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THE HIGHLAND COUNCIL
Resources Committee – 5th October 2005
Report by Director of Corporate Services
Smoking Cessation Support in Support of the Policy on Managing Smoking at Work
Summary

This report proposes that smoking cessation support be made available for elected members and staff in
support of the policy on Managing Smoking at Work.
Introduction
It was agreed at the last meeting of the Resources Committee that the revised smoking policy – ‘Managing Smoking at Work’ be approved subject to minor amendments. Reference to restrictions on smoking within the “curtilage” of Council premises has now been removed and guidance on implementation of certain aspects of the policy is currently being developed. The final policy document is attached as Appendix 1. It was also agreed that a further report would be submitted to the meeting of the Committee outlining the arrangements for Smoking Cessation Support. Smoking Cessation
There are financial and other reasons why people may choose to give up smoking, but the most important is the adverse effect that smoking has on health. The National Health Service considers smoking tobacco to be the largest avoidable single cause of serious ill-health and premature death in the United Kingdom. In 1997 it was estimated that smoking tobacco caused one in five deaths in the UK. In addition, non-smokers exposed to environmental tobacco smoke are at greater risk than those not exposed; for non-smokers living with smokers there is a 24% excess risk of developing lung cancer and a 23% excess risk of developing Ischaemic Heart Disease. As a major employer, the Highland Council has the opportunity to make a significant impact on health in the Highlands by encouraging members and employees to give up smoking if they wish to do so. It is estimated that approximately 27% of the adult population currently smoke. The number of Highland Council employees who smoke is not known, but using the percentage figure it is estimated that it could be in excess of 3,000. The NHS estimate that approximately 33% of all smokers attempt to give up each year. It is difficult to estimate the uptake of a smoking cessation support campaign but if approximately 1,000 people could be encouraged to give up smoking, it would have major health benefits for the individuals concerned, their families, the Council and the wider community in which they live. Cessation Methods
The following smoking cessation methods are currently available in the Highlands and information is supplied in respect of the service provider, cost and estimated success rates:- a) NHS Highland Smoking Cessation Service
The NHS has specialist smoking cessation advisers based in Caithness, Ross-shire, Inverness and Lochaber. They provide smokers with one to one, and in some areas, group support to quit and also support the use of Nicotine Replacement Therapy (NRT). Other support may be provided on prescription, such as Zyban. In relation to NRT Individuals are assessed on the basis of their smoking habits and appropriate levels of NRT are then offered as a prescription. An initial prescription for one weeks supply is offered together with ongoing support over the following timescale:- - If the person has refrained from smoking for a week, then a further two weeks NRT is supplied - If the person has still refrained from smoking for this additional two week period then a further four weeks NRT is supplied. If the individual is required to pay prescription charges then the cost for seven weeks supply of NRT would be £19.20 (3 prescription charges). NRT products are available to purchase over the counter at most pharmacists at an average cost of £17 per one weeks supply. An individual opting for the NHS supported method could therefore save approximately £100 over a seven week period on the cost of NRT products. The success rate for this method of cessation (intensive NHS support plus NRT) is claimed to be in the NHS Highland are prepared to work with the Highland Council, and this may involve training and/or other financial support. b) Allen Carr Counselling Method
This method of smoking cessation involves the individual or group attending a series of three counselling sessions during which the psychology of smoking is addressed. This method has been piloted and adopted by several large organisations including The Scottish Executive, the Scottish Parliament and Glasgow and Dundee City Councils. The company offer a money back guarantee if an individual has failed to stop smoking after three months subject to the person having attended all three sessions. The total cost of the treatment sessions is £210 per person plus VAT. The success rate for this method of cessation is claimed to be high. For example, the pilot study undertaken by the Scottish Executive in May 2004 showed that 84% of the people who attended all three counselling sessions stopped smoking as a result.
c) Hypnotherapy

