Aims and objectives:
The aims of the project are to:
1. Increase awareness of the impact of Second Hand (Environmental) Smoke on health.
2. Encourage people in the county to have smoking restrictions in their home/car.
3. Engage all people in Lincolnshire and get 85% of them to sign up to the gold promise (not to smoke anywhere in their homes).
4. Develop an environment conducive to quitting smoking and raise awareness of Phoenix Smoking Cessation Service in the County.
5. Deter smokers from withdrawing into their homes when the Government legislate against smoking in enclosed/public places.
The project principles are to:
1. Have negotiated goals.
2. Sign a contract (commitment).
3. Positive messages about immediate benefits of smoking restrictions.
4. Reinforcement from health workers.
Negotiated goals are:
1. Gold promise - totally smoke free.
2. Silver promise - A big step to protecting family
3. Bronze promise - A positive step to protecting family
Rewards are:
On signing up, people receive congratulations certificate and information re keeping promise. They also receive pack promoting smoke free homes/zones containing room door hangers, window stickers, table cards etc.
They will also be supporting the Dept of Health, WHO and UNICEF by protecting people from Second Hand Smoke.
Support for the change:
The project has been channelled through the Lincolnshire Smoke Free Alliance and added new partners such as housing associations, unions and Sure Starts.
Updates have been presented to PCTs and the GOEM who have both committed support for the project. The project is integral to the alliances 3-year strategy and an example of this is it is part of the Lincolnshire Fire Brigades 3-year Community Strategy.
Patient and public influence:
The original livery for the project was influenced by the old Community Health Council primary care group members. All people committing to the project are given the opportunity to comment on the project and are contacted later to ascertain smoke free status and gather further comments. This is at 6 and 12-month stage.
Further changes to the information will be given to the PCT's patient involvement reading group for feedback and it is hoped the new Patient and Public Involvement Forums will take an active part in the project's future development.
Impact on the workforce:
All Phoenix staff have been trained to deliver this project in the field. Many of the network Advisors in Sure Starts, MOD sites, Pharmacies and GP practices are able to raise awareness of the project as it is part of Phoenix's brief intervention (Step1) training. Brief intervention training allows health, social and other professionals the ability to identify, give appropriate information and signpost all prospective clients to the project and ultimately to smoking cessation.
Measuring the results:
The only other comparable projects are far smaller and less ambitious than this. We have been responsible for setting up other smaller (PCT sized) projects across England. We have also assisted Sweden setting up Smoke Free Homes and have helped the Dept of Health and the Health Development Agency in their scoping of best practice.
Thousands of people have committed to signing up to provide a better environment for their children, relatives and friends. Some of these are now being tracked into smoking cessation as a consequence.
To date, this is by far the most advanced and robust project of its kind in the UK. (Probably the world).
Improved performance:
The project now has in excess of 3 thousand households signed up to the gold promise. This means:
1. All the children within this environment are 4/5 times less likely to start smoking themselves.
2. Many will not now be admitted to A&E services with smoke related illnesses (especially under 5s)
3. More children will be attending school and social events/activities.
4. There will be less readmissions for chronic disease patients whose family friends previously smoked.
5. It is hoped there will be 10,000 households signed up by 31st March 2005.
Reflecting diversity:
The project is split to address the diverse population of Lincolnshire. As many people (60%) from disadvantaged areas smoke in the family home/car compared to 17% in more affluent areas there is a focus on engaging these people through Sure Starts, Housing Associations etc.
The rural aspects are engaged with the support of unions (NFU), DEFRA and local partnerships such as Boston and South Holland. Many itinerant groups are engaged within the Phoenix network such as travellers, Portuguese population etc.
Sharing the learning:
We have presented the work at PCTs and the East Midlands Tobacco Alliance to share good practice. We also presented at regional and national Sure Start events resulting in many local initiatives being set up in the South and Northwest of England. This will drive the necessity for larger more coordinated initiatives, which will facilitate further partnership involvement.
Only Lincolnshire has a whole county approach.
Outstanding features:
There are many including:
1. Acquiring funding (and other resources such as use of communications) from many partners.
2. Putting together a genuine partnership model where all bring something to the table.
3. Having in place a project that will alleviate the Health Secretary's concerns about having a ban in enclosed/public places. Mr Reid felt a ban may drive smokers from workplaces to homes. Smoke Free Homes obviates this.
4. The project is driven by very determined alliance partners who all share the same goal.
5. Innovative and exciting campaign which will impact on Phoenix's Dept of Health challenging 4-week quit targets.
