Ayrshire and Arran Tobacco Control Strategy Volume 2 (Fact File) 2012 - 2021 “Moving Towards a Smoke Free Ayrshire and Arran” Contents Page 1. Introduction 3 2. Demography of Ayrshire & Arran 4 - 10 3. National Policy Drivers 11 - 15 4. Local Policy Drivers 16 - 20 5. Tobacco Related Data 21 - 38 6. Prevention and Education 39 - 43 7. Provision of Smoking Cessation Services 44 - 50 8. Health Protection 50 - 57 9. Stakeholder Involvement 58 10. Performance Management 59 11. Conclusion 60 12. Appendix 1 61 – 65 13. Appendix 2 66 1. Introduction Facilitating a reduction in the proportion of the population who smoke has been a priority for a number of years, at both a national and local level. The benefits of achieving this reduction are well established, with smoking being described as the number one cause of preventable death in Scotland (Beyond Smoke Free, 2010). In the current financial climate, the incentives and benefits of reducing the number of people who smoke could not be more apparent, with smoking related illnesses costing the NHS around £400 million a year (Scottish Government, 2010). While the financial implications of tobacco make the benefits of reducing smoking rates extremely advantageous, the number of deaths due to smoking related illnesses (13,500 Scots per year, Scottish Government, 2010) and the number of hospital admissions caused by smoking (33,500 admissions per year, Scottish Government, 2010) makes a reduction in tobacco consumption an imperative. This document, aims to provide an overview of the evidence which supports the production and need for the actions outlined in Volume I of the Ayrshire and Arran Tobacco Strategy. This will be achieved by highlighting information on the following key areas: - The demography of Ayrshire and Arran - The national tobacco policy drivers - The local tobacco policy drivers - Tobacco related data - The main approaches to tobacco control - Second Hand Smoke (passive smoking) - Protection and Controls - Stakeholder Involvement - Performance Management. This report will form a crucial part of an evidence base which will be used to inform and drive the work of a multi-agency Tobacco Strategy Group. 2. The Demography and Epidemiology of Ayrshire and Arran 2.1 Ayrshire and Arran is located in mid south central Scotland and is surrounded by Inverclyde and East Renfrewshire in the North, by Lanarkshire in the East and Dumfries and Galloway in the South. Figure 1: Map of NHS Ayrshire and Arran Source: http://www.scotland.gov.uk/Publications/2007/03/07153942/4 NHS Ayrshire & Arran covers an area of 750,464 square hectares in the south west of Scotland, from Skelmorlie in the north to Ballantrae in the south and Muirkirk in the east. The area covers a mix of rural and urban development with an overall population density of 0.56 people per square hectare, slightly below the national average. Out of the total population of 367,510 people1, around 80% live in community settlements of over 500 people. 1 2008 VPS survey 2.2 Population profile for Ayrshire and Arran Ayrshire and Arran is comprised of three locality areas: North, East and South Ayrshire, which all vary in population size (Figure 2). The mid-year population estimates for 2009 indicate that North Ayrshire has the largest population of 135,510, compared to 120,210 in East Ayrshire and 111,440 in South Ayrshire. Within each of the three areas, there are more females than males. Figure 2: Overview of estimated mid year population for East, North and South Ayrshire and for Scotland, 2009 East North South Scotland Population size - All 120,210 135,510 111,440 5,194,000 Females 62,065 71,229 57,995 2,678,712 Males 58,145 64,281 53,445 2,515,288 Source: General Register Office of Scotland (GROS) 2010 Based on the mid-2008 population estimates2, the key settlements within Ayrshire and Arran are: Irvine (North Ayrshire) 32,920 Kilmarnock (East Ayrshire) 44,390 Ayr (South Ayrshire) 46,070 The age profile for each area in Ayrshire and Arran are similar (Figure 3) with North Ayrshire having the highest number of individuals in each age group apart from the over 75 age group where the number of people in South Ayrshire is greater. In 2009, there is a noticeable difference in the population age profiles that can be seen in the oldest age group (75+), where the number of people in South Ayrshire is greater than that found in East and North Ayrshire. In all other groups the number of people within East Ayrshire is greater than South Ayrshire apart from the 55-64 age group where they are both similar. Figure 3: The number of people within each age group in East, North and South Ayrshire, mid-year estimates 2009 2 http://www.gro-scotland.gov.uk/files2/stats/population-estimates/08mye-localities-table1.xls 30,000 25,000 20,000 15,000 10,000 Number of Persons 5,000 0 Under 16 16-24 25-34 35-44 45-54 55-64 65-74 75+ Age Group East Ayrshire North Ayrshire South Ayrshire Source: General Register Office of Scotland (GROS) 2010 Other settlements with a population of over 10,000 include: Kilwinning, Prestwick, Troon, Saltcoats, Largs and Ardrossan. Cumnock in the east has a population of just over 9,000 people. There are also eight settlements with under 1,000 residents. NHS Ayrshire & Arran boundaries are coterminous with those of the three local authorities, North, South and East Ayrshire Councils. 