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Battlefield Croftfoot Carmunnock Crosshill M S a r c m Castlemilk Greater h 2 0 o Cathcart Gorbals 1 0 k Croftfoot Govani hill n A Crosshill Kings g Park s o C f s C o Greater LB angside e m M e m E Gorbals Ms ount u P s n s o i p t s m y Govanhill u Florida l a H a e t e i t Kings Park Pa ollokshields o l n t i n h o L Langside & Shawlands i t v n i C n a g Mount SimR shill r N i e n e P S e Florida Sa trathbungo o p r u t e n t o h Pollokshields e Toryglen d r E r s a h s t s Shawlands i Battlefield p Simshill Cat rmunnock Strathbungo Castlemilk Toryglen Cathcart Battlefield Croftfoot Carmunnock Crosshill Castlemilk Greater Cathcart Gorbals Smoking Cessation Needs Assessment Report Contents Contents Page Acknowledgements ii Welcome iii Executive Summary v 1 Introduction 1 2 Methodology 3 3 Culturally sensitive cessation services – learning from others 5 4 Attitudes to tobacco use and the current Stop Smoking Service in South East Glasgow 7 5 Conclusions and recommendations 19 Appendices: Appendix 1 Breakdown of sample 27 Appendix 2 Discussion guides 28 Appendix 3 Case studies 32 Page i Acknowledgements Smoking Cessation Needs Assessment Report Acknowledgements The authors of this report would like to acknowledge everyone who contributed to this needs assessment including staff from NHS Greater Glasgow & Clyde, staff from South East Glasgow CHCP, representatives of the local South Asian and Eastern European community, case study participants and local community organisations. Prepared for: Nicola Fullarton, Health Improvement Lead, South East CHCP Prepared by: Linda McCall, Principal Consultant Alistair McCrae, Principal Consultant Izabela Nowak, Consultant Page ii Smoking Cessation Needs Assessment Report Welcome Welcome This report details the key findings from the Smoking Cessation Needs Assessment of the BME communities within South East Glasgow CHCP. Tobacco use remains the number one cause of preventable ill health and death within Scotland, and over 31% of adults in this area smoke. South East CHCP has a very diverse population, including the highest BME population in Scotland. Evidence shows that although a high Bailie James Scanlon percentage of the BME communities Chair, South East Glasgow Community Health & Care Partnership smoke, or use tobacco products, very few access local cessation services. This needs assessment was commissioned to examine whether services are culturally sensitive, whether they meet the needs of our diverse population, and to inform future service delivery. We look forward to working in parnership with a range of local organisations and agencies in taking forward an agreed local action plan. Page iii Smoking Cessation Needs Assessment Report 1 Gorbal s 1 2 East Polllo kshk iel ds 2 Govanh ill Shawlandsawlan Tor yglenl Battlttlefie ld Kings ParkP Croft foott Soc ial Work O ffices 1 Gorbal s 2 East Pollokshiel ds 3 3 3 Castlem ilk Ca stlemi lkk Healt h Centres 1 Gorbal s 2 Govanhill Ca rmun noc k 3 Castlem ilk Forsyth Hous e SE CHCP Headquarters Page iv Smoking Cessation Needs Assessment Report Executive Summary using one-to-one depth interviews and focus groups, was adopted and the research was conducted in five waves as follows: Background • A literature review to identify smoking prevalence amongst BME communities Population figures for the South East of and to highlight examples of best practice Glasgow reveal a significant black and minority in culturally sensitive Stop Smoking ethnic (BME) community in the area, services elsewhere in the UK predominantly of South Asian and Indian descent but with an increasing number of • Development of case studies of 6 Eastern Europeans (Slovakian in particular). examples of best practice • Interviews with 17 key partners of the Although smoking has reduced amongst current Stop Smoking Service in the SE Scottish adults to around 25% of the CHCP area population, the number of smokers in deprived • Interviews with 15 key informants from areas and amongst BME communities remains the local BME community higher. UK Census information and anecdotal evidence from the Department of Communities, • 9 focus groups with representatives of Local Government and studies by ASH, suggest Pakistani, Indian and Eastern European that smoking is particularly high amongst tobacco users from the local community. Eastern European immigrants and Asian communities (around 29% - 40%). Learning from others In common with other areas in Glasgow, South The literature review combined searches in a East Glasgow CHCP (SE CHCP) offers a range of range of journals and databases and reviews of smoking cessation support including groups, national statistical sources and specialist one-to-one support and pharmacotherapy organisations’ websites. The search was available in