DHSSPS Consultation on smoking in enclosed public places and workplaces

The Institute of Public Health welcomes the current consultation on smoking in enclosed workplaces and public places. Having considered the three options given the Institute strongly supports option 5c – “a total ban on smoking in all enclosed workplaces and public places”. This clearly outlines that a total ban on smoking in all enclosed public places and workplaces is the only option which will adequately protect the health of all workers and contribute to reducing the prevalence of smoking in the population of Northern Ireland.As an organisation set up to promote North South co-operation we believe that a similar approach to smoking in public places and workplaces should be taken to that in the Republic of Ireland where there is clear evidence that such policies are practical, well supported and effective.

Statistics on Smoking Cessation Services in Northern Ireland: 08/09: Pre Release Access List

2008/09 Pre-Release Access List

Annual Statistics on Smoking Cessation Services in NI

Annual Reports and Deprivation Maps

Towards a tobacco free society : Report of the Tobacco Free policy Review Group

This report is the latest of four reports dealing with various aspects of smoking. There is some inevitable overlap in these reports and the actual recommendations may be somewhat different but there is a common objective of seeking the most effective measures possible to dramatically reduce the level of smoking in our society and above all to prevent our children from starting to smoke Download the Report here

Speech by Mr. Micheál Martin TD – Meeting The Challenges Of Cultural Diversity In The Irish Healthcare Sector

