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4. How we will deliver

South Gloucestershire’s aspiration is to create a tobacco-free generation by 2025. Our focus is to continue to promote the shift in social attitudes so that choosing not to smoke is the normal thing no matter who you are or where you live. Continuing to reduce the attractiveness of tobacco, particularly to young people is an important part of this. However whilst this strategy has a focus on prevention we are committed to providing the very best services for those who wish to stop smoking, working to reduce prevalence through prevention and cessation services.

Alongside this work we need to maintain our focus on protecting people, especially children from the harms of second-hand smoke. It is important that individuals, families and communities share and contribute to our vision of a tobacco-free generation and communicating this widely will remain a key area of work.

This strategy sets out a challenging programme for Tobacco Control and will require action from partners from across Local Government, NHS England, the CCG, acute trusts, private organisations and the third sector. Partners will include:

  • trading standards
  • environmental health
  • schools
  • children centres
  • priority neighbourhood groups
  • primary and secondary care
  • maternity services
  • Public Health England
  • employers and voluntary organisation across South Gloucestershire.

Progress to date

Timeline of key Tobacco Control interventions in recent years in the UK.

A graph showing the timeline of key tobacco control interventions

England has already come a long way in shifting cultural attitudes to smoking:

2002    The EU Directive on tobacco advertising was adopted with new large health warning appearing on cigarette packaging in early 2003.

2007    The Government announced that the legal age for the purchase of tobacco will be raised to 18 years from 1 October 2007.

2012    Regulation prohibiting the display of tobacco in large stores under the Health Act 2009 came into force. Small shops had until April 2015 to comply with the legislation.

2015    A smoking ban in cars with children under the age of 18 came into force 1 October 2015.

2016    Standardised packaging regulations came into force from May 2016. Full enforcement measures will come in May 2017.


Smoking is an addiction largely taken up in childhood and adolescence. Two-thirds of smokers say they began smoking before the age of 18. Nine out of 10 started before the age of 19[1].

If smoking is seen by young people as a normal part of everyday life, they are much more likely to become smokers themselves. Research tells us that ‘a 15 year old living with a parent who smokes is 80 per cent more likely to smoke than those living in a household where no one smokes’[2].

This strategy will focus on a life course approach to prevention, working with a range of partners who can impact in this area including those working with children and families. As a result of this strategy, a range of interventions aimed at preventing the uptake of smoking in young people will be delivered and are captured in the action plan.

We will also take a holistic approach to working with individuals, families and groups recognising the links smoking has on other lifestyle choices such as, diet, and exercise and lifestyle issues such as stress, income and wellbeing.

Smokers start young

Nationally there has been a decline in young people smoking over the last decade.  In 2014/15 there were estimated to be 12.71% of 15 year olds stating they were regular or occasional smokers. In South Gloucestershire 6.8% were regular smokers, higher than both the South West average (6.3%) and the England average (5.5%). Year 10 smoking prevalence is significantly higher in those who are entitled to Free School Meals and higher rates of smoking were found in schools in the geographical areas of Patchway and Filton.

A person’s ability to stay Smokefree and their decision to quit smoking is influenced by their social network. Research suggests that smoking cessation spreads through social networks just as smoking does. Cost effective campaigning uses the power of social networks in the local community. It does this by empowering people to create Smokefree environments and motivating and encouraging smokers to quit, supporting them through their attempt. Utilising the Return on Investment Tool available from The National Social Marketing Centre demonstrates that the current level of investment in social marketing delivered by Smokefree South Gloucestershire saves the public sector approximately £370,000 per lifetime health gain.

We will continue to promote messages that encourages smokers to make healthier lifestyle choices to stop the cycle of smoking within families and certain groups. If we are to create a smokefree generation, continued investment needs to be made in reaching the entrenched smoker within the groups that are harder to reach.

