Wiltshire Tobacco Alliance strategy (2025)

Most people who are trapped in a uniquely lethal tobacco addiction start in their teens. 80% of adults who smoke report that they started smoking before the age of 18 and children who grow up with caregivers who smoke are around four times more likely to start smoking and are exposed to greater levels of second-hand smoke.

Even before a baby is born, exposure to smoke whilst in the womb, whether from the mother or second-hand smoke, restricts oxygen supply to the baby and exposes it to harmful toxins.

We will:

• - Support smokefree pregnancies and childhoods through good quality ante- and postnatal support around smoking cessation and smokefree homes.
• - Improve pre-conception education and support to stop smoking
• - Raise awareness of the harms of second-hand smoke to children and young people and normalise smokefree environments.
• - Agree and promote an evidence-based Wiltshire vaping statement that recognises that whilst UK regulated vapes are an effective stop smoking aid for adults, vapes are not for young people or never smokers.
• - Continue to gather and share local survey data to paint an accurate picture of true smoking prevalence among children and young people.
• - Develop behaviour change resources with external experts that are tested with young people to de-normalise smoking and vaping and offer support for those to quit.
• - Further engage with a range of stakeholders to improve insight including children and young people, wider range of professionals, and families.
• - Provide training to professionals working with children and young people so that they feel confident to provide evidence based effective stop smoking and vaping support.
• - Implement and promote a fully functioning children and young people nicotine products and smoking cessation service –local, digital and face to face.

Health inequalities are preventable differences in health outcomes across population groups, with tobacco use being a significant driver. In Wiltshire, which has areas of both affluence and deprivation, smoking rates are disproportionately higher in low-income groups. Among residents employed in a routine and manual occupation, smoking prevalence is 14.5% —significantly higher than the county average. Unemployed residents report even higher smoking rates at 21.9%, compared with 8.3% among those in a managerial and professional occupation. Tragically, two in three long term smokers will die from a smoking-related illness, often decades before they would have otherwise, losing an average of 10 years of life expectancy.

Vulnerable groups experiencing health inequalities often face additional barriers to accessing healthcare services. It is crucial, therefore, that local cessation services are accessible and specifically tailored to support those most affected by smoking-related health disparities.

Wiltshire’s commitment to reducing smoking and its impacts on health inequality is essential to advancing overall health outcomes in the county and ensuring that every resident can lead a healthier, smoke-free life.

We will:

• - Prioritise access to stop smoking support within the community, for our underserved communities where smoking rates remain stubbornly high, including those: living with mental health, working in a routine and manual occupation, living in social housing, experiencing substance use, experiencing homelessness, GRTB.
• - Increase community presence and drop-in support at locations that work for service users.
• - Promote equitable access to the full range of evidence-based stop smoking aids.
• - Develop and promote stop smoking cross -organisational referral pathways to increase opportunities for underserved communities to access stop smoking support, including within the Voluntary, Community, Social Enterprise (VCSE) sectors.
• - Provide access to NCSCT and local training to resident facing organisations around opportunistic and brief interventions to equip people with the skills and knowledge to have conversations about smoking and offer interventions.
• - Increase provision to make it as easy as possible for people to access stop smoking services.
• - Listen to all stakeholders and take actions to co-produce stop smoking services with people who use them.

Wiltshire’s aspiration to create a Smokefree Generation by 2029 is reliant on a whole systems approach where all stakeholders are collaborating on effective multi-faceted interventions.

We will:

• - Develop the Wiltshire TCA to ensure voices from all groups across Wiltshire are heard. A priority will be to collaborate with those people who are so underserved that we have no or limited data, such as LGBTQ+, EAL.
• - Strengthen partnership between health, social care, local communities and local government.
• - Promote smokefree policies in key organisations, such as the workplace.
• - Work with Partners to reduce the availability and supply of tobacco and nicotine containing products to children.
• - Work with Partners to reduce the availability of and access to illegal and illicit tobacco and vapes.
• - Support the Treating Tobacco Dependence programme, ensuring collaboration across the system to support delivery.
• - Normalise stopping smoking as a powerful step towards personal freedom from addiction and industry manipulation by actively promoting evidence-based communication resources across networks.