Scottish Ministerial Working Group on Tobacco Control minutes: June 2019

Attendees and apologies

Chair:

Mr Joe FitzPatrick, Minister for Public Health, Sport and Wellbeing

Present:

Mr John Lee, Scottish Grocers Federation
Mr David Woodrow, National Federation of Retail Newsagents (Scotland)
Professor Linda Bauld, University of Edinburgh 
Professor Amanda Amos, University of Edinburgh
Mrs Sheila Duffy, ASH Scotland
Professor Sally Haw, University of Stirling
Mr Peter Cheema, Scottish Grocers Federation
Mr Daniel Jones, British Heart Foundation Scotland
Mrs Debbie Sigerson, NHS Health Scotland
Mr George Dodds, NHS Health Scotland
Ms Dawn Adamson, Society of Chief Officers of Trading Standards in Scotland
Ms Anna Bennett, Young Scot
Mr Craig Somers, Society of Chief Officers of Environmental Health in Scotland
Dr Alison McCallum, NHS Lothian
Ms Karen Gray, NHS Lothian
Ms Tracy McGillivray NHS Lothian

SG officials:

Mr Morris Fraser, Tobacco Control Team
Mr Elaine Mitchell, Tobacco Control Team
Mr Stephen Young, Tobacco Control Team
Mrs Julie Landsberg, Health and Social Care Analysis

Apologies:

Dr Andrew Fraser, NHS Health Scotland
Mr Adam Osprey, Community Pharmacy Scotland
Mr Frank Toner, British Lung Foundation
Mr Garrick Smyth, COSLA
Professor Gerard Hastings, University of Stirling
Mr Gregor McNie, Cancer Research UK
Mrs Liz Sadler, Scottish Government
Mr James Cant, British Heart Foundation Scotland 
Ms Moyra Burns, Scottish Health Promotion Managers
Mr Paul Waterson, Scottish Licensed Trade Association
Mr John Glen, Tobacco Control Team

Items and actions

Welcome and introductions

The Minister welcomed everyone to the meeting and thanked members for their contribution to reducing the harm caused by tobacco and that Ministers were particularly happy to see the continued focus of effort and the continued improvement in successful quits in areas where smoking rates are highest.

Members were asked to declare if there were any additions to the statements previously provided relating to Article 5.3. The group indicated that there were no further changes to report since the previous meeting.

The Minister noted apologies and that the minutes of the last meeting of 27 March 2018 have been cleared in advance of this meeting, noting any additional comments should be forwarded to the Tobacco Control Team. 

Smoking prevalence 2017

Julie Landsberg gave a presentation to the group on Smoking statistics. A link to the presentation is attached for ease of reference.

In discussion the following points were made: 

• smoking prevalence is down to 18% in 2017/18
• the deprivation gap has narrowed but rates remain three times higher in the most deprived areas than in the least
• statistics show that 68% of smokers want to quit smoking

Questions were asked around the fact that prevalence rates remain higher in Scotland and Northern Ireland. Morris Fraser explained that one element of this was that proportion of deprivation was higher in these nations. Another element was migration and the impact of ethnicity and culture. The smoking levels of different migrant populations varied and the migration patterns to Scotland and Northern Ireland brought with them some of the migrant populations with the highest smoking rates. We know from the Scottish Core Questions Survey for example that people from Poland are more likely to be smokers than people from many Asian countries, which have culturally lower rates of smoking.

In discussion, Professor Bauld advised that there is going to be a new data set on smoking available for Scotland shortly. This data set will be provided by the newly established SPECTRUM group, of which she is a Director. This will effectively extend the toolkit which provides monthly smoking data in England to top make this level of data available for Scotland for the first time.

Comments were also raised around why there was a low uptake of Varenicline in Scotland? The drug commonly known as Champix has been shown to be much more effective than NRT in helping people quit. Morris Fraser informed the group that the drug had been under scrutiny over apparent links to mental health issues in the USA. The suspected link has now been disproven but there was likely to be some hesitation to prescribe it amongst some pharmacists and GPs.  

Members of the public are also likely to have read scare stories about the drug and as one in three smokers have a mental health condition, there is likely to remain some reluctance to try the treatment. The uptake of electronic cigarettes by those attempting to stop smoking may have also kept the use of Varenicline lower than desired.

Dr McCallum added that there was also a lot of propaganda about the dangers of stopping smoking and the effectiveness of interventions. This is something she thinks should be looked into. Health boards are also not always keen to spend money on smoking cessation products.  

Professor Amos advised that there was evidence that disadvantaged smokers where less likely to be offered Varenicline. Although health inequalities were reducing this could be improved if the drug was more readily available to disadvantaged groups. The Minister said that increasing the appropriate use of Varenicline should be an action point.

Questions were also asked about the availability of data for the rates of quits using electronic cigarettes and the capture of data on people quitting out with services. Julie Landsberg advised that there is currently no specific data available around this other than the overall numbers of people who reported having given up each year as recorded in the Scottish Health Survey. The rate of people quitting overall in Scotland continued to rise year-on-year. 

