017. • Disband the Drug, Alcohol and Tobacco (DAAT) Strategic Commissioning Team. Services for drugs, alcohol and tobacco control are part of the Council’s Public Health responsibilities but are defined as discretionary services. The proposal is for the whole team to be made redundant in 2016-17 and its functions to be split up and either terminated, absorbed into Public Health, or transferred to other Council departments. • Terminate the funding provided by the Council to the FRESH North East Tobacco Control Office and Balance North East Alcohol Office. These are defined as discretionary services and are currently jointly contracted, with the other 11 North East Councils, to March 2017. The proposal is for Darlington to end its contributions on the 31st of March 2017. Darlington LG Branch of Unison is concerned at the impact these proposals will have, not just for the immediate service users and the staff that deliver the services but for other, probably overburdened, services and staff that will have to deal with the fall-out. Whilst funding for First Stop and Fresh/Balance has funding secured for another year, DAAT is due to be disbanded much earlier. This will be a significant loss to the community because of the essential work DAAT does, particularly around prevention of harm to young people and its partnership working with other agencies. After speaking to [...], I believe [...] can put together a workable plan to deliver these services into the future, albeit in a different way, but they will need time to do this. I would suggest keeping DAAT going for a further year to allow [...] to put together a plan B.

Cut S04 (Stop Smoking and Tobacco Control)

I’m writing to express ASH’s support for Darlington Council’s continued funding of a regional tobacco control programme. We are unable to respond to the detailed questionnaire but wanted to take this opportunity to set out clearly why ASH believes the regional tobacco programme in the North East offers exceptional value for money for the Council. Action on Smoking and Health (ASH) is the country’s leading charity dedicated to ending the harm from smoking. Find out more about ASH here: We understand that this is a time of unprecedented pressure on local government finances and localities have been forced to take difficult to decisions about where to prioritise investment. However, given the contribution that reducing smoking makes to tackling health inequalities and delivering on key public health indicators, such as the reduction of premature deaths, investment in the regional tobacco control programme should be a priority. ASH has developed a tool which helps local authorities understand the impact of smoking on their community, which shows that smoking in Darlington costs £30.1 million a year (see attached document setting this out). The programme in the North East has been an exemplar for the rest of the country demonstrating what can be achieved both in terms of outcomes and value for money where local authorities join resources up across a region. In the North East, Fresh achieves a great deal for localities for the investment made, for example: • Media campaigns such as the highly successful recent 16 Cancers campaign which no single local authority could deliver alone. • Securing a high level of PR for smoking issues throughout the year (nearly £2.5 million PR value in 15/16) which again local authorities would struggle to achieve, particularly in the context of diminishing corporate resources to undertake such work • Opportunity for best practice to be shared and developed across the region through the coordination of various regional forums and networks • Delivery of ground breaking new approaches to reducing smoking such as the recent roll out of the highly successful babyClear programme to reduce the number of women who smoke in pregnancy • Undertaking region-wide work that could not be replicated successfully at a local level such as tackling illicit tobacco • Tracking various metrics which it would be difficult for each locality to invest the resource in alone such as public opinion and assessing size of illicit market • Acting as an important hub of expertise for tobacco control professional across the region able to provide strategic advice and practical support to the 12 alliances, the commissioners This activity has resulted in some major achievements for the North East: • Smoking has declined by more than a third from 2005 to 2014, with the biggest decline of any region in England from 1 in 3 adults regularly smoking in 2005, it is now down to 1 in 5 (19.9%). This is 165,000 fewer smokers. • Smoking related mortality in the North East is declining faster than the national average. • The North East has highest public support for tobacco control measures • North East maternal smoking rates have fallen by 4.0% (from 20.7% to 16.7%) compared to a 2.6% decline nationally The investment in a regional tobacco control programme has been exceptional value for money and provided a blue print for other areas of public health and firmly placed the NE on the international map for innovative, effective, collaborative working. ASH strongly urges the council to maintain its investment in this programme. There are few other areas of public health, or indeed tobacco control, where such a small level of investment could deliver so much for the people of Darlington.

