Nationally, the prevalence of smoking among adults dropped from 24% in 2005 to 21% in 2008 (ONS, 2010). Smoking prevalence in Kent was higher than the national figure at 24.9%. The variation in prevalence is significant and varies between 16% in Sevenoaks and 26.3% in Dartford (see health and social care maps)
There were approximately 281,300 smokers in Kent in 2009 - at least 276,300 adults and approximately 5,000 children and young people between the ages of 11 and 16.
Figure 1: Synthetic estimates of smoking prevalence among over 18s in Kent
Deaths and hospital admissions attributable to smoking in Kent
Of the 11,250 deaths of Kent residents aged 35 and over in 2008, approximately 2,250 (20%) can be attributed to smoking. The majority of these are due to lung cancer, chronic airway obstruction and ischaemic (coronary) heart disease.
Approximately 10,300 hospital admissions of Kent residents aged 35 and over in 2008 can be attributed to smoking (5% of the total 205,932 admissions). The majority of these are due to chronic airway obstruction, lung cancer and ischaemic heart disease (The Information Centre, 2009).
Smoking prevalence is strongly linked to deprivation. 45% of men and 40% of women in the most deprived 15% of households are current smokers (Low Income Diet and Nutrition Survey, 2007). Routine and manual smokers are defined by their occupations and most do not fall into the lowest quintile in terms of deprivation levels.
Those under 34 years are setting the most quit dates, but this age group are less likely to be successful at quitting. Those that are most successful in quitting are the older population.
Figure 2: Numbers of Kent residents quitting smoking by age group in 2009/10
Source: The Information Centre 2009/10 data
Males are more successful at quitting than females. Eastern and coastal Kent services have been more successful at getting both men and women to quit and are better than the England average. West Kent has had a lower success rate and the percentage of people quitting is lower than the England average.
Figure 3: Percentages of eastern and coastal, and west Kent residents quitting smoking by gender in 2009/10 compared with south east coast and England
Source: The Information Centre 2009/10 data
In recent years the proportions of young people smoking has declined. In 2006, the proportion of 11 to 15 year olds who said that they had smoked at least once in their lives was 39%; this fell to 33% in 2007 and 32% in 2008 (The Information Centre, 2010). The survey defines regular smoking for this age group as usually smoking at least once a week. The proportion of this age group who were regular smokers was 9%in 2006, and 6%in both 2007 and 2008. Girls are more likely to smoke than boys and there is an increase in the prevalence of regular smoking with age.
In the south east 7% of young people between 11 and 15 years old smoke with more girls smoking than boys (The Information Centre, 2010). This is despite the increase in age at which it is legal to buy tobacco to 18.
Three in ten (29%) of pupils have tried smoking at least once. This proportion is the lowest measured since the survey began in 1982, when more than half of pupils (53%) had tried smoking. In the south east 35% of young people self-report ever smoking a cigarette, compared to 29% nationally. More girls have tried smoking at least once (36%) than boys (33%).
There are approximately 37% homes within England in which dependent children are living with smokers and potentially exposed to second-hand smoke (ASH, 2011).
Smoking in Pregnancy
The number of maternities has been fairly steady in Kent and is currently around 16,000 per year (Department of Health, 2010).
The prevalence of smoking during pregnancy is low among Kent residents compared to the England Average; it was 25.5% in 2003/4 but had decreased to 17% in the first three quarters of 2009/10, although the rate of this fall appears to be decreasing.
This level equates to approximately 1,500 Kent-resident mothers still smoking at the time of delivery each year. It also indicates that around half the women who smoke are stopping smoking during pregnancy.
In the west Kent Forensic Secure Units, smoking status is not routinely recorded in primary care patient records (Prickett, 2011), and exact prevalence figures are therefore unknown. Anecdotally prevalence is estimated at 80%. Knowledge of a patient's smoking behaviour is important to the psychiatrist at an individual level because it may complicate assessment and treatment.
Notable changes in need since JSNA April 09
The vulnerable groups identified as a priority to target with interventions and services remain the same. Stop smoking services are providing Brief Intervention training to midwives in the acute trust which incorporates ensuring smoking status is recorded. This should also help to improve the quality of local data about the prevalence of smoking in pregnancy.