I Southampton Strategic Assessment Smoking Intelligence Strategic I

I Southampton Strategic Assessment Smoking Intelligence & Strategic. I Analysis Team Southampton City Council I

I Contents § Introduction to smoking and the overall prevalence in Southampton § Prevalence by population group § Sub city smoking prevalence § Adult smoking cessation and quit rates § Smoking and Maternity § Young people smoking and vaping prevalence § Smoking morbidity and mortality § Tartan rugs § Data Insights

I Introduction to smoking and Southampton’s overall smoking prevalence Back to contents

Back to contents I Smoking headlines Smoking is the leading cause of preventable death and disease in the UK of lung cancers are caused by smoking 90% Nearly 3 x more smokers in lower earners compared to higher earners In 2015 the total smoking related cost to the was £ 2. 6 billion 100, 000 people die in the UK EVERY YEAR from smoking. Smoking also increases your risk of developing more than 50 serious health conditions. There is a £ 5. 3 billion employer smoking 68% burden in work split by; smoking breaks 32% (68%) absences (32%) 1 in 9 pregnant women smoke

Back to contents I Southampton’s smoking prevalence (APS) – benchmarking & trends • Prevalence data from a survey • Higher than the England average and 2 nd highest amongst ONS comparators • National rate declining quicker nationally than locally Smoking Prevalence in adults - current smokers 2017 Southampton & Comparator Local Authorities: Persons ONS statistical neighbours Isle of Wight 14. 1 Hampshire 14. 4 Local neighbours Smoking prevalence in adults - Southampton and England trend: 2011 to 2017 Persons 25. 0 9. 0 York 20. 7 Bath and North East Somerset 13. 4 Bournemouth 13. 8 England 14. 9 Portsmouth 15. 2 Newcastle upon Tyne 15. 2 Liverpool 15. 5 Coventry 15. 9 0 16. 9 15. 5 14. 9 10. 0 Southampton England 5. 0 0. 0 Source: Annual Population Survey 5 10 Percentage of Current Smokers Source: Annual Population Survey 17. 8 17. 4 15 20 2017 18. 4 15. 0 2016 Plymouth 20. 5 2015 17. 4 18. 4 2014 Southampton 20. 4 17. 8 19. 3 2013 17. 0 19. 8 21. 4 21. 3 2012 16. 7 20. 0 2012 Leeds Sheffield Percentage of people 11. 1 Bristol

Back to contents I Southampton’s smoking prevalence (QOF) – benchmarking & trends • Prevalence from GP practice registers • Significantly higher than England average and 2 nd highest amongst ONS comparators • National rate decline reflecting local trend Smoking Prevalence in adults (QOF) - current smokers 2017/18 Southampton & Comparator Local Authorities: Persons ONS statistical neighbours Isle of Wight Bath and North East Somerset York 18. 0 13. 6 Sheffield 16. 7 England 17. 2 Coventry 18. 2 Newcastle upon Tyne 18. 4 Leeds 19. 1 Southampton 25. 0 Bristol 20. 5 Portsmouth 20. 6 Southampton 20. 6 Liverpool 20. 9 0 21. 6 18. 1 15. 0 21. 1 20. 6 17. 2 10. 0 5. 0 0. 0 5 10 15 Percentage of Current Smokers Source: Quality and Outcomes Framework via Public Health England 20 25 2015/16 20. 2 19. 2 2014/15 19. 4 22. 3 20. 0 2013/14 Plymouth Bournemouth Percentage of patients 13. 3 22. 7 England 2017/18 14. 6 Local neighbours 2016/17 Hampshire Smoking prevalence in adults (QOF) - Southampton and England trend: 2013/14 to 2017/18 Persons Source: Quality and Outcomes Framework via Public Health England

I Southampton’s smoking prevalence – population groups Back to contents

Back to contents I Routine and manual workers – benchmarking & trends • Local smoking prevalence for routine and manual workers higher than England since 2013 and 2 nd highest amongst comparators. Smoking prevalence in adults in routine and manual occupations (current smokers) 2017 Southampton & Comparator Local Authorities: Persons ONS statistical neighbours Smoking prevalence in adults in routine and manual occupations - current smokers Southampton and England trend: 2011 to 2017 Persons Local neighbours Hampshire 25. 6 Isle of Wight 22. 8 45. 0 Bristol 18. 8 40. 0 Liverpool 22. 4 Bournemouth 24. 5 York 24. 6 England 25. 7 Percentage 35. 0 27. 3 5. 0 Leeds 27. 4 0. 0 Newcastle upon Tyne 27. 5 Southampton 27. 7 Bath and North East Somerset 30. 0 Southampton Source: Public Health England 35 England 2017 Sheffield 27. 7 26. 5 2016 10. 0 28. 1 2015 27. 0 29. 5 25. 7 2014 Portsmouth 30 29. 6 2013 15. 0 2012 26. 9 25 30. 1 30. 2 29. 9 32. 1 2011 Plymouth 5 10 15 20 Percentage of Current Smokers 30. 8 20. 0 26. 1 0 31. 7 31. 1 30. 0 Coventry Source: Public Health England 33. 3

Back to contents I Routine and manual workers - inequalities • Local smoking prevalence for routine and manual workers significantly higher than local all adult smoking prevalence in years 2011 to 2016. Smoking prevalence occupation inequality- Ratio: Southampton: 2011 to 2017 Southampton Ratio Routine and manual smokers - 18+ (%) Adult smokers 18+ (%) 10. 0 33. 3 35 29. 9 Prevalence 30 31. 7 30. 8 30. 2 29. 5 27. 7 25 20 6. 0 20. 7 21. 3 21. 4 20. 5 17. 8 15 17. 4 10 1. 8 2. 2 2. 4 1. 8 3. 4 2. 0 0 4. 0 2. 4 5 8. 0 Odds Ratio 40 2011 2012 2013 2014 2015 2016 2017 0. 0 Source: Annual Population Survey via Public Health England • No evidence that the inequality gap is reducing either nationally or locally.

I Back to contents Routine and manual workers – place of work • No data on where routine and manual workers live, but there is data on where they work.