Several hypnotherapists operate throughout the Highland Council Area and offer smoking cessation support. Hypnotherapy is a natural therapy which uses a combination of skills including counselling, mind analysis and hypnotic techniques. It is not recognised by NHS Highland however as a medical treatment therefore referral by a GP prescription or through NHS smoking cessation is not available. Individuals who choose this method will be expected to pay in the region of £35 per session, with normally three sessions per full treatment. The total cost would therefore be in the region of £105. This cessation method also claims to have a high success rate, with individual sessions having a 91.3% success rate, and group sessions a 85% success rate. d) Acupuncture
As well as hypnotherapy, acupuncturists operate throughout the Highland Council Area and provide services that are not available through the NHS. The technique can be used to help people stop smoking and an individual is normally required to attend three sessions at a total cost of £100. This method again claims a high success rate for smoking cessation of between 90 – 95% Highland Council Support
The Council could offer the following assistance in terms of encouraging elected members and employees to give up smoking should they wish to do so.:- a) Provide employees with a list of the full range of smoking cessation support available in the Highland Council Area and allow individual choice for preferred cessation method. Facilitate group sessions for the range of smoking cessation methods through the use of Provide financial support of 50% of the cost of the chosen cessation method subject to a It is proposed that it be delegated to the Director of Corporate Services to ensure that appropriate arrangements are put in place to ensure the proper administration of the suggested support.
5 Resource
Implications
If 1,000 employees were to take up the offer of cessation support as outlined in 4.1(c), then the maximum total cost would be £50,000. This could be considerably less however, depending on the numbers who choose the NHS cessation method. The Corporate Services budget has £20,000 available for Occupational Health initiatives in the current financial year. Where possible any additional funds could be provided from Corporate Services underspends or through an additional request for funding being made to the Budget Working Group. It should be noted that other large organisations such as the Scottish Executive, Scottish Parliament and Dundee and Glasgow City Councils have all provided some financial assistance to employees who wish to give up smoking. It is anticipated that there would be benefits to the Council from a healthier workforce, lower absence rates and supporting staff and with a positive impact on service delivery. 6. Recommendations

6.1 That the Committee agree the range of smoking cessation support measures outlined in
6.2 That it be delegated to the Director of Corporate Services to ensure that appropriate arrangements be put in place to ensure the proper administration of the suggested support. Signature: Designation: Director of Corporate Services Date: 28th September, 2005 APPENDIX 1
The Highland Council
Managing Smoking at Work
INTRODUCTION
The Council as the largest employer in the Highlands and because of its concern for
public health and its position of influence, will take a lead role on regulating smoking
in the workplace. The Council recognises the practical benefits of such a role
including:
• An improved working environment • A healthier workforce • Reduced absence through smoking related illnesses • Positive public image • A demonstrable concern for the health, safety and welfare of members of staff The policy will assist in achieving the aims and, objectives of the Council’s Health & Safety policy, namely: • The provision and maintenance of a working environment for employees that is, so far as is reasonable and practical, safe, without risk to health and adequate as regards facilities and arrangements for their welfare at work. • Ensuring so far as is reasonably practical that working conditions at all workplace locations are free from avoidable risks to health of employees.
The policy reflects the duties of the Council to its employees’ health, safety and
welfare under the Health & Safety at Work etc. Act 1974 and the Workplace (Health,
Safety and Welfare) Regulations 1992.
POLICY AIMS/OBJECTIVES

