Directorate - Health and Adult services
Service area - North Yorkshire County wide
Proposal being screened - Living Well Smokefree – E-Cigarette supply
Officer(s) conducting screening - Mark O'Brien
What are you proposing to do?
Supply of e-cigarettes as a treatment option within the Living Well Smokefree stop smoking service. E-cigarettes will provide an alternative to Nicotine replacement therapy. Evidence to date shows that e-cigarettes are less harmful than cigarettes and can be effective for helping people to quit smoking. They are also the most used stop smoking tool in the UK. This will be a 12-week programme (as all stop smoking treatments in our service are) with the intention of reducing the amount somebody uses an e-cigarette (harm reduction), getting smokers to a 0% nicotine liquid or to quit Nicotine all together.
Why are you proposing this?
What are the desired outcomes? Taking advantage of the current, most effective way of stopping smoking, which has been proven with evidence-based research.
Desired outcomes:
- increase successful quit outcomes.
- high sustainability i.e. decreased number of relapses
- increased knowledge regarding the benefits of e-cigarettes in relation to reducing harm caused by tobacco (where other stop smoking methods have been unsuccessful)
- increased knowledge regarding how to use/safely store e-cigarettes.
- work towards the national ambition of a Smokefree 2030 (<5% of the population are smokers)
Does the proposal involve a significant commitment or removal of resources?
The commitment to roll out the e-cigarette process does not involve removal of resources; however, it involves working with an Independent British Vaping Association-NextGen360 who will supply the starter kits and relevant e-cigarette liquids/pods throughout the client’s 12-week programme, in addition to troubleshooting any issues.
The eligibility criteria for participants wanting to use an e-cigarette are as follows:
- must be a smoker.
- must not pregnant (initially, but will be reviewed once the NHS begin providing e-cigarettes to pregnant ladies)
- must be able to physically use an e-cigarette (training provided free of charge)
- must be eighteen or over.
- must live/work/or be registered with a GP within North Yorkshire.
- be able to set a quit date at sign up.
- be available for appointments and follow-up calls at the various key points of the pilot and follow up (up to 52 weeks).
- provide a CO reading at key points in the quit journey.
- provide feedback.
- consent to terms/sign waiver.
Impact on people with any of the following protected characteristics as defined by the Equality Act 2010, or North Yorkshire County Council’s additional agreed characteristics.
Protected characteristics
- Age - no
- Disability - no
- Sex - no
- Race - no
- Sexual orientation - no
- Gender reassignment - no
- Religion or belief - no
- Pregnancy or maternity - no
- Marriage or civil partnership - no
North Yorkshire County Council additional characteristics
- People in rural areas - no
- People on a low income - no
- Carer (unpaid family or friend) - no
Does the proposal relate to an area where there are known inequalities/probable impacts
The ordering system for an e-cigarette involves using the internet to create an account online. This could be an issue for people who do not have access to the internet. In this circumstance, those people will be given a code and a phone number to call. The code will be verbalised on the call and the NextGen 360 staff member will create an account over the telephone, to enable them to access the service.
People with certain disabilities may not be able to use e-cigarettes, or it could be deemed inappropriate depending on their condition; however, this does not affect the other stop smoking treatments that will continue to be offered to this protected characteristic group. Any differential impact should therefore be minor and mitigated by the alternative offer.
Pregnant women have been excluded due to insufficient evidence being available at the time of implementing this offer but will be reviewed at a later date. When the NHS long term plan is fully implemented in all areas and all trusts are distributing e-cigarettes as a stop smoking tool to pregnant women, we will review our offer to ensure there is continuity of treatment/care between Living Well Smokefree and the NHS long term plan. As an alternative to e-cigarettes, pregnant women will still be offered other appropriate stop smoking treatments. The above will be kept under review until further evidence/guidance emerges re safety of e-cigarettes for pregnant women, and distribution commences within all trusts. At this stage, consideration will be given to extending the offer to this group.
This issue will be kept under review. Any differential impact should therefore be minor and mitigated by the alternative offer.
Will the proposal have a significant effect on how other organisations operate?
The process will not affect other organisations in terms of operation. NextGen360 offer training and guidance to everyone, including those with protected characteristics. There is a support line that participants can access via telephone or online should they require advice/support regarding the use of their e-cigarette.
Decision
Equality impact assessment not relevant or proportionate.
Reason for decision
Whilst there is some potential for differential impact on some disabled people and on pregnant women, in that they may not be able to access this smoking cessation tool, they will still be offered other smoking cessation treatments. Any differential impact will therefore be effectively mitigated. This will be kept under review and as evidence/guidance emerges re safety for pregnant women, or more accessible e-cigarette kit, the offer will be extended to these groups.
Signed - Louise Wallace, Director of Public Health
Date - 28 August 2024 / 16 June 2023