Reducing smoking