It gives me great pleasure to accept the invitation to address this conference on “Meeting the Challenges of Cultural Diversity in the Irish Healthcare Sector” which is being organised by the Irish Health Services Management Institute in partnership with the National Consultative Committee on Racism and Interculturalism. The conference provides an important opportunity to develop our knowledge and understanding of the issues surrounding cultural diversity in the health sector from the twin perspectives of patients and staff. Cultural diversity has over recent years become an increasingly visible aspect of Irish society bringing with it both opportunities and challenges. It holds out great possibilities for the enrichment of all who live in Ireland but it also challenges us to adapt creatively to the changes required to realise this potential and to ensure that the experience is a positive one for all concerned but particularly for those in the minority ethnic groups. In the last number of years in particular, the focus has tended to be on people coming to this country either as refugees, asylum seekers or economic migrants. Government figures estimate that as many as 340,000 immigrants are expected in the next six years. However ethnic and cultural diversity are not new phenomena in Ireland. Travellers have a long history as an indigenous minority group in Ireland with a strong culture and identity of their own. The changing experience and dynamics of their relationship with the wider society and its institutions over time can, I think, provide some valuable lessons for us as we seek to address the more numerous and complex issues of cultural diversity which have arisen for us in the last decade. Turning more specifically to the health sector which is the focus of this conference, culture and identity have particular relevance to health service policy and provision in that The first requirement is that we in the health service acknowledge cultural diversity and the differences in behaviours and in the less obvious areas of values and beliefs that this often implies. Only by acknowledging these differences in a respectful way and informing ourselves of them can we address them. Our equality legislation – The Employment Equality Act, 1998 and the Equal Status Act, 2000 – prohibits discrimination on nine grounds including race and membership of the Traveller community. The Equal Status Act prohibits discrimination on an individual basis in relation to the nine grounds while for groups it provides for the promotion of equality of opportunity. The Act applies to the provision of services including health services. I will speak first about cultural diversity in relation to the patient. In this respect it is worth mentioning that the recognition of cultural diversity and appropriate responses to it were issues which were strongly emphasised in the public consultation process which we held earlier this year in the context of developing National Anti-Poverty targets for the health sector and also our new national health strategy. Awareness and sensitivity training for staff is a key requirement for adapting to a culturally diverse patient population. The focus of this training should be the development of the knowledge and skills to provide services sensitive to cultural diversity. Such training can often be most effectively delivered in partnership with members of the minority groups themselves. I am aware that the Traveller community, for example, is involved in in-service training for health care workers. I am also aware that the National Consultative Committee on Racism and Interculturalism has been involved in training with the Eastern Regional Health Authority. We need to have more such initiatives. A step beyond the sensitivity training for existing staff is the training of members of the minority communities themselves as workers in our health services. Again the Traveller community has set an example in this area with its Primary Health Care Project for Travellers. The Primary Health Care for Travellers Project was established in 1994 as a joint partnership initiative with the Eastern Health Board and Pavee Point, with ongoing technical assistance being provided from the Department of Community Health and General Practice, Trinity College, Dublin. This project was the first of its kind in the country and has facilitated The project included a training course which concentrated on skills development, capacity building and the empowerment of Travellers. This confidence and skill allowed the Community Health Workers to go out and conduct a baseline survey to identify and articulate Travellers’ health needs. This was the first time that Travellers were involved in this process; in the past their needs were assumed. The results of the survey were fed back to the community and they prioritised their needs and suggested changes to the health services which would facilitate their access and utilisation. Ongoing monitoring and data collection demonstrates a big improvement in levels of satisfaction and uptake and ulitisation of health services by Travellers in the pilot area. This Primary Health Care for Travellers initiative is being replicated in three other areas around the country and funding has been approved for a further 9 new projects. This pilot project was the recipient of a WHO 50th anniversary commemorative award in 1998. The project is developing as a model of good practice which could inspire further initiatives of this type for other minority groups. Access to information has been identified in numerous consultative processes as a key factor in enabling people to take a proactive approach to managing their own health and that of their families and in facilitating their access to health services. Honouring our commitment to equity in these areas requires that information is provided in culturally appropriate formats. The National Health Promotion Strategy 2000-2005, for example, recognises that there exists within our society many groups with different requirements which need to be identified and accommodated when planning and implementing health promotion interventions. These groups include Travellers, refugees and asylum seekers, people with intellectual, physical or sensory disability and the gay and lesbian community. The Strategy acknowledges the challenge involved in being sensitive to the potential differences in patterns of poor health among these different groups. The Strategic aim is to promote the physical, mental and social well-being of individuals from these groups. The objective of the Strategy on these issues are: While our long term aim may be to mainstream responses so that our health services is truly multicultural, we must recognise the need at this point in time for very specific focused responses particularly for groups with poor health status such as Travellers and also for refugees and asylum seekers. In the case of refugees and asylum seekers examples of targeted services are screening for communicable diseases – offered on a voluntary basis – and psychological support services for those who have suffered trauma before coming here. The two approaches of targeting and mainstreaming are not mutually exclusive. A combination of both is required at this point in time but the balance between them must be kept under constant review in the light of changing needs. A major requirement if we are to meet the challenge of cultural diversity is an appropriate data and research base. I think it is important that we build up our information and research data base in partnership with the minority groups themselves. We must establish what the health needs of diverse groups are; we must monitor uptake of services and how well we are responding to needs and we must monitor outcomes and health status. We must also examine the impact of the policies in other sectors on the health of minority groups. The National Health Information Strategy, currently being developed, and the recently published National Strategy for Health Research – Making Knowledge Work for Health provide important frameworks within which we can improve our data and research base. A culturally diverse health sector workforce – challenges and opportunities The Irish health service can benefit greatly from successful international recruitment. There has been a strong non-national representation amongst the medical profession for more than 30 years. More recently there have been significant increases in other categories of health service workers from overseas. The Department recognises the enormous value that overseas recruitment brings over a wide range of services and supports the development of effective and appropriate recruitment strategies in partnership with health service employers. These changes have made cultural diversity an important issue for all health service organisations. Diversity in the workplace is primarily about creating a culture that seeks, respects, values and harnesses difference. This includes all the differences that when added together make each person unique. So instead of the focus being on particular groups, diversity is about all of us. Change is not about helping “them” to join “us” but about critically looking at “us” and rooting out all aspects of our culture that inappropriately exclude people and prevent us from being inclusive in the way we relate to employees, potential employees and clients of the health service. International recruitment benefits consumers, Irish employees and the overseas personnel alike. Regardless of whether they are employed by the health service, members of minority groups will be clients of our service and consequently we need to be flexible in order to accommodate different cultural needs. For staff, we recognise that coming from other cultures can be a difficult transition. Consequently health service employers have made strong efforts to assist them during this period. Many organisations provide induction courses, religious facilities (such as prayer rooms) and help in finding suitable accommodation. The Health Service Employers Agency (HSEA) is developing an equal opportunities/diversity strategy and action plans as well as training programmes to support their implementation, to ensure that all health service employment policies and practices promote the equality/diversity agenda to continue the development of a culturally diverse health service. The management of this new environment is extremely important for the health service as it offers an opportunity to go beyond set legal requirements and to strive for an acceptance and nurturing of cultural differences. Workforce cultural diversity affords us the opportunity to learn from the working practices and perspectives of others by allowing personnel to present their ideas and experience through teamwork, partnership structures and other appropriate fora, leading to further improvement in the services we provide. It is important to ensure that both personnel units and line managers communicate directly with their staff and demonstrate by their actions that they intend to create an inclusive work place which doesn´t demand that minority staff fit. Contented, valued employees who feel that there is a place for them in the organisation will deliver a high quality health service. Your conference here today has two laudable aims – to heighten awareness and assist health care staff to work effectively with their colleagues from different cultural backgrounds and to gain a greater understanding of the diverse needs of patients from minority ethnic backgrounds. There is a synergy in these aims and in the tasks to which they give rise in the management of our health service. The creative adaptations required for one have the potential to feed into the other. I would like to commend both organisations which are hosting this conference for their initiative in making this event happen, particularly at this time – Racism in the Workplace Week. I look forward very much to hearing the outcome of your deliberations. Thank you.