Cut S04 (Stop Smoking and Tobacco Control)

We are responding to the consultation exercise related to the proposed 100% cut to Fresh and Balance from 2017/18. We did not think it was appropriate to complete the questionnaire but did want to provide further thoughts in relation to the proposal. We also emailed to the official consultation feedback on 10th February 2016 when initial views were called for. This email is pasted below for ease of reference. We wish to express our continued serious concern at the implication- locally, regionally, and nationally- of this 100% cut. We are of course very conscious of the significant pressure the authority is under and do sympathise with the team and the predicament that you are under in terms of making 'savings' and the difficult decisions that need to be made. But we would ask that you reconsider this 100% cut and consider some financial contribution to the programmes for 17/18 even if this is a nominal amount. Any contribution would be welcomed and would importantly keep the authority tied into the locally together North East approach around these two very important public health issues. This approach has been going for a decade now and the North East has shown real leadership with the approach being viewed as the exemplar for elsewhere. There is a real risk that by withdrawing totally from contributing to the Programme it could cause instability indeed risk the whole viability of the programme. We believe that the contribution that you currently make to Fresh and Balance is exceptional value for money and that Darlington has benefited significantly from this investment into the regional pooled budget. We have always delivered 100% of our KPIs in the Service Level Agreement and provided much more beyond the SLA. In the last year alone, the Borough through its combined £56,000 contribution to Fresh and Balance has received: • Two world class integrated mass media campaigns ("16 cancers" for tobacco with TV, radio, digital, social media, PR and "Spot of Lunch" for alcohol with TV, digital and PR. Both of these have reached significant numbers of Darlington residents with evidence based messages supporting behaviour change. • Nearly £6 million of earned media coverage across the region around tobacco and alcohol issues throughout the year • Promotion and support to Stoptober and Dry January campaigns • Expert advice around a range of topics including: smoking cessation commissioning, tobacco regulation, alcohol licensing etc • Expert advice and support to Tees Esk Wear Valley Trust on smoking culminating in the Trust going 100% smokefree in March • In depth report on alcohol's impact on the emergency services • An alcohol licensing conference and an event on alcohol in secondary care • Training to trading standards on the EU Tobacco Products Directive • Three different quarterly tobacco forums and two quarterly alcohol forums for Darlington to attend and gain up to date information on range of issues, share practise • Ongoing work around smoking in pregnancy through the babyClear initiative with the independent evaluation showing, amongst others, this has nearly doubled quit rates and led to a 6% increase in birth weights of babies born to mothers who have quit during pregnancy • Ongoing advocacy on issues of direct relevance to the borough including: tobacco tax in the budget, impact of tobacco poverty on local communities and campaign for a levy on the tobacco industry, alcohol duty and minimum unit price, drink driving and health labelling • Provision of local data to Darlington on smoking cessation, smoking in pregnancy, alcohol related hospital admissions, cost of alcohol harm, cost of alcohol admissions by GP surgery • Annual public opinion survey on tobacco issues, showing NE support remains the highest in the country with expectation from the public for more action • Annual public opinion survey on alcohol harm showing local data on drinking levels, awareness of alcohol harms and support for evidence based policies • Electronic cigarettes research and evidence event attended by a number of professionals from Darlington and Fresh briefing on e-cigs provided • Assistance for responses to government consultations including tobacco licensing and the CMO guidance In summary, we hope that you can reconsider this proposal and instead consider some level of a contribution from 2017/18 towards Fresh and Balance. We have enjoyed working with you over the years and thank you for all of the support to date- financial but also through the leadership to the Alcohol Partnership, during the previous 'review' period pre transition, and of course through the local delivery of work on tobacco and alcohol.

Cut S04 (Stop Smoking and Tobacco Control)

Letter from Fresh and Balance regarding funding


Cut S04 (Stop Smoking and Tobacco Control)

Response to the Fresh and Balance proposals