Back to contents I Current smokers by age and gender Count of current smokers among registered patients - May 2017 Southampton: by gender and age band Males Females 2, 500 2, 000 1, 500 Source: ACG Tool 2522 2513 2541 2146 2463 1745 2343 1624 2197 1837 2092 1929 1729 1523 1348 1173 990 915 652 682 378 446 15 to 19 20 to 24 25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 to 69 70 to 74 75 to 79 Age band 80 to 84 39 79 1850 2600 <15 325 750 0 15 13 500 77 156 1, 000 189 259 Count of registered patients 3, 000 85 to 89 • 17. 2% of males and 15. 4% of females are current smokers • Highest count of smokers for males (2, 541) are aged 30 -34 years • Highest count for females (2, 600) are aged 20 -24 years 90+

Back to contents I Smoker characteristics by Experian Mosaic group Southampton smokers were more likely to: live in terraced houses or flats Re nt and/or renting live in single households than married households have lower household incomes have ‘difficult’ or ‘very difficult’ financial stresses have a high use of social networks (Facebook and Twitter - most popular)

Back to contents I Smoking prevalence in other population sub-groups • Gay males, gay females and bisexual females are more likely to smoke than their heterosexual gender groups. • Residents from Eastern European countries have a higher smoking prevalence (over 50% among Latvians, Lithuanians and Slovakians). Traveller communities, Bangladeshi males and Pakistani males have a higher smoking prevalence. • Just over 51% of people with serious mental illness in Southampton smoke, significantly higher than nationally (41%). Local data shows higher smoking prevalence by condition in those diagnosed with schizophrenia, bipolar and personality disorders.

I Smoking prevalence – sub city Back to contents

Back to contents I Smoking prevalence at ward level (ACG) • Current smokers prevalence at ward level ranges from 9. 7% in Bassett to 23. 3% in Bitterne ward. Current smokers amongst registered patients - May 2017 Southampton wards: by gender Current smokers amongst registered patients May 2017 Southampton wards: Persons Bassett 9. 7 10. 1 Swaythling 12. 8 Bevois 13. 7 Bevois Bargate 14. 4 Bargate Shirley 14. 9 Shirley Bitterne Park 15. 3 Bitterne Park Woolston 15. 4 Woolston Southampton 16. 3 Southampton Sholing 16. 9 Sholing Peartree 17. 3 Peartree Portswood Swaythling Harefield 18. 5 Harefield Freemantle 19. 0 Freemantle Coxford 19. 2 Coxford Millbrook 20. 2 Millbrook Redbridge 20. 7 Redbridge Bitterne 23. 3 Bitterne 0 Source: ACG Tool 9. 1 10. 3 8. 4 11. 6 12. 6 13. 0 11. 3 16. 2 13. 4 17. 4 14. 1 15. 7 13. 8 16. 4 14. 3 15. 4 17. 2 17. 0 16. 9 17. 3 18. 8 16. 8 21. 0 18. 4 20. 0 19. 5 21. 0 19. 6 21. 9 22. 7 24. 0 Bassett Portswood 2 4 6 8 10 12 Percentage 14 16 18 20 22 24 26 0 Source: ACG Tool 2 4 6 8 10 12 14 16 18 Females Males 20 24 22 Percentage • Men are more likely to smoke than women, except in Sholing and Woolston. 26

Back to contents I Smoking prevalence at Better Care Cluster level (ACG) Current smokers amongst registered patients May 2017 Southampton wards: by gender Current smokers amongst registered patients May 2017 Southampton wards: Persons Cluster 3 10. 7 Cluster 3 9. 8 11. 6 Cluster 4 14. 0 Cluster 4 12. 6 16. 5 Southampton 16. 3 Southampton 15. 4 17. 2 Cluster 5 16. 9 Cluster 5 17. 3 16. 6 Cluster 2 18. 3 Cluster 2 17. 5 19. 1 Cluster 6 18. 7 Cluster 6 17. 9 19. 5 Cluster 1 18. 8 Cluster 1 17. 5 20. 1 0 Source: ACG Tool • • 2 4 6 8 10 12 Percentage 14 16 18 20 22 24 26 0 Source: ACG Tool 2 Females Males 4 6 8 10 12 Percentage 14 16 18 20 22 24 26 Cluster 1 is the Better Care Cluster with the highest rate for current smokers amongst its registered patients (18. 8 %). There are higher current smoker rates amongst male registered patients compared to male patients.

Back to contents I Smoking prevalence age bands at Better Care Cluster level (ACG) 15 -24 3000 25 -34 35 -44 45 -54 55 -64 65 -74 75 -84 85+ 2500 2000 1500 1093 1161 823 768 591 354 109 33 1200 1202 745 613 367 135 51 13 770 1560 1344 1689 1174 678 273 80 699 1749 1527 1640 1185 668 311 79 0 534 923 938 896 629 469 162 31 500 1068 2761 2465 2013 1451 715 286 92 Number of registered patients known to be current smokers Count of registered patients known to be smokers by age band - May 2017 Better Care Clusters: Persons Cluster 1 Cluster 2 Cluster 3 Cluster 4 Cluster 5 Cluster 6 Source: ACG tool • Highest count by cluster and age band is 2, 761 registered patients known to be smokers aged 25 -34 years living in Cluster 1. Next highest - 2, 465 known smokers aged 35 -44 also living in Cluster 1.

Back to contents I Smoking prevalence at IMD quintile Proportion of registered patients recorded as current smokers by England Deprivation Quintile: May 2017 25 Percentage of patients 20 R 2 = 0. 9969 15 10 5 0 Source: • • 20. 2 17. 0 14. 5 11. 8 8. 5 20% most deprived 2 nd quintile 3 rd quintile 4 th quintile 20% least deprived Adjusted Clincal Groups database Socio-demographic factors contribute to smoking. People living in more deprived areas of the city are more likely to smoke than people living in less deprived areas of the city.

I Adult smoking cessation and quit rates Back to contents

Back to contents I Support and treatment for current smokers • QOF data shows percentage of current smoker GP patients who have an offer of support and treatment recorded within the previous 24 months • Southampton City CCG average was 92. 3% • % for Alma Road Solent GP Surgery and Alma Road Surgery (both 99. 8%) • % West End Road Surgery (79. 2%) • QOF numbers of current smokers (2016/17) and Southampton Healthy Living (SHL) clients for Smoking Cessation support by GP surgery (2017/18) estimates: • 5. 5% Southampton City CCG GP registered smokers are SHL clients for smoking support • % for University Health Service (34. 0%) • % St Peters Surgery, Victor St Surgery, Raymond Road Surgery 2%

