Scotland's Future is Smoke Free: A Smoking Prevention Action Plan

APPENDIX 2:
RECOMMENDATIONS FROM THE SMOKING PREVENTION WORKING GROUP REPORT "TOWARDS A FUTURE WITHOUT TOBACCO"

Targets

1 New separate targets should be set for boys and girls at both 13 and 15 as follows:

% regular smokers at these ages

	Rate in 2002 SALSUS	Rate in 2004 SALSUS	Target for 2010	Target for 2015	Target for 2020	Target for 2025
Boys age 13	6	5	4	3	2	2
Girls age 13	9	7	6	5	4	3
Boys age 15	16	14	12	10	8	6
Girls age 15	24	24	20	15	10	6

2 The following new targets should be set for 16-24 year olds:

	Rate in 1998 Scottish Health Survey	Rate in 2003 Scottish Health Survey	Target for 2010	Target for 2015	Target for 2020
Adults age 16-24	35%	30%	25%	20%	15%

Research

3 Priority should be given to commissioning research that can provide a clearer understanding of current knowledge, attitudes and behaviour relating to the use of tobacco, alcohol and other drugs among 16-24 year olds. Regular surveys of 13 and 15 year olds should be continued.

4 All the new measures proposed in this report should, if implemented, be subject to rigorous evaluation to establish their impact and cost-effectiveness.

Reducing availability

The Scottish Executive should implement an integrated series of measures aimed at substantially reducing the availability, affordability and attractiveness of cigarettes and other tobacco products to young people. It should:

5 ensure that much greater efforts are made to enforce the prevailing legal age of purchase. These should include: the use of proof of age; active test purchasing; prosecution with heavy fines and education of retailers and trading standard officers.

6 introduce a negative licensing scheme to enable vendors who repeatedly sell cigarettes to under-age customers to be prohibited from selling tobacco products.

7 amend the current offence of selling tobacco products to anyone under the age of 16 by raising the minimum age to 18. There should be a sufficient delay between amending the legislation and its implementation to prepare both customers and retailers for a smooth transition. Its impact should be carefully evaluated.

8 urge the UK Government annually to increase the price of tobacco products at a rate faster than inflation.

9 make representations to the UK Government to urge that health considerations are taken into account in the decision making process of EU policy concerning the taxation of tobacco products, as is required by the Framework Convention on Tobacco Control.

10 refer the issue of the sale of packs of ten cigarettes to the UK Government for consideration in the light of further research into its likely impact.

11 commission research to ascertain the extent to which young people in Scotland purchase cigarettes in packs of ten.

12 commission research to ascertain the current extent of use of smuggled or personally imported tobacco by young people.

13 ensure that Customs and Excise and the police in Scotland both put a high priority on activities aimed at reducing the influx of smuggled tobacco.

14 urge the UK Government to maintain and if necessary increase the investment in staff and equipment needed to control the influx of smuggled tobacco.

15 urge the UK Government to review the appropriateness of the current limits for the importation of cigarettes from other EU countries for personal use and the effectiveness of the controls thereof.

16 urge the UK Government to work collaboratively with the EC and other Member States to help develop a comprehensive international protocol on illicit tobacco as agreed at the first Conference of the Parties of the Framework Convention on Tobacco Control.

17 reinforce the UK Government's intention to require graphic photographs of smoking-related diseases to be displayed on cigarette packets.

18 together with the UK Government and other devolved administrations, look at ways to reduce positive images of smoking in the media and associated publicity materials, including reviewing any additional measures which might be taken to strengthen the ban on tobacco advertising and promotion introduced in 2002.

19 prohibit the display of cigarettes at the point of sale, to be replaced by a simple list of the brands available and their prices.

Discouraging young people from smoking

The Scottish Executive should also implement an integrated series of measures aimed at discouraging young people from starting to smoke and encouraging and enabling young smokers to stop:

20 Building on previous work by Health Scotland and the Health Education Board for Scotland, an ongoing, multi-stranded media campaign should be designed and implemented to discourage the uptake of smoking by young people of any age. One strand should have a strong focus on developing messages and using media that will have resonance with girls and young women in disadvantaged circumstances. Another should target young people in their late teens.

21 A comprehensive reassessment and reform of education on tobacco, alcohol and other drugs in Scottish schools should be carried out by a working group whose members bring expertise in drugs education research and delivery and in the design, integration and delivery of complex educational programmes across the curriculum.

22 Given the importance of parents' influence upon whether or not their child will smoke, an integral part of drugs education in school should be to inform parents about tobacco, alcohol and other drugs and their responsibilities in this regard. This should mainly be done by sending parents clear, consistent information at regular points during their child's progress through school.

23 At the relevant stages, parents should be encouraged by midwives, health visitors, general practitioners and hospital doctors, nursery staff and teachers to create a smoke-free home and not smoke when their children are present.

24 Embracing the concept of the Health Promoting School, all schools should develop an holistic approach to the health and well-being of their pupils. The aim should be to ensure that the school's ethos, policies, services and extra-curricular activities all foster the health and well-being of all the pupils. This should include having and strictly enforcing a school no-smoking policy covering everyone using the school grounds.

25 Given the association between smoking (and other drug use) and mental health problems, truancy and juvenile offending, all schools should have effective systems for the assessment, support and care for such pupils, including the ability to liaise effectively with social services where necessary.

26 Given the clear evidence that many young people start to smoke or progress from occasional to regular smoking (and drink heavily or use other drugs) once they leave school, Universities, Colleges of Further Education, student associations, the National Union of Students and other major training providers should be invited to explore how they could better enable students or trainees to avoid starting to smoke or misuse alcohol or other drugs. This could be developed within the framework of "The Health Promoting University".

27 Research studies should be commissioned to test innovative, carefully designed ways of protecting and dissuading young people in disadvantaged areas from starting to smoke or becoming regular smokers.

28 All community-based youth organisations should be encouraged to adopt clear no-smoking policies and to use the opportunities open to them to reinforce the message about the addictiveness and harm to health of smoking.

29 In the light of the recent poor outcome of the pilot smoking cessation services for young people in Scotland we recommend that active consideration is given to developing other approaches within a carefully designed evaluation framework.

Making things happen

30 Given that implementation of the recommendations in this report would largely affect young people, a representative sample of young people should be consulted to seek their views on the recommendations.

31 The recommendations in this report should be used by the Scottish Executive as the basis for developing a fully resourced five year Action Plan, with built in performance measures subject to monitoring by the Scottish Ministerial Group for Tobacco Control.