hospitals, GPs and community looking for Stop Smoking services specifically pharmacies. A service for pregnant smokers is aimed at local BME populations in areas with also available. However, local data suggests similar demographic, socio-economic and that only 1.4% of clients using the community deprivation profiles as the South East of smoking cessation services in South East Glasgow. It identified 9 Stop Smoking projects Glasgow are from the BME population. across the UK, from which 6 were selected and profiled as case studies. Methodology Whilst each service was designed specifically to Given the large BME population in the area, SE meet the needs of local BME communities, CHCP wished to ensure that their Stop Smoking there were a number of common themes in services were culturally sensitive and met the their approach to delivering a culturally needs of local ethnic smokers. They also sensitive service, particularly in terms of: wished to establish what factors would be important to encourage local BME smokers to • Contact and engagement: use the service. • The services were marketed A combination of literature review, case study specifically at the BME community development and stakeholder engagement, using local community links. Page v Smoking Cessation Needs Assessment Report • Service delivery: community suggested that there were two key • Cessation services linked with other factors preventing members of the BME health issues appeared more community using the current Stop Smoking successful in encouraging services - cultural influence and lack of engagement with, and attendance awareness of the local service. The research from, the local BME community. indicated that both issues impacted on the Stop Smoking service’s ability to: • Confidentiality of service provision was critical to encourage • Contact and engage with the BME attendance (particularly amongst community; female South Asian smokers). • Deliver effective stop smoking support to • Services were delivered at times which the BME community; suited the BME community. This often meant that services were provided in • Provide an effective infrastructure to evenings or at weekends. support service delivery. • Service infrastructure: Contact and engagement • Services were delivered in locations which the BME community was Whilst many of the barriers to effective contact familiar with and comfortable in. and engagement are specific to each culture, two issues were common to both communities, • Workforce planning and development: namely: • Engagement and attendance was most successful when the services • Lack of awareness of the service; were delivered by members from • Language barrier and literacy issues, the BME communities targeted, particularly amongst older South Asians overcoming potential issues with and the Slovakian community. cultural sensitivity and language. • All staff providing the service had In addition to lack of awareness, South Asian received specific training in both tobacco users were concerned about anonymity the service pathway and in smoking and confidentiality. Keeping their habit hidden cessation. is of paramount importance to female smokers who go to considerable lengths to hide their These themes were explored in more detail with smoking. Even male smokers suggested that key partners, key informants and smokers from they preferred not to smoke at home and did the South Asian and Eastern European not smoke in their parents’ house. communities in South East Glasgow to establish to what extent they impacted upon the local They suggested that, as a result, they would be Stop Smoking service. unlikely to seek advice about stopping smoking from their community leaders and some female Attitudes to current service smokers would be reluctant to raise the matter provision in South East Glasgow with anyone, even their GP. Feedback from the key partners, key informants The Eastern European population, Polish and and representatives of the local BME Slovakian, are fairly transient preventing Page vi Smoking Cessation Needs Assessment Report regular contact with services and also creating • The ability to drop in and out of the more pressing problems with housing and service to accommodate other family employment, reducing their concern about, and commitments. interest in, stopping smoking. Smoking is also an accepted pastime amongst Eastern Smoking is a highly sensitive topic in the South Europeans, with whole families smoking in the Asian community. Key informants providing community. group support in other equally sensitive health areas such as mental health and domestic Service delivery violence emphasised the need for the service In both communities, key informants and infrastructure to support: smokers were aware that smoking was bad

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