Back to contents I Adult rates for successful quitters - trends • Southampton’s successful quit rate in 2017/18 (443 per 100, 000 smokers)…. • Lowest rate since 2013/14 • Significantly lower than England (1, 477 per 100, 000 smokers in 2017/18) of successful (CO validated) at 100, 000 4 -weeks per 100, 000 smokers. Rate of successful quitters (CO validated) at 4 -weeks per smokers. Southampton and England trend: 2013/14 to 2017/18 Southampton and England trend: 2013/14 to 2016/17 3, 000 Southampton DSR per 100, 000 smokers Rate per 100, 000 smokers 2, 625. 4 Southampton England 2, 500 2, 003. 9 2, 019. 8 1, 854. 2 2, 000 1, 624. 9 1, 627. 0 1, 500 1, 816. 8 1, 596. 51, 579. 0 1, 422. 8 1, 000 1, 786. 7 1, 477. 3 1, 608. 1 1, 582. 1 1, 401. 1 500 442. 8 0 2017/18 2015/16 2016/17 Source: Public Health England 2014/15 2015/16 2013/14 2014/15 2013/14 0 2016/17

Back to contents I Southampton Healthy Living clients 'Successful quits’ Percentage of Southampton Healthy Living clients 'Successful quits' Southampton GP practices and partnerships: 2017/18 Mulberry House Surgery About half (49. 8%) the city’s GP registered smokers receiving smoking support (for any number of quit attempts) in 2017/18 had ‘successfully quit’ 33. 3 Shirley Health P'ship 39. 4 Victor Street Surgery 39. 5 Solent GP P'ship 39. 6 Highfield Health University Health Service Bath Lodge Practice 40. 0 43. 2 Burgess Road Surgery 43. 5 Hill Lane Surgery 46. 2 Chessel Practice 49. 1 Southampton 49. 8 Brook House Surgery 50. 0 Alma Road Surgery 50. 0 41. 7 Living Well P'ship 50. 6 Woolston Lodge Surgery 51. 3 Lordshill Health Centre 51. 5 West End Road 54. 2 St. Mary's Surgery 54. 8 Atherley House Surgery 56. 0 St. Peters Surgery 61. 1 Old Fire Station Surgery 61. 5 Aldermoor Surgery 64. 2 Cheviot Road Surgery 69. 7 Walnut Tree Surgery 71. 4 Townhill Surgery 75. 0 Raymond Road Surgery 85. 7 0 5 The three lowest percentages by GP practice/partnership population are located in areas with the lowest deprivation quintiles 10 15 Source: Southampton Healthy Living 20 25 30 35 40 45 50 Percentage 55 60 65 70 75 80 85 90 95 100 Results should be treated with some caution due to the large confidence intervals

I Smoking and Maternity Back to contents

Back to contents I Smoking at time of delivery – benchmarking & trends § Southampton’s smoking at time of delivery – 14. 4% § Significantly higher than England (10. 8%) § Ranked 2 nd highest prevalence amongst its comparators Smoking status at time of delivery - Southampton and ONS Comparators: 2017/18: Persons ONS statistical neighbours Hampshire 8. 7 Isle of Wight Bath and North East Somerset Bristol 7. 5 Percentage of mothers smoking at delivery: Southampton and England trend: 2010/11 to 2017/18 Local neighbours Southampton 14. 5 18. 0 16. 0 Bournemouth 10. 4 14. 0 York 10. 4 Leeds 10. 5 England 10. 8 Plymouth 10. 9 Coventry 11. 8 Sheffield 12. 0 Portsmouth 12. 7 Liverpool 13. 7 2. 0 Southampton 14. 4 0. 0 Newcastle upon Tyne 15. 1 0. 0 Rate (%) 10. 2 Source: Public Health England 20. 0 12. 0 16. 3 13. 6 16. 7 13. 3 10. 0 15. 4 12. 8 16. 5 14. 7 12. 2 11. 7 14. 4 11. 0 13. 8 10. 7 14. 4 10. 8 8. 0 6. 0 4. 0 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17 2017/18 5. 0 10. 0 Percentage 15. 0 20. 0 Source: Public Health England.

Back to contents I Local smoking and maternity headlines • Southampton 2017/18: • Smoking at time of booking (1 st antenatal appt. 8 -12 wks) 16. 3% • Smoking at time of discharge (after giving birth) 14. 1% • Quit rate between booking and discharge 21. 1% of those smoking at booking had quit by discharge • Central government’s national ambition is to reduce smoking at time of delivery to 6% or less by 2022

Back to contents I Smoking at booking – Ward & Better Care Clusters § § 16. 3% of Southampton mothers were smoking at midwifery booking Differences by Better Care Clusters range from 9. 4% (Cluster 3) to 19. 3% (Cluster 2). Ward ranges from Bassett (6. 5%) to Bitterne (29. 4%) Percentage of mothers smoking at booking: - Southampton and electoral wards: 2017/18 Percentage of mothers smoking at midwifery booking: Southampton and Better Care Clusters 2017/18 Cluster 3 Cluster 4 Southampton Cluster 1 Cluster 5 Cluster 6 Cluster 2 9. 4 16. 3 17. 2 17. 5 19. 1 19. 3 5. 0 10. 0 15. 0 20. 0 Percentage of mothers smoking at booking Sources: UHS Midwifery database: Southampton CCG 6. 5 6. 6 Bitterne Park 13. 2 0. 0 Bassett Portswood 25. 0 7. 7 Freemantle 12. 2 Swaythling 12. 3 Bargate 12. 7 Shirley 12. 9 Sholing 13. 9 Bevois 14. 7 Peartree 16. 3 Southampton 16. 3 Woolston 19. 4 Coxford 19. 6 Harefield 21. 2 Redbridge 21. 5 Millbrook 21. 5 Bitterne 29. 4 0. 0 5. 0 10. 0 15. 0 20. 0 25. 0 30. 0 Percentage of mothers smoking at booking Sources: UHS Midwifery database: Southampton CCG 35. 0 40. 0

Back to contents I Smoking at discharge – Ward & Better Care Clusters § § 14. 1% of Southampton mothers were smoking at discharge Differences by Better Care Clusters range from 8. 3% (Cluster 3) to 17. 8% (Cluster 6). Ward ranges from Bassett (6. 5%) to Bitterne (27. 8%) Percentage of mothers smoking at discharge: Southampton and Better Care Clusters 2017/18 Percentage of mothers smoking at discharge: Southampton wards: 2017/18 8. 3 Cluster 3 10. 4 Cluster 4 Bassett 6. 5 Portswood 6. 6 Bitterne Park 7. 7 Bargate 9. 2 Freemantle 9. 5 Sholing 14. 1 Southampton 14. 6 Cluster 5 14. 6 Cluster 1 17. 3 Cluster 2 17. 8 Cluster 6 0 5 10 15 Percentage of mothers smoking at discharge Source: UHS Midwifery database: Southampton CCG 20 9. 6 Swaythling 10. 4 Shirley 10. 5 Bevois 12. 4 Peartree 13. 4 Southampton 14. 1 Woolston 17. 3 Millbrook 17. 9 Harefield 18. 1 Redbridge 18. 5 Coxford 19. 0 Bitterne 27. 8 0. 0 5. 0 10. 0 15. 0 20. 0 25. 0 30. 0 35. 0 Percentage of mothers smoking at discharge Source: UHS Midwifery database: Southampton CCG 40. 0