2.2 Demography of Ayrshire and Arran Comparison between the census results of 2001 with that of 1991 indicated a reduction in the Ayrshire and Arran population of 1.03%, compared to an increase in the national average of 1.27%. The Voluntary Population Survey (VPS) in 2008 indicated a further fall of 0.2%. The population in North Ayrshire has declined by under 0.7% between 1991 and 2008, while in South Ayrshire, the reduction was 0.9%. Over the same period however, the population of East Ayrshire has decreased by 2.1%. Within settlements the changes are even more significant: Comparisons between 1991 and 2001 indicate changes ranging from a 20% reduction in population in Bellsbank and New Cumnock to a 26% increase in Coylton and a 58% increase in population in Loans3. 3 http://www.scrol.gov.uk/scrol/analyser/analyser?topicId=1&tableId=&tableName=Usual+resident+population&selectedTopicId=&aggregated=fa 2.3 Minority Ethnic population The 2001 Census4 indicated that the proportion of the population in ethnic minority groups in Scotland was 2% in comparison to 1.3% in 1991. For Ayrshire and Arran, the corresponding figures were 0.68% in 2001 in comparison to 0.49% in 1991. Nevertheless, NHS Ayrshire & Arran has the fifth lowest non European population in Scotland, with East, South, and North Ayrshire Council areas having the 5-7th lowest rates among the 32 local authorities. The largest ethnic groups in Ayrshire and Arran are fairly similar throughout Ayrshire and Arran’s localities: Chinese (0.18%) and Indian (0.16%). However, there is slight variation in East Ayrshire compared to the other council areas with an Indian population of 0.07% compared to a Pakistani cultural population of 0.14%. NHS Ayrshire & Arran provides documentation and translation in any language, and interpreters, when required. 2.4 Religious affiliation in Ayrshire and Arran In the 2001 census, 53% of the population described themselves as being allied to the Church of Scotland. This level is the third highest of any Health Board area in Scotland. The proportion of people allied to the Church of Scotland is another confirmation of the cultural homogeneity of the Ayrshire and Arran population. Slightly over 24% of the population described themselves as having no religion, the fifth lowest in Scotland. 2.5 Socioeconomics of Ayrshire and Arran Scottish Index of Multiple Deprivation (SIMD) data, indicates that there are significant differences in socio-economic status and deprivation levels throughout Ayrshire; with areas of significantly high poverty close to areas of very low poverty. It is recognised, furthermore, that most people who are dependent on income related benefits or who are otherwise socially excluded live out with recognised areas of poverty. lse&subject=&tableNumber=&selectedLevelId=&postcode=&areaText=&RADIOLAYER=&actionName=view- results&clearAreas=&stateData1=&stateData2=&stateData3=&stateData4=&debug=&tempData1=&tempData2=&tempData3=&tempData4=&a reaId=052&areaId=031&areaId=055&areaId=085&areaId=045&areaId=032&areaId=042&areaId=086&areaId=044&areaId=120&areaId=096& areaId=082&areaId=081&areaId=077&areaId=094&areaId=050&areaId=057&areaId=058&areaId=040&areaId=051&areaId=036&areaId=103 &levelId=9 4 http://www.gro-scotland.gov.uk/files1/stats/key_stats_chareas.pdf From the 2009 SIMD data5, there are 480 recognised data zones in Ayrshire and Arran (out of a Scottish total of 6505). Of these, a total of 28 are in the 5% most deprived areas of Scotland and another 28 in the 10% most deprived areas. In contrast, there are three areas in Ayrshire and Arran that are among the 5% least deprived in Scotland and another 18 in the 10% least deprived6. Figure 4 displays the significant inequalities between the most deprived areas in Ayrshire and Arran and the least deprived. Figure 4: Percentage Population by data zone (%) Local Authority Area East North South Ayrshire and Arran Rate Ayrshire Ayrshire Ayrshire total 5% most deprived 7% 6% 4% 6% 5-10% most deprived 6% 7% 3% 5% 10-5% most affluent 2% 1% 8% 4% 5% most affluent 1% 0% 1% 1% Grand Total 100% 100% 100% 100% Breaking down the proportion of the Ayrshire and Arran population living within quintiles 1-5 of employment deprivation (using SIMD 2009) (Figure 5).