Health Inequalities Resource Pack
In the UK, smoking rates have declined year-on-year in response to a comprehensive evidenced-based tobacco control strategy. However, while rates have broadly declined across society, they remain disproportionately high in some communities and inequalities in smoking rates have grown since the turn of the century.
Regardless of background, the majority of adult smokers want to stop. Most begin smoking in childhood, as a result of environmental determinants, and only realise how hard it is to quit after becoming addicted. More than two thirds of those who try smoking go on to become regular smokers. Once addicted quitting is tough, with a recent estimate suggesting that on average people who smoke will try 30 times before succeeding. The more those around you smoke, the more likely you are to start smoking and the more difficult it is to quit, perpetuating these cycles, and transmitting inequalities across generations.
Smoking is responsible for at least half the difference in life expectancy between the richest and poorest in society. However, higher rates of smoking and greater levels of addiction are not only found among those in lower socio-economic groups, but also among other sections of the population, many of whom already experience health and wider socially determined inequalities. Higher rates of smoking both drive and exacerbate these inequalities, leading to poorer health outcomes and even locking people into poverty.
Going smokefree, particularly for those who are most addicted, is easier with support and through targeted action. Only by eliminating the inequalities in smoking rates and achieving a smokefree society for everyone can disparities in life expectancy and quality of life be significantly reduced. Local authorities can and do play a central role in this and should ensure that comprehensive strategies are in place to deliver equality in health.
ASH with the support of the Faculty of Public Health, the Association of Directors of Public Health, Public Health England and Fresh has produced this set of materials to help reduce smoking rates among people experiencing health inequalities.
The pack is designed as a set of pragmatic tools, setting out the problems and solutions, to support the case for targeted tobacco control in groups with high smoking prevalence. Below you will find a range of briefings about population groups which experience higher rates of smoking and tobacco addiction as well as a compilation of ASH’s resources on health inequalities and how best to tackle them.
Condensed briefing on the relationship between smoking and low socio-economic groups. September 2019.
Condensed briefing on the relationship between smoking and people in contact with the criminal justice system. September 2019.
Condensed briefing on the relationship between smoking and mental health conditions. September 2019.
Condensed briefing on the relationship between smoking and people with multiple needs. September 2019.
Condensed briefing on the relationship between smoking and people with long-term conditions. September 2019.
Condensed briefing on the relationship between smoking and pregnancy. September 2019.
Condensed briefing on the relationship between smoking and the LGBT communities. September 2019.
Condensed briefing on the relationship between smoking and people experiencing homelessness. September 2019.
Condensed briefing on the relationship between tobacco and ethnic minority groups in Great Britain. September 2019.
*NEW* Evidence into practice briefings
This evidence into practice briefing looking at smoking prevalence among people from different BME backgrounds. The briefing sets out the current evidence, a series of case studies and lessons for practice on what local authorities can be doing to further reduce tobacco use among BME populations. March 2020.
This joint evidence into practice briefing from ASH and the LGBT Foundation sets out evidence and examples for local authorities on engaging with smokers from LGBT communities to reduce the high levels of tobacco use among LGBT populations. March 2020.
This briefing looks at the evidence around use of different smokeless tobacco products among communities in England and the risks these products pose to health. It includes case studies from local areas and recommendations for practice to help further reduce tobacco consumption. March 2020.
Tools and Resources
This report focuses in detail on the need for greater support for social housing tenants to quit and the significant contribution this could make to eliminating health and wider inequality.
The Pan-London Homeless Hotel Drug and Alcohol Service (HDAS) was commissioned by the Mayor of London and City of London at the end of March 2020, in the context of the “Everyone In” policy. This policy placed rough sleeping populations in emergency hotel accommodation across the country to protect them from COVID-19, enabling them to self-isolate. There was concern that a significant proportion of London’s rough sleeping population would have support needs in relation to substance misuse (SM) and tobacco use. HDAS was commissioned to address this need.
This ‘lessons learned’ report presents findings and evaluation of the support offered by HDAS and local treatment services for SM and tobacco harm reduction and also provides practical guidance based on this experience for how rough sleepers can best be supported with SM and tobacco harm reduction both when immediately off the streets in temporary accommodation and when moving into more permanent accommodation.
The first of these three videos features:
- Dr Sharon Cox, London South Bank University, and Dr Debbie Robson, Kings College London, discussing how smoking is not only related to disadvantage but maintains it
- Professor Lynne Dawkins, London South Bank University, introducing tobacco harm reduction
- Professor Peter Hajek, Queen Mary University, discusses the evidence on e-cigarettes
In the second video:
- Dr Debbie Robson and Dr Allan Tyler, London South Bank University, discuss their work on smoking cessation and homelessness and share some key insights for practice
- Prof Lynne Dawkins and Dr Catherine Kimber, London South Bank University, discuss e-cigarettes and cover some basic trouble shooting points on how they’re used
The Partnership aims to bring together organisations committed to improving the health and lives of people with mental health conditions and has a range of resources to support this goal.
This page will regularly be updated with the latest ASH resources on health inequalities