Back to contents I Quit rate between booking and discharge: Better Care Cluster & IMD § 21. 1% of Southampton mothers smoking at booking had given up by discharge Differences by Better Care Clusters range from 18. 2% (Cluster 6) to 24. 6% (Cluster 4) Deprivation decile ranges from most deprived quintile (15. 1%) to least deprived quintile (50. 0%) – over 3 times more likely to quit in least deprived Quit rate between booking and discharge: Southampton and Better Care Clusters 2017/18 120 18. 2 Cluster 6 Cluster 1 20. 1 Southampton 21. 1 Cluster 2 21. 8 Cluster 5 22. 5 Cluster 3 22. 6 Cluster 4 24. 6 0 100 Quit rate (%) § § Quit rate between booking and discharge by England Deprivation Quintile: 2017/18 R 2 = 0. 9829 80 60 40 20 0 5 10 15 Quit rate (%) Source: UHS Midwifery database: Southampton CCG 20 25 30 15. 0 24. 7 29. 3 42. 9 50. 0 20% most deprived 2 nd quintile 3 rd quintile 4 th quintile 20% least deprived Sources: UHS Midwifery database: Southampton CCG

Back to contents I Deep dive smoking, previous births and deprivation • The odds of a mother from the most deprived quintile smoking at time of delivery is 9. 31 times higher than a mother from the least deprived quintile. • Deprivation quintile increases the likely number of child births by, on average, half a child (0. 54) for each increasingly deprived quintile a mother lives in. • On average, having adjusted for the number of births, a woman is 8. 14 times more likely to smoke at time of delivery if she lives in the most deprived quintile compared to the least deprived quintile. • The number of previous live births is positively associated with the likelihood of smoking after delivery; the magnitude of this association varies by deprivation quintile No. of previous Table of modelled live births probability of smoking at 0 time of delivery by 1 England deprivation 2 quintile and no. of 3 previous births 4 Source: UHS Midwifery database: Southampton CCG 1 17. 7% 20. 9% 24. 5% 28. 5% 32. 8% Deprivation quintile 2 3 11. 3% 7. 1 % 14. 9% 9. 8% 19. 3% 13. 5% 24. 6% 18. 3% 30. 9% 24. 4% 4 5. 3% 7. 1% 9. 4% 12. 4% 16. 1% 5 2. 6% 3. 1% 3. 6% 4. 3% 5. 1%

I Back to contents Young people smoking and vaping prevalence

Back to contents I Young people smoking prevalence – benchmarking • Southampton's % of current smokers aged 15 years (11. 7%) - 2 nd highest among comparators & significantly higher than England (8. 2%) • Southampton's % of regular smokers aged 15 years (8. 3%) ranks 2 nd highest among comparators and significantly higher than England (5. 5%) Percentage of regular smokers: 2014 Southampton & LAIT Children’s Services Statistical Neighbour Benchmarking Tool statistical neighbours: Persons aged 15 Percentage of current smokers: 2014 Southampton & LAIT Children’s Services Statistical Neighbour Benchmarking Tool statistical neighbours: Persons aged 15 Comparator Areas Local neighbours 7. 2 Hampshire 11. 2 Isle of Wight 7. 7 Derby Hampshire 4. 9 Isle of Wight 6. 9 Derby 5. 1 Coventry 8. 1 England 5. 5 England 8. 2 Sheffield 5. 5 Sheffield 8. 2 Coventry 5. 8 Peterborough 9. 1 Plymouth 6. 0 Plymouth 9. 2 Southend-on-Sea 6. 4 Southend-on-Sea 9. 9 Peterborough 6. 6 Portsmouth 10. 9 Bournemouth 7. 0 Bournemouth 11. 0 Bristol 7. 8 Bristol 11. 3 Portsmouth 8. 2 Southampton 11. 7 Southampton 8. 3 Stoke-on-Trent 12. 5 0 10. 4 Stoke-on-Trent 2 Sources: What About YOUth 4 6 Percentage 8 10 12 14 Local neighbours 0 2 Sources: What About YOUth (WAY) 4 6 Percentage 8 10 12

Back to contents I Young people vaping prevalence – benchmarking • Research has found that most ecigarette experimentation among young people does not lead to regular use, and levels of regular use in young people (who have never smoked) remain very low • In 2014/15 an estimated 21. 4% of Southampton’s 15 year olds had used e-cigarettes. Higher than national rates (18. 4%) and lower than most of Southampton’s ONS comparators Use of e-cigarettes 2014/2015 Southampton & Comparator Local Authorities: Persons aged 15 ONS statistical neighbours Hampshire 16. 7 Isle of Wight 22. 2 Coventry 13. 5 Southend-on-Sea 16. 4 Bristol 18. 0 Portsmouth 18. 3 England 18. 4 Southampton 21. 4 Peterborough 22. 0 Plymouth 22. 7 Derby 23. 7 Stoke-on-Trent 25. 5 Sheffield 26. 3 Bournemouth 27. 7 0 5 Source: Public Health England 10 Local neighbours 15 Percentage 20 25 30

I Smoking morbidity and mortality Back to contents

Back to contents I Smoking morbidity and mortality headlines Smoking accounts for 5. 5% of the NHS budget Smoking accounts for 1 in 6 of all deaths in England Smoking is responsible for over 85% of lung cancer cases £ £ £ (The most common cancer death – 1 in 5 cancer deaths) 3 million people in the UK suffer from COPD (Chronic Obstructive Pulmonary Disease) for which smoking is the biggest preventable risk factor. COPD is the fifth biggest killer in the UK and 86% of these deaths are caused by smoking. £

