Memorandum by Ms Jane Sunter, Public Health
Development Manager—Tobacco Control, North, South and Central
Manchester Primary Care Trust (WP 84)
I work within the Manchester Public Health Development
Service, managing the tobacco control remit on behalf of North,
South and Central Manchester Primary Care Trust (PCT). This includes
the coordination and management of the Manchester Stop Smoking
Service.
1. The national current estimate of smoking
prevalence taken from the General Household Survey (2002) is 26%.
Smoking prevalence varies considerably between geographical and
socio-economic areas, with the North West currently holding the
highest overall prevalence (28%) of all-English regions.
1.1 In Manchester the estimated prevalence
of smoking is considerably higher than even North West totals,
with 40% of the population smoking in North Manchester PCT, 37%
in South Manchester PCT and 35% in Central Manchester.
1.2 In order for us to hit the ambitious
target advocated to reduce the smoking prevalence to 11% by 2022,
cities like Manchester need to take brave and drastic action to
start to turn the tide of the high mortality and morbidity rates
in its population. This action would also have an impact in helping
to contribute to the steep quit targets set through the Local
Delivery Plan process.
1.3 Whilst the Manchester Stop Smoking Service
welcomes the spirit of the White Paper in promoting choice in
the individual and personalizing health care, we feel that the
White Paper has not gone far enough in recommending that smoking
should be banned in all enclosed public places and work places.
We had hoped that the Government would use the White Paper to
spearhead the campaign, enabling our cities to become Smoke Free,
following the highly positive outcomes of the Irish experience.
2. The White Paper states that between 10-30%
of pubs would fall in to the "not serving food" category
and would, therefore, be exempt from any smoking ban. In Manchester,
we know however, that this figure may rise up to 80-90% of pubs
being exempt, reflecting the high levels of social inequalities
present in some Manchester wards. The recommendations of the White
Paper, as they are currently proposed, would actually widen the
gap in health inequalities experienced by many socially deprived
groups within the city.
2.1 The Manchester Stop Smoking Service
is currently undertaking a survey in conjunction with Smoke Free
North West, University of Manchester and John Moores University
to assess the current provision of food serving in the pubs of
Manchester. This will provide us with base line information to
enable us to monitor changes in attitude to smoke free work places
and reduction or expansion of the serving of food in licensed
premises.
2.2 The publication of the White Paper was
an opportune time for the Government to become a trail-blazer
in applying its own recommendations for "new action"
and "fresh thinking" around Smoke Free status for cities
and communities, but the document's lack of leadership has led
to disappointment and confusion in how cities now take this agenda
forward on behalf of their communities.
3. On a Greater Manchester level, many of
the Local Authorities are now working with the NHS to move their
cities and communities to Smoke Free status. Licensees have, however,
expresses concern that as Smoke Free status is achieved at different
rates in each area, and many pubs will be exempt from becoming
Smoke Free and an un-level playing field will be created. This
could mean that individuals unable to smoke and drink in Manchester
may travel to Stockport for a night out, creating an impact on
the local economy. A blanket ban would have removed any discrepancies
and create a fair and equitable market across the Greater Manchester
conurbation.
3.1 As a service, we are now more than equipped
to be able to deal with the growing demand of people requesting
support to quit. As the campaign to move Manchester to Smoke Free
status by 2006 continues, the White paper has been instrumental
in increasing the debate around the concept of what it means to
be Smoke Free. The White Paper has not, however, taken the opportunity
the lead the way in tackling the greatest threat to public health
within this century.
| 
