joint strategic needs assessment foundation profile - JSNA

Interative Hull Atlas: www.hullpublichealth.org/Pages/hull_atlas.htm More information: www.jsnaonline.org and www.hullpublichealth.org
four weeks through the local smoking cessation service. The reduction in the number of
deaths required locally to meet the local life expectancy target was calculated.
Information on the number of deaths caused by smoking (using equivalent information
as in Table 101) was calculated, and assumptions were made as to the percentage of
smokers who would no longer die having quit smoking through the smoking cessation
service.
Whilst the life-time risk is generally quoted as one in two, there is very little information
on the year-on-year risk so it is not straightforward to estimate the effect on quitting
smoking. The year-on-year relative risk of dying cannot be assumed to be twice as high
for smokers compared to non-smokers as smoking only causes specific diseases and
the time delay will vary depending on the disease. Furthermore, it is necessary to have
some information on the reduction in risk of death following smoking cessation. Some
information is available here, but it is generally limited to mortality from specific diseases
and then not denoted as year-on-year reductions in risk.
Therefore, as this year-on-year risk is not readily available, an assumption was made
about the percentage of smoking-related deaths that would be prevented within the next
five years, and the effect on the smoking cessation service was calculated.
The local life expectancy targets were calculated on the same basis as the Public
Service Agreement (PSA) 2004 target (MH Treasury 2004) for England (see section
7.7.5 on page 196 for more information). The same percentage change was applied to
Hull‟s baseline life expectancy to calculate the local targets for 2009-2011 which were to
increase life expectancy in Hull to 76.8 years for men and 81.0 years for women. In
order to achieve this, it was estimated that there should be a reduction of 545 deaths in
the annual number of deaths to 2009-2011.
If 50% of smokers die of smoking-related causes, and if was assumed that 5% would die
from smoking-related causes within the next five years and their deaths are prevented
then what would the effect on life expectancy be? In order to achieve the local life
expectancy targets, then the annual average number of deaths for 2009-2011 would
need to be 545 fewer than 2003-2005. In order for the average annual number of
deaths to be this much lower, if 5% of smokers who would have died within the next few
years (prior to 2011) no longer die because they have quit smoking, then there would
need to be 10,900 current smokers who permanently quit (545 divided by 0.05). For
2005/2006, approximately 900 quit at four weeks, and if it is assumed that all of them
continued to not smoke in the long-term (70% long-term quit rate), then the service
would need to be increased 12-fold. Whereas, if it assumed that 30% of those who quit
at four weeks started to smoke again (resulting in long-term quit rate of 49%), then the
service would need to increase 17-fold. If only 2% of smokers would have died within
the next few years (prior to 2011), then there would need to be 27,250 current smokers
who quit permanently (545 divided by 0.02). If the four-week quit rate is maintained then
the smoking cessation service would need to increase 30-fold, and if 20% of the fourweek
quitters start smoking again (resulting in a long-term quit rate of 56%), then the
service would need to increase 38-fold. Table 108 summarises further examples of the
increase in the smoking cessation service necessary.
Joint Strategic Needs Assessment Foundation Profile – Hull Health Profile: Release 3. March 2011. 268