Back to contents I Smoking attributable hospital admissions –benchmarking & trends • Southampton rate of 1, 676 smoking attributable hospital admissions per 100, 000 population in 2017/18 • Significantly higher than England average (1530. 4 per 100, 000) and mid rank amidst its ONS comparators Smoking attributable hospital admissions (aged 35+ yrs): Southampton & Comparator Local Authorities: 2017/2018 Local neighbours 877. 3 Isle of Wight Hampshire 1055. 8 Bath and North East Somerset 1075. 5 Portsmouth 1406. 7 Leeds 1418. 9 York 1505. 4 England 1530. 4 Plymouth 1671. 8 Southampton 1676. 1 Coventry 1699. 8 Sheffield 1907. 6 1, 500 1, 687. 0 1, 699. 2 1, 675. 2 1, 658. 2 1, 638. 0 1, 671. 2 1, 726. 3 1, 685. 0 1, 530. 4 1, 000 500 0 2017/18 Source: Public Health England 2016/17 Source: Public Health England 500 1000 1500 2000 2500 3000 Directly Age Standardised Rate per 100, 000 Population 1, 676. 1 1, 612. 9 1, 597. 7 2015/16 0 1, 995. 6 1, 791. 0 2014/15 2410. 0 England 1, 800. 1 2013/14 2129. 6 1, 883. 9 2, 000 2012/13 Liverpool Newcastle upon Tyne Southampton 2, 121. 1 2011/12 2036. 8 2, 234. 3 2010/11 1970. 0 2, 500 2009/10 Bristol Bournemouth Directly Age Standardised Rate per 100, 000 Population ONS statistical neighbours Smoking attributable hospital admissions Southampton and England trend: 2009/10 to 2017/18 Persons aged 35+

Back to contents I Smoking attributable hospital admissions – sub city • The rate of smoking attributable hospital admissions for the city was 1785 per 100, 000 population (2014/15 to 2016/17) • Rates of smoking attributable hospital admissions by ward ranged from 1219 per 100, 000 population (Bassett) to 2411 per 100, 000 population (Coxford Better Care Cluster 2) Smoking attributable hospital admissions - Southampton wards: 2014/15 to 2016/17 (pooled) Bassett 1, 219. 0 Bitterne Park 1, 345. 1 Shirley 1, 500. 6 Portswood 1, 510. 0 Freemantle 1, 589. 0 Sholing 1, 705. 8 Millbrook 1, 771. 9 Southampton 1, 784. 6 Harefield 1, 825. 2 Bevois 1, 833. 0 Peartree 1, 837. 7 Woolston 1, 905. 6 Bitterne 1, 953. 7 Bargate 1, 997. 5 Swaythling 2, 042. 9 Redbridge 2, 156. 2 Coxford 2, 410. 6 0 200 400 600 800 1000 1200 1400 1600 1800 2000 2200 2400 2600 Directly Age Standardised Rate per 100, 000 Population Source: NHS Digital - Hospital Episode Statistics (HES), Office for National Statistics (ONS) and

Back to contents I Smoking attributable mortality – benchmarking & trends • Southampton rate of 334. 3 smoking attributable deaths per 100, 000 population in 2015 -17 - Smoking attributable mortality: 2015 -17 Southampton & Comparator Local Authorities: Persons aged 35+ ONS statistical neighbours Hampshire 209. 5 Isle of Wight 251. 0 Bath and North East Somerset 197. 1 York 220. 9 Bournemouth 255. 8 England 262. 6 Sheffield 279. 5 Coventry 283. 2 Bristol 289. 1 Plymouth 309. 3 Leeds 311. 7 Portsmouth 324. 4 308. 4 300 400 321. 1 290. 7 284. 4 279. 7 274. 8 283. 5 340. 8 272. 0 334. 3 262. 6 200. 0 Southampton 150. 0 England 100. 0 500 Directly Age Standardised Rate per 100, 000 Population. Source: Public Health England 2015 -17 200 319. 8 2014 -16 100 300. 9 250. 0 319. 1 2013 -15 Source: Public Health 300. 0 322. 2 2012 -14 0 350. 0 354. 7 2011 -13 430. 6 338. 3 2010 -12 Liverpool 343. 2 2009 -11 383. 4 400. 0 2008 -10 334. 3 Smoking attributable mortality - Southampton and England trend: 2007 -09 to 2015 -17 Persons aged 35+ 2007 -09 Southampton Newcastle upon Tyne Local neighbours Directly Age Standardised Rate per 100, 000 Population Southampton 3 rd highest amongst ONS comparators and significantly higher than England average (263 per 100, 000) and has remained so since 2007 -09 •

Back to contents I Hospital Admissions for COPD – benchmarking & trends • Southampton rate of emergency hospital admissions for COPD (621 adults per 100, 000 adults aged 35+) 2016/17 • Southampton 3 rd highest amongst ONS comparators and significantly higher than England average (417. 3 per 100, 000) and increasing more sharply than nationally Emergency hospital admissions for COPD: 2016/17 Southampton & Comparator Local Authorities: Ages 35+ Hampshire 283. 4 Isle of Wight 254. 9 Bath and North East Somerset 250. 8 York 351. 6 459. 9 Coventry 467. 2 Leeds 527. 8 Sheffield 536. 1 620. 7 Liverpool 740. 7 Newcastle upon Tyne 767. 3 0 Sources: Public Health 200 400 600 800 1000 Directly Age Standardised Rate per 100, 000 Population 400 409. 7 300 389. 0 411. 0 390. 1 Southampton 415. 0 411. 2 417. 3 England 200 100 0 Sources: Public Health England 2014/15 599. 7 585. 8 500 2013/14 Bristol Southampton 620. 7 589. 9 557. 0 2012/13 549. 8 617. 0 546. 0 2011/12 539. 2 600 606. 3 2010/11 Portsmouth Bournemouth 700 2016/17 417. 3 800 Emergency hospital admissions for COPD- Southampton and England trend: 2010/11 to 2016/17 Persons aged 35+ 2015/16 England Plymouth Local neighbours Directly Age Standardised Rate per 100, 000 Population ONS statistical neighbours

Back to contents I Hospital Admissions for COPD – sub city (Ward/BCC) • Southampton rate of emergency hospital admissions for COPD • • by ward ranges from Bitterne Park (231. 4 per 100, 000 pop) to Coxford (1, 229 per 100, 000 pop) by cluster range 451 per 100, 000 population (Cluster 3) to 956 per 100, 000 population (Cluster 2) Emergency COPD hospital admissions - Southampton wards: 2014/15 to 2016/17 (pooled) Persons aged 35+ Bitterne Park Shirley Bassett Freemantle Portswood Sholing Millbrook Bargate Southampton Bitterne Woolston Swaythling Peartree Harefield Bevois Redbridge Coxford Cluster 2 contains Coxford - the ward with significantly higher rates than any other ward in the city. 231. 4 345. 0 352. 2 413. 7 425. 9 436. 5 535. 8 582. 3 588. 1 617. 3 635. 6 659. 6 689. 6 705. 4 714. 9 758. 5 1, 229. 2 0 200 400 600 800 1000 1200 Directly Age Standardised Rate per 100, 000 Population Emergency COPD hospital admissions - Southampton Better Care Clusters: 2014/15 to 2016/17 (pooled) Persons aged 35+ 1400 Source: NHS Digital - Hospital Episode Statistics (HES), Office for National Statistics (ONS) Cluster 3 450. 6 Cluster 6 497. 9 Cluster 1 512. 3 Southampton 588. 1 Cluster 5 608. 4 Cluster 4 612. 4 Cluster 2 995. 5 0 200 400 600 800 1000 Directly Age Standardised Rate per 100, 000 Population 1200 1400 Source: NHS Digital - Hospital Episode Statistics (HES), Office for National Statistics

Back to contents I Emergency hospital admissions for COPD 1600 Emergency hospital admissions for COPD in persons aged 35+ years Inequalities Trend - Most Vs Least Deprived IMD England Quintiles (IMD 2015) 2010 -13 to 2015 -18 (pooled) 8. 0 1400 7. 0 1200 Most Deprived England Quintile (IMD 1) 961 976 1000 800 600 400 937 973 985 5. 86 6. 90 5. 17 4. 64 194 166 136 188 212 2012/13 to 2014/15 2013/14 to 2015/16 2010/11 to 2012/13 2011/12 to 2013/14 1068 6. 0 5. 0 4. 94 200 0 Least Deprived England Quintile (IMD 5) 4. 11 260 4. 0 3. 0 2. 0 1. 0 2014/15 to 2016/17 Sources: Hospital Episode Statistics, ONS Mid-Year Population Estimates & IMD (2015) 2015/16 to 2017/18 0. 0 X times higher DSR per 100, 000 population aged 35+ years Highest LSOA rates - west of the city (Coxford and Redbridge) and the east (Harefield) In the most deprived quintile of the city the emergency COPD hospital admission rate is 4 times higher than in the least deprived quintile of the city

Back to contents I Mortality from COPD – benchmarking & trends • Southampton death rate of COPD (75 adults per 100, 000 adults) 2015 -17 • Southampton 3 rd highest amongst ONS comparators and significantly higher than England average (53 per 100, 000) and increasing locally overall unlike the overall national decrease All deaths from chronic obstructive pulmonary disease: Southampton & Comparator Local Authorities: 2015 -17 Hampshire 39. 6 Isle of Wight Bath and North East Somerset York 42. 4 46. 9 Bournemouth 47. 2 England 52. 7 Coventry 54. 2 Directly Age Standardised Rate per 100, 000 Population ONS statistical neighbours Local neighbours 33. 5 Sheffield 54. 7 Bristol 57. 3 Leeds 58. 9 Plymouth 62. 0 Portsmouth 74. 4 30. 0 20. 0 10. 0 2015 -17 2014 -16 Source: Public Health England 2013 -15 120 2012 -14 100 2011 -13 80 2010 -12 60 2009 -11 40 Directly Age Standardised Rate per 100, 000 Population 2008 -10 20 2007 -09 Source: Public Health England 40. 0 2006 -08 0 50. 0 2005 -07 95. 3 60. 0 2004 -06 Liverpool England 70. 0 2003 -05 82. 8 Southampton 80. 0 2002 -04 75. 4 90. 0 2001 -03 Southampton Newcastle upon Tyne All deaths from COPD, Southampton and England trend: 2001 -03 to 2015 -17:

Back to contents I Mortality from COPD – sub city (Ward/BCC/IMD) • Southampton death rate of COPD (72 adults per 100, 000 adults) 2012 -16 • Mortality rate over 2. 5 times higher for those living in the most deprived quintile vs. least deprived quintile and rate ranges 62. 3 (Cluster 6) to 81. 4 (Cluster 4) and 40. 9 (Bitterne Park) to 98. 9 (Redbridge) Deaths from COPD - Southampton wards: 2012 to 2016 (pooled) persons 40. 9 42. 8 56. 3 56. 5 57. 3 67. 2 71. 8 72. 8 74. 4 76. 3 79. 5 87. 8 88. 4 89. 2 91. 9 97. 3 98. 9 0 20 40 60 80 100 120 Directly Age Standardised Rate per 100, 000 Population Source: Primary Care Mortality Database, Office for National Statistics 62. 3 65. 2 71. 4 71. 8 76. 8 78. 5 81. 4 0 20 40 60 80 100 Directly Age Standardised Rate per 100, 000 Population Source: Primary Care Mortality Database, Office for National Statistics (ONS) 140 Directly Age Standardised Rate per 100, 000 Population Bitterne Park Bassett Shirley Portswood Harefield Sholing Southampton Millbrook Bevois Peartree Coxford Woolston Freemantle Swaythling Bitterne Bargate Redbridge Cluster 6 Cluster 3 Cluster 2 Southampton Cluster 5 Cluster 1 Cluster 4 140 Deaths from COPD by England Deprivation Quintile: DSR per 100, 000 Population: 2012 to 2016, persons 120 100 R 2 = 0. 9259 80 60 40 20 0 99. 8 80. 3 52. 0 47. 4 38. 2 20% most deprived 2 nd quintile 3 rd quintile 4 th quintile 20% least deprived Source: Primary Care Mortality Database, Office for National Statistics (ONS) 120

Back to contents I Mortality from lung cancer – benchmarking & trends • Southampton lung cancer death rate (71. 1 adults per 100, 000) 2015 -17 • Southampton 3 rd highest amongst ONS comparators and significantly higher than England average (56. 3 per 100, 000) and overall decreasing locally similar to national decrease Local neighbours ONS statistical neighbours Isle of Wight Bath and North East Somerset York Bournemouth England Bristol Sheffield Coventry Plymouth Portsmouth Leeds Southampton 74. 1 70. 0 60. 0 50. 0 65. 1 64. 1 63. 4 63. 6 63. 3 62. 6 61. 7 60. 9 60. 2 59. 5 58. 7 57. 7 56. 3 40. 0 30. 0 20. 0 10. 0 2015 -17 2014 -16 2013 -15 Source: Public Health England 2012 -14 Source: Public Health 71. 6 71. 1 69. 0 69. 4 71. 0 2011 -13 120 73. 5 2010 -12 100 England 2009 -11 80 76. 8 2008 -10 60 73. 6 74. 3 2007 -09 40 70. 7 2006 -08 20 75. 6 74. 8 80. 0 2005 -07 0 Directly Age Standardised Rate per 100, 000 Population Southampton 81. 9 82. 0 2004 -06 Liverpool 90. 0 2003 -05 Newcastle upon Tyne 100. 0 2002 -04 45. 8 48. 1 41. 9 43. 7 55. 4 56. 3 59. 0 63. 6 65. 6 66. 2 66. 4 73. 3 74. 1 96. 3 99. 9 Hampshire All deaths from Lung Cancer, Southampton and England trend: 2001 -03 to 2015 -17 2001 -03 Directly Age Standardised Rate per 100, 000 Population All deaths from lung Cancer: Southampton & Comparator Local Authorities 2015 -17