SLÃÅN: Smoking Patterns in Ireland: Implications for policy and services

SLÃÅN: Smoking Patterns in Ireland: Implications for policy and services Click here to download PDF 1.1mb

Stopping smoking made easier

This booklet takes smokers through the stages of stopping smoking as well as answers common questions smokers ask about smoking

Passive smoking: there's nothing passive about it

This leaflet highlights the health risks of passive smoking to adults and children, and suggests way of minimising your exposure to second-hand smoke.

Guidance on food for religious faiths

This poster provides guidance for schools on foods for religious faiths.

For your heart's sake stop smoking

On World Heart Day, 29 September 2011, the Public Health Agency is urging all smokers to stop smoking and reduce their risk of developing heart disease (cardiovascular disease - CVD) or suffering a stroke or a heart attack.Heart disease is one of the leading causes of death and illness in the UK. Research shows that smoking is one of the main contributors of the disease, causing around 25,000 deaths a year in the UK. Cigarette smokers are two times more likely than non-smokers to suffer a heart attack.The majority of people who suffer a heart attack before the age of 50 are smokers. Cigarette smoke causes heart disease by:· reducing oxygen to the heart;· increasing blood pressure and heart rate;· increasing blood clotting;· damaging cells that line coronary arteries and other blood vessels, causing narrowing of the arteries.From the moment smoke reaches your lungs, your heart is forced to work harder. Your pulse quickens, forcing your heart to beat an extra 10 to 25 times per minute, as many as 36,000 additional times per day. Because of the irritating effect of nicotine and other components of tobacco smoke, your heartbeat is more likely to be irregular. This can contribute to cardiac arrhythmia and many other serious coronary conditions, such as heart attack.For smokers who already suffer from heart problems, quitting will dramatically help. Many heart patients notice an almost immediate improvement when they stop smoking. Often, they need less medication and can cope better with physical exertion.Gerry Bleakney, Head of Health and Social Wellbeing Improvement, PHA, said: "Smoking is one of the major causes of cardiovascular disease and smokers are almost twice as likely to have a heart attackas someone who has never smoked. One in every two long-term smokers will die prematurely from smoking-related diseases, many suffer very poor health before they die. However one year after successfully quitting smoking, an individual will have reduced their risk of having a heart attack to half that of a person continuing to smoke."Across Northern Ireland, there are over 600 support services for people who wish to stop smoking, based in GP surgeries, community pharmacies, hospitals, community centres and workplaces. I would encourage everyone who is thinking about quitting to log on to our Want 2 Stop website: www.want2stop.info and order a 'Quit Kit' free of charge alternatively contact the Smokers' Helpline on 0808 812 8008."