The role of social networksThe role of campaigns

  • We will continue to deliver effective communication and education campaigns to increase awareness of the risk of smoking and prevent uptake of tobacco use by using a range of communication media including digital marketing and online training and information
  • We will ensure our campaigns reach the communities already with high smoking prevalence including routine and manual workforce, deprived communities, and mental health service users
  • We will work towards creating environments where young people and adults choose not to smoke
  • We will continue to train the wider public health workforce and partners on the harms of smoking tobacco and second-hand smoke so that they have the skills to intervene early


Smoking is harmful not only to smokers but also to the people around them. Children from less affluent backgrounds suffer greater levels of exposure to second-hand smoke when growing up. Infants of parents who smoke are more likely to suffer from serious respiratory infections such as bronchitis, symptoms of asthma and problems of the ear, nose and throat. There is also a risk of children getting meningitis and cancer. Exposure to smoke in the womb increases risk of miscarriage, still birth, premature and low birth weight babies and Sudden Infant Death Syndrome (SIDS) and is also associated with psychological problems in childhood[3].

In South Gloucestershire the prevalence of smoking at time of delivery (SATOD) is 9.3%, the lowest in the South West with the national average being 12%. The local smoke cessation service has seen nearly a 30% increase in pregnant women accessing support between 2013/14 to 2014/15 with 75% quitting.  Further work needs to be done to ensure this success and to support those women who are at risk of going back to smoking once their baby is born.

Importantly, evidence from three Cochrane systematic reviews identified that legislative smoking bans in public and workplaces do not change self-reported exposure to second-hand smoke in the home[4].

We know that children from socio-economically disadvantaged backgrounds are generally more heavily exposed to second-hand smoke.

Smoking cessation and the development of Smokefree settings should be a priority where prevalence is high and where the client group requires the most support. This includes the home, mental health units and prisons. The latter, can be promoted via Smokefree grounds and buildings and with on-site stop smoking support.

Access to easily available and cheaply priced illicit tobacco undermines the drive to discourage smoking. Tackling illicit tobacco involves local police, trading standards as well as national bodies such as Her Majesty’s Revenue and Customs (HMRC) and the UK Border Agency. This area of work covers everything from underage sales to counterfeit and smuggled tobacco. The illicit trade in tobacco covers a wide range of activities that includes;

  • Smuggling – the unlawful movement of tobacco products from one jurisdiction to another, without applicable tax being paid. A special category of tobacco smuggling involves cheap/illicit whites – these are lawfully produced in one country, with tax often paid in that country but are intended for smuggling into countries with higher tax rates.
  • Counterfeiting – the illegal manufacturing of an apparently lawful and well-known product, with apparent ‘trademarks’, but without the owners’ consent.
  • Bootlegging – where tobacco products are legally bought in one country and then transported to another with a higher tax rates, in amounts beyond those reasonable for personal use.
  • Illegal manufacturing – cases where tobacco products are manufactured without declaration to the relevant authorities


We will work with the wider public health workforce to reduce exposure to and protect people from second-hand smoke.

We will work with partners to reduce the availability and supply of tobacco products to children and young people.

We will work with partners to ensure compliance with Smokefree and tobacco sales legislation.

We will work with partners to reduce supply and demand for illegal tobacco.

The importance of settings

[1] Health & Social Care Information Centre Statistics on Smoking in England 2014. Available online at

[2] Loureiro, M., Sanz-de-galdeano, a. and Vuri, d. (2010). Smoking Habits: Like father, Like son, Like Mother, Like daughter? Oxford Bulletin of Economics and Statistics, 72(6), pp.717–743.

[3] Loureiro, M., Sanz-de-galdeano, a. and Vuri, d. (2010). Smoking Habits: Like father, Like son, Like Mother, Like daughter? Oxford Bulletin of Economics and Statistics, 72(6), pp.717–743.

[4] Callinan JE,  Clarke A, and Doherty K, Kelleher C (2010). Legislative smoking bans for reducing secondhand smoke exposure, smoking prevalence and tobacco consumption. Cochrane Review Available on line at