Back to contents I Mortality from lung cancer – sub city (Ward/BCC/IMD) • Southampton lung cancer death rate (2012 -16) 71. 1 adults per 100, 000 • Mortality rate over 3 times higher for those living in the most deprived quintile vs. least deprived quintile and rate ranges 47. 2 (Cluster 3) to 86. 6 (Cluster 2) and 40. 6 (Bassett) to 102. 7 (Redbridge) Deaths from Lung Cancer - Southampton wards: 2012 to 2016 (pooled) persons 40. 6 Portswood 42. 2 Bargate 55. 5 Shirley 56. 1 Freemantle 57. 3 Harefield 57. 8 Swaythling 60. 0 Bitterne 70. 1 Southampton 71. 1 Sholing 76. 1 Bitterne Park 76. 6 Woolston 79. 3 Bevois 82. 1 Millbrook 87. 8 Peartree 90. 7 Coxford 93. 9 Redbridge 47. 2 65. 3 67. 5 71. 1 73. 6 82. 3 86. 6 0 10 20 30 40 50 60 70 80 90 100 Directly Age Standardised Rate per 100, 000 Population Source: Primary Care Mortality Database, Office for National Statistics (ONS) 102. 7 0 Cluster 3 Cluster 4 Cluster 6 Southampton Cluster 1 Cluster 5 Cluster 2 10 20 30 40 50 60 70 80 90 100 110 120 130 140 Directly Age Standardised Rate per 100, 000 Population Source: Primary Care Mortality Database, Office for National Statistics (ONS) Directly Age Standardised Rate per 100, 000 Population Bassett Deaths from Lung Cancer - Southampton wards: 2012 to 2016 (pooled), persons 110 Deaths from Lung Cancer by England Deprivation Quintile: DSR per 100, 000 Population: 2012 to 2016, persons 140 120 100 80 60 40 20 0 R 2 = 0. 9501 100. 9 83. 7 51. 6 37. 5 30. 7 20% most deprived 2 nd quintile 3 rd quintile 4 th quintile 20% least deprived Source: Primary Care Mortality Database, Office for National Statistics (ONS)

I Tartan Rugs Back to contents

Back to contents I Isle of Wight Leeds Liverpool Newcastle upon Tyne Plymouth Portsmouth Sheffield York 272. 0 13. 8 1, 983. 4 620. 7 339. 6 7. 1 1, 113. 5 250. 8 201. 1 11. 5 2, 292. 3 549. 8 257. 1 11. 2 2, 162. 5 599. 7 306. 2 10. 9 1659. 6 467. 2 295. 2 57. 7 70. 7 42. 5 52. 0 61. 7 66. 0 46. 1 51. 4 74. 7 103. 4 98. 2 65. 8 68. 4 65. 5 47. 1 52. 2 75. 4 31. 8 47. 1 59. 0 54. 9 39. 8 37. 2 58. 4 89. 7 85. 0 55. 4 69. 8 54. 5 49. 9 26. 5 34. 5 17. 9 24. 9 25. 6 32. 3 19. 0 27. 9 34. 1 34. 4 29. 8 28. 0 29. 3 23. 7 9. 2 1, 204. 7 283. 4 212. 0 14. 6 1, 082. 4 254. 9 259. 0 10. 2 1, 725. 5 527. 8 331. 7 14. 3 2, 390. 6 740. 7 441. 8 14. 5 2, 792. 2 767. 3 399. 9 11. 7 1, 873. 5 459. 9 312. 9 12. 7 1, 592. 7 539. 2 336. 6 12. 9 2, 042. 7 536. 1 285. 9 11. 1 1, 598. 9 351. 6 245. 8 Smoking Prevalence in adults (%) 417. 3 14. 9 17. 4 13. 8 11. 1 15. 9 14. 4 14. 1 16. 7 15. 5 15. 2 18. 4 15. 2 17. 0 9. 0 Prevalence current smokers (QOF) (%) Hampshire 1, 685. 1 Prevalence people with severe mental illness (%) Coventry 10. 7 Smoking prevalence in adults in routine and manual occupations (%) Bristol Smoking attributable deaths from heart disease (per 100, 000 population) Bournemouth Deaths from COPD (per 100, 000 population) Bath and North East Somerset Deaths from lung cancer (per 100, 000 population) Southampton 2. 8 2. 7 2. 2 3. 5 3. 1 3. 0 2. 1 2. 3 3. 0 3. 4 2. 8 2. 7 3. 0 2. 4 Smoking attributable hospital admissions (per 100, 000 population) Emergency hospital admissions for COPD (per 100, 000 population) Smoking attributable mortality (per 100, 000 population) England Smoking at time of delivery (%) Smoking (England analysis) Low birth weight of term babies (%) Local authority ONS Comparators – Tartan Rug 25. 7 27. 7 30. 0 24. 5 18. 8 26. 1 25. 6 22. 8 27. 4 22. 4 27. 5 26. 9 27. 0 27. 3 24. 6 40. 5 51. 3 38. 7 37. 3 40. 2 36. 6 39. 5 42. 4 50. 9 41. 7 42. 0 42. 6 41. 2 36. 7 17. 6 21. 1 13. 6 20. 3 20. 8 18. 6 14. 9 18. 4 19. 5 21. 5 19. 0 19. 9 20. 0 17. 0 13. 6