• To ensure, so far as is reasonably practical, that a smoke free working • To emphasise the positive health benefit to be gained by stopping smoking and to encourage and assist staff and elected members to stop smoking if they wish to do so.
SCOPE
A complete ban on smoking in all wholly or substantially enclosed Council
premises will be applied.
This policy will apply to all employees, councillors, visitors, contractors and members
of the public using Council premises.
For the purposes of this policy, “Council Premises” means any premises or parts of
premises under the management control of the Highland Council.
“Wholly or substantially enclosed” means that a public place or workplace is
‘wholly or substantially enclosed’ if it has a ceiling or roof and, except for doors,
windows and passageways is wholly enclosed, whether permanently or
temporarily; or if it has an opening which is lessthan half of the area of its walls.
In addition, Council employees will not be permitted to smoke;

a. In Council owned vehicles b. In privately owned vehicles whilst carrying passengers on Council business c. In certain external areas associated with enclosed Council premises including access doorways. This restriction is intended to prevent smoking in close proximity to entrance doorways and approaches to Council buildings.
The only exceptions to this policy will be designated smoking areas in the
Council’s residential homes. These are considered to be dwelling places and as such
the residents and their visitors will be allowed to smoke in the designated areas.
This policy will apply equally to all future premises and will be taken into account at
the design stage of any new build, refurbishment or relocation project.
Employees are sometimes required to work in designated smoking areas or are
required to visit other places where people smoke (i.e. client’s homes). In these
circumstances work methods will be adopted which minimise individual exposure to
tobacco smoke. These employees will have annual risk assessments to monitor the
situation and health checks from the Council’s Occupational Health Service provider
will be available.

COUNSELLING AND ASSISTANCE
As the Council takes a positive attitude regarding health, safety and welfare at work,
any Council member or employee who smokes, and wishes to use the policy as an
opportunity to give up or cut down on smoking will receive appropriate
encouragement and support.
A range of measures will be available including:
• Healthy lifestyle advice • Publicity materials, information and signage • Other recognised means such as nicotine replacement therapy and/or
Preliminary advice will be available through the Council’s Occupational Health
Service
Where possible assistance provided will be accommodated within normal working
hours, without loss of pay, though it may involve commitment outwith normal hours,
for which there will be no payment.

ARRANGEMENTS FOR SMOKING
Smokers should be encouraged to seek help to attempt to give up smoking. The
following arrangements will apply to employees who wish to continue to smoke;
• There will be no designated smoking breaks. • Employees will only be entitled to smoke outwith their contractual hours. • In all circumstances the requirement for a ban on smoking in all wholly or substantially enclosed Council premises will apply, this includes all access doorways and approaches to Council buildings.
IMPLEMENTATION
The policy will be effective from 1st January 2006
Directors will be responsible for implementation of the policy within their Services
and for monitoring its effectiveness, in consultation with the recognised trade unions.
Signage will be provided at the entrances and throughout all Council owned and
leased premises indicating that smoking is not permitted.
All staff have a responsibility to bring the policy to the attention of anyone who is
smoking on Council premises.
Staff should report a breach of the policy by a non-employee to their line manager.
The line manager will then request that the person leaves the premises if they wish to
continue to smoke.

DISCIPLINE AND GRIEVANCE

If a manager is aware of an employee ignoring the policy this should be discussed
with the employee and smoking cessation offered.

Where an employee ignores this approved policy, such conduct will be pursued under
the Council’s disciplinary procedures. The Council’s grievance procedure is available
for staff to pursue individual complaints.

SPONSORSHIP
Highland Council will not support or solicit any sponsorship from tobacco product
manufacturers.
The Council supports a ban on all tobacco advertising. To this aim the Council will
not allow any advertising of tobacco within Council premises.
Any existing and legally binding sponsorship or advertising agreements with tobacco
manufacturers will not be renewed.
The Council will not permit any tobacco sales in any Council premises.
GUIDANCE
Guidance will be produced to assist with the implementation of this policy throughout
the diverse range of Council work activities, workplaces, other premises and vehicles
etc. In addition it will reflect guidance to be produced by the Scottish Executive on
compliance with the legal requirements of legislation which will ban smoking in
wholly or substantially enclosed public places and workplaces from 26th March 2006.

Source: http://www.highland.gov.uk/NR/rdonlyres/CE7E67C4-A719-4297-8813-685F4D408F73/0/Item13res14105.pdf