Four key public health organisations unite to tackle health inequalities.

Monday 03 December 2007
Four leading public health organisations are urging local planners to target smoking as a way of tackling health inequalities. Smoking prevalence is a key indicator not just for smoking-related diseases but also for health inequalities, since smoking is responsible for over half the difference in mortality rates across the social classes.[1] Reducing health inequalities is one of the Government’s stated aims and it has set a target to reduce smoking in the overall population to 21% by 2010 and to 26% among ‘routine and manual’ groups. [2] Although recent Government measures such as the smokefree workplace legislation will help to cut overall smoking rates, if the target to reduce smoking in manual groups is to be reached more will have to be done at the local level. As local authorities are currently consulting on new Local Area Agreements, including funding plans and performance indicators, a number of organisations are calling for such Agreements to include targets to reduce smoking.

The Heads of four key organisations are now writing to lead members in local authorities and Primary Care Trusts to urge them to seek to include within the targets for the Local Area Agreement a reduction in smoking at local level as a ‘stretch target’, in order to reduce health inequalities. [3] [4] (A stretch target is one that stretches performance over and above the basic agreed performance indicators.) The organisations concerned are:
• Association of Directors of Public Health
• Chartered Institute of Environmental Health
• Faculty of Public Health
• Trading Standards Institute

Graham Jukes, Chief Executive of CIEH, said:

“Smokefree legislation and smokefree policies have achieved a great deal, but smoking remains the biggest single preventable cause of ill-health and premature death and a key marker of health inequalities. In order to reduce smoking among those who are most disadvantaged, it is vital that challenging targets are set so that progress towards this goal can be properly monitored. We therefore urge all those involved in drawing up Local Area Agreements to include smoking prevalence as a stretch target.”

Professor Alan Maryon-Davis, President of the Faculty of Public Health, said:

“Smoking is still the biggest killer – and it is concentrated in disadvantaged communities. By focusing on these vulnerable groups we can reduce smoking rates and tackle health inequalities at the same time. A win-win strategy.”

Deborah Arnott, Director of the health campaigning charity ASH, said:

“ASH welcomes this initiative by the four key organisations representing those working in public health in local authorities and Primary Care Trusts, the CIEH, the Faculty of Public Health, the Association of Director’s of Public Health and the Trading Standards Institute. This is a recognition of the central role that smoking plays in exacerbating health inequalities between the most affluent in society and routine and manual workers.”


Notes and links:
[1] Jarvis, M. J. and Wardle, J (2005) Social patterning of health behaviours: the case of cigarette smoking. In: Marmot, M. and Wilkinson, R. (eds) Social Determinants of Health. Oxford: Oxford University Press, 2ndedition.
[2] The smoking targets form part of the Department of Health’s Public Service Agreement and were originally set out in the 2004 PSA Targets. Current smoking prevalence among all adults in England is 24% but among routine and manual groups it is 31%.
[3] Text of Letter sent by CIEH, TSI, ADPH & FPH
[4] CIEH ASH briefing paper on Local Area Agreements and smoking prevalence

Contact: Deborah Arnott 020 7739 5902 (w) 079 7693 5987 (m) ISDN available

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