Back to contents I Currently smoking residents survey (%) Successful quitters* 50. 0 25. 0 81. 3 11. 3 56. 8 18. 9 54. 2 23. 3 24. 0 22. 7 59. 3 23. 5 61. 5 76. 6 15. 3 16. 8 13. 8 68. 2 24. 2 55. 6 93. 9 19. 2 20. 0 18. 4 59. 5 32. 4 48. 7 88. 4 57. 3 19. 0 21. 0 16. 8 61. 1 25. 9 46. 8 57. 3 57. 8 18. 5 18. 8 18. 3 65. 6 29. 5 59. 5 321. 5 72. 8 87. 8 20. 2 21. 0 19. 5 58. 5 24. 5 42. 7 1, 837. 7 413. 8 76. 3 90. 7 17. 3 69. 2 18. 7 74. 5 1, 510. 0 255. 5 56. 5 42. 2 10. 1 11. 6 8. 4 64. 4 16. 4 60. 5 18. 5 2, 156. 2 455. 1 98. 9 102. 7 20. 7 21. 9 19. 6 62. 5 29. 2 60. 0 10. 5 1, 500. 6 207. 0 56. 3 56. 1 14. 9 15. 7 14. 1 55. 6 26. 7 47. 1 13. 8 9. 6 1, 705. 8 261. 9 67. 2 76. 1 16. 9 17. 0 66. 3 23. 8 61. 9 2. 3 12. 6 10. 4 2, 042. 9 395. 8 89. 2 60. 0 12. 8 13. 0 12. 6 54. 9 15. 7 70. 8 2. 5 19. 3 17. 3 1, 905. 6 381. 3 87. 8 79. 3 15. 4 14. 3 16. 4 61. 3 22. 6 55. 7 14. 1 9. 2 1, 784. 6 1, 997. 5 352. 9 349. 4 71. 8 97. 3 71. 1 55. 5 6. 4 6. 5 1, 219. 0 211. 3 42. 8 15. 1 12. 4 1, 833. 0 429. 0 74. 4 27. 8 1, 953. 7 370. 4 7. 6 7. 7 1, 345. 1 19. 4 19. 0 2, 410. 6 12. 3 9. 5 21. 2 18. 1 2. 2 21. 5 Peartree 2. 0 Portswood 3. 1 Redbridge Shirley Low birth weight of term babies (%) 16. 3 12. 7 Bargate 2. 4 2. 3 Bassett 2. 3 Bevois 3. 3 Bitterne 2. 4 29. 4 Bitterne Park 1. 7 Coxford 2. 4 Freemantle 3. 1 Harefield 2. 3 Millbrook Indicators by Ward Southampton Current smokers amongst registered patients - Persons (%) Current smokers amongst registered patients - Males (%) Current smokers amongst registered patients - Females (%) 9. 1 16. 2 Deaths from Lung Cancer 10. 3 Deaths from COPD 55. 9 49. 4 Emergency COPD hospital admissions 23. 1 21. 4 Smoking attributable hospital admissions 62. 0 59. 5 Mothers smoking at discharge (%) 15. 4 13. 4 Mothers smoking at booking (%) Ever smoked- residents survey (%) Ward tartan rug 16. 3 14. 4 17. 2 17. 4 40. 6 9. 7 82. 1 13. 7 91. 9 70. 1 138. 8 40. 9 737. 5 79. 5 1, 589. 0 248. 2 1, 825. 2 423. 2 17. 9 1, 771. 9 16. 3 13. 4 6. 6 21. 3 1. 7 12. 8 Sholing 1. 5 Swaythling Woolston *For this indicator a high value is better

Quit rate between booking and discharge (%) Quit rate of mothers who stopped smoking when pregnancy was confirmed (%) 2. 4 2. 6 2. 5 2. 9 2. 0 16. 3 17. 2 19. 3 9. 4 13. 2 17. 5 14. 0 14. 5 17. 2 8. 3 10. 4 14. 5 21. 1 20. 0 21. 8 21. 9 24. 6 22. 5 93. 4 94. 7 84. 0 91. 7 96. 7 95. 3 Cluster 6 2. 2 19. 1 17. 7 18. 2 92. 2 16. 3 18. 8 18. 3 10. 7 14. 0 15. 4 17. 5 9. 8 12. 6 17. 3 352. 9 307. 4 16. 9 17. 2 20. 1 19. 1 11. 6 16. 5 16. 6 18. 7 19. 5 17. 9 Deaths from COPD Deaths from Lung Cancer Emergency COPD hospital admissions Current smokers amongst registered patients - Females (%) Mothers smoking at discharge (%) Southampton Cluster 1 Cluster 2 Cluster 3 Cluster 4 Cluster 5 Current smokers amongst registered patients - Males (%) Mothers smoking at midwifery booking (%) Indicators by Ward Current smokers amongst registered patients - Persons (%) Low birth weight of term babies (%) I Back to contents Better Care Cluster tartan rug 597. 3 270. 4 367. 5 365. 0 71. 8 78. 5 71. 4 65. 2 81. 4 76. 8 71. 1 73. 6 86. 6 47. 2 65. 3 82. 3 298. 8 62. 3 67. 5

I Data Insights Back to contents

I Back to contents Summary 1 § Smoking prevalence is declining in Southampton and nationally. However, prevalence in Southampton is higher than the national average and the majority of our statistical neighbours § Smoking prevalence at sub-city level shows variation in prevalence by GP surgery, electoral ward and Better Care Clusters. The three electoral wards where 1 in 5 smoke are Millbrook, Redbridge and Bitterne. The tartan rugs show highest level of need; Redbridge and Bitterne, and Cluster 6 § Gender differences show males are more likely to smoke. Age patterns show more male registered patients aged 30 -34 years and females aged 20 -24 years are known to be smokers (with higher frequencies and rates in Cluster 1) § Southampton has higher than national rates for smoking prevalence for residents in routine and manual occupations with highest work place densities in Shirley, Bargate, Portswood and Bassett

I Back to contents Summary 2 § The link between deprivation shows strong correlation and statistically explains the inequalities between the variation of smoking prevalence, smoking related ill-health and mortality of the city’s residents § Mosaic profiling shows smokers are more likely to be younger residents, in rented accommodation, in single households, low income and financial stresses. Profiling suggests communication preferences of email, Facebook and Twitter § People with mental health conditions are 3 times more likely to smoke than the city average and occurs more significantly amongst those with schizophrenia, bipolar and personality disorders § Lesbian, gay, bisexual and transgender (LGBT) individuals are more likely to smoke as are residents born in Eastern European countries and speaking English as a second language

I Back to contents Summary 3 § Southampton’s prevalence of smoking at time of delivery is significantly higher than the national average. The odds of a mother from the most deprived quintile smoking at time of delivery is 9. 31 times higher. The quit rate between smoking at booking and delivery has increased overall and deprivation again is a key negative factor § The majority (two thirds) of GP practices are engaging with 90%+ smokers § Smoking attributable hospital admissions and COPD hospital admissions in the city are significantly higher than the England average. Deaths from COPD, lung cancer and smoking attributable conditions have all remained significantly higher than the England average since 2005 -07. By ward Bassett has significantly lower for these indicators Redbridge and generally has significantly higher rates § Deaths from COPD have seen an overall decrease nationally however the rate has increased for Southampton

I I Intelligence & Strategic Analysis Team Southampton City Council E-mail: strategic. analysis@southampton. gov. uk Website: https: //data. southampton. gov. uk/ Municipal Block – West, Civic Centre, Southampton, SO 14 7 LT