Action plan report 

Morris Fraser gave a presentation which provided a report on the first year of the tobacco control action plan. He said that delivery of the action plan was not only for the Scottish Government but as a result of the work undertaken by all the people gathered round the table, and others, who collectively were making a difference.  

A link to the presentation is attached for ease of reference.

In discussion the following points were made:

• the stop-smoking campaign, Getting Through 72 was aimed at tackling the feelings of some potential quitters who think it will be difficult and lengthy to give up smoking. The campaign is still being assessed for impact. This was one of many campaigns which have been supported by the Scottish Fire and Rescue Service - due to the prevalence of home fires caused by cigarettes
• Directors of Public Health had made a recommendation that vaping should be permitted consistently across Scotland on hospital grounds but not near buildings
• if smoking were removed in Scotland, it would have the same effect as  effect of lifting one in three children in the most deprived areas out of poverty
• the main focus of action in the second year of the action plan will be on prevention. A stocktake of all the activity currently going on is being undertaken. A forum has been set up to look at further ways we can help prevent people from taking up smoking

Pete Cheema asked what budget was available for tackling illicit trade and highlighted that this was a problem for retailers and we should look at how to tackle this issue in a better way. It was highlighted that this was a reserved matter.  

The Scottish Government were also asked what assistance it could provide to retailers to convert people to using vapes, noting that any assistance would be helpful. Morris Fraser said that the SG is aware of the importance to the economy of the retail sector, that we are alive to their concerns about reducing the number of smokers in Scotland and that we are willing to work with them.

The Minister asked how Pete Cheema would see that looking going forward, to which Mr Cheema replied that work was underway and that this warranted further discussion post meeting. This was agreed by the Minister as an action point.

Dr McCallum reminded those present that the WHO framework convention calls for all healthcare facilities to be smoke free rather than just hospitals and said that we should look at the issue of smoking across all these environments. She said tackling smoking around hospital buildings was the beginning of the process and there was a need to move on with this to try to implement wider coverage quickly.

Morris Fraser advised that we have three or four actions on that included in the Action Plan. Tackling smoking around Local Authority buildings, schools etc. were in our plans and we are looking at how to encourage businesses to see that it was in their best interests to help their staff quit. The focus for the next 12 months though, will be on prevention and we will move on to other healthcare environments these areas after that. Professor Bauld also volunteered that she is happy to help with the SG’s work.  

Sheila Duffy noted that we still need to be careful around messaging, keep it front and centre, about the risks and dangers of smoking tobacco.

John Lee enquired if the review on the Tobacco Register had taken place. Morris Fraser said that we do not currently have an action on this but a review of the register. It was agreed that from a research point of view, the Tobacco Register had been a great help.  

Pete Cheema said that his organisation was receiving numerous calls about the UK Government’s Track and Trace system, which came into effect on 31 May 2019, and that retailers were finding the system difficult to use. It was highlighted that any issues with this system should be taken up with HMRC.

Sub-group reports 2017

Dawn Adamson reported on the work of Trading Standards. A link to the report is attached for ease of reference. 

In discussion the following points were highlighted:

• enforcement work around illicit tobacco and test purchasing continued in line with the targets that had been set by the Scottish Government. The failure rate from test purchasing remains around 10% by the rate of failure at follow-up visits was going down
• the enforcement community welcomed the Scottish Government’s continued support for this work
• local authorities continued to provide advice and helped with training retailers on Nicotine Vapour Product requirements and found compliance to be generally good
• the tobacco detection dog continued.  The dog was used by seventeen authorities last year to trace illicit tobacco
• local authorities noted that there were developments being made across the UK on digital ID as a way to provide proof of age for purchasing tobacco.  While these could not be used in Scotland, authorities would want to keep up with developments in other parts of the UK

Craig Sommers provided an update that his society’s Environmental Health Group had reconvened at the beginning of March.

George Dodds gave an update on the prevention sub-group. The group has reconvened and are in the process of finalising the remit and membership of the group. It is considered a good model of how a sub-group should work. There have been two very productive meetings to date, sharing information and studies around young adults smoking, e-cigarettes and responsive work. 

Professor Bauld provided an update that the research sub-group was a very vibrant sub-group and continued to inform us about relevant Scottish, UK and International research in the field of Tobacco Control. The group to date had had two meetings. Some of the group’s members and been highly successful in raising funding over the last year, which reflected the continuing commitment to research and evidence on tobacco control in Scotland.

Next steps

Morris Fraser advised that the Scottish Government has committed to publishing two consultations in 2019. The first would be on smoking around hospital buildings. A summer consultation would allow for an autumn slot in Parliament with a view to introducing legislation early 2020. The second consultation would be on restrictions on the advertising and promotion of NVPs.

AOB

Professor Haw provided an update that the international conference in June was now being postponed. However, it is hoped that the conference can be re-arranged to take place around the end of the year, which would be around the time of the first anniversary of prisons going smoke-free in Scotland.

It was also agreed that a doodle poll will follow with potential dates for the next meeting of the group.