Smoking causes mouth cancer, PHA warns

Mouth cancer awareness week begins on the 13 - 20 November. With this in mind the Public Health Agency is urging everyone to be aware of the signs and symptoms of mouth cancer and is encouraging all smokers thinking about stopping smoking to make the decision to stop today.In Northern Ireland 195 people were diagnosed with mouth cancer in 2009. The disease causes one death every five hours in the UK and yet it is one of the least well-known cancers. Smoking and excess alcohol consumption is associated with an increased risk of developing mouth cancer, which can occur in or on any part of the mouth, tongue, lips, neck and throat. In its very early stages, mouth cancer can be easy to ignore. Most people with mouth cancer have no early symptoms at all, but others may have:an ulcer in the mouth or on the lip that won't heal; constant pain or soreness; red or white patches in the mouth;a lump on the lip, tongue or in the neck; bad breath; unexplained bleeding in the mouth; numbness in the mouth; loose teeth.The earlier the disease is caught, the better. Survival rates rise to 90 per cent if the cancer is treated before it has spread. Gerry Bleakney, Head of Health and Social Wellbeing Improvement, PHA, said: "Certain lifestyle choices can increase an individual's risk of developing mouth cancer. Tobacco is considered to be the main cause of mouth cancer, with three in four cases being linked to smoking. Excess alcohol consumption is also a known factor, with those who both smoke and drink excessively being up 30 times more likely to be at risk. "Mouth cancer and the treatment required can be traumatic for the patient as this may affect functions such as speech, chewing and swallowing. The positive news is that stopping smoking is associated with a rapid reduction in the risk of oral cancers. Regular trips to the dentist are also a must because half of all mouth cancer cases are detected by dentists."I would encourage everyone who is thinking about quitting to log on to our Want 2 Stop website www.want2stop.info and order a 'Quit Kit' free of charge. Alternatively contact the Smokers' Helpline on 0808 812 8008. "Health Minister Edwin Poots said: "Smoking is the single greatest cause of preventable illness and premature death in Northern Ireland.It is a major risk factor for oral cancer, as well as coronary heart disease, strokes and other diseases of the circulatory system. Approximately 2,300 people die each year in Northern Ireland from smoking related illnesses. Quitting smoking is the single most effective step people can take to improve their long term health."A key objective of the Department's new ten-year tobacco control strategy, due to be published next month,is to prevent people from starting to smoke. Funding provided by the Department for smoking cessation services has resulted in around 650 such services being made available in Northern Ireland in a range of settings, including pharmacies, GP surgeries and community centres. These services have helped almost 80,000 smokers to set a quit date between 2008/09 and 2010/11."The Minister added: "It is also important for people to look after their oral health by regularly attending the dentist for check-ups, as any problems can be picked up and treated at an early stage."

The PHA message is clear for World COPD Day - smoking is bad for your lungs

In 2011, 31,574 people were registered as having Chronic Obstructive Pulmonary Disease (COPD) in Northern Ireland. The most common cause of COPD is smoking and to mark this year's World COPD day, which takes place on Wednesday 16 November, the Public Health Agency is encouraging all smokers to make a decision to stop smoking today and reduce their risk of developing the disease.COPD refers to a group of diseases which includes emphysema, chronic bronchitis, and in some cases asthma. With COPD, the airways in the lungs become damaged, causing them to become narrower, therefore restricting airflow and thus making it harder to breathe. The most common symptoms of COPD are breathlessness, wheezing, abnormal sputum (a mix of saliva and mucus in the airway), and a chronic cough often mistaken for a 'smokers' cough'. Symptoms can range from mild to severe, depending upon how advanced the disease is. In advanced cases, daily activities, such as walking up a short flight of stairs, can become very difficult.There is no cure for COPD. Stopping smoking is the single most effective wayto reduce your risk of developing COPD and avoid any further damage to the lungs. Gerry Bleakney, Head of Health and Social Wellbeing Improvement, PHA, said: "Smoking causes the lining of the airways to become inflamed and damaged and is the biggest cause of COPD. The risk of developing COPD increases the more an individual smokes and the longer they smoke. "The good news is that making changes to your lifestyle can reduce your risk of developing COPD. Stopping smoking reduces the risk of developing COPD and also slows down its progression. There is support available to help you quit and I would encourage everyone thinking about stopping smoking to log on to our Want 2 Stop website www.want2stop.info and order a 'Quit Kit' free of charge. Alternatively contact the Smokers' Helpline on 0808 812 8008 for help on planning to stop smoking or to find out where your nearest Stop Smoking Service is. "The Health Minister Edwin Poots said: "The impact of living with COPD can place a considerable strain on the lives of those suffering from the condition and their families. I understand that most smokers want to quit but it is not always easy to succeed and that several attempts are frequently necessary. I would therefore urge all smokers on world COPD day, to make that commitment to stop smoking. Professional help and support are readily available. There are almost 650 smoking cessation services provided all over Northern Ireland, mostly in community pharmacies, but also in GP surgeries, hospitals, community halls and schools."

Smoking and Public Health: A Review of Reviews of Interventions to Increase Smoking Cessation, Reduce Smoking Initiation and Prevent Further Uptake of Smoking - Evidence Briefing

This evidence briefing collates review-level evidence of interventions including those targeted at pregnant women and evidence for tackling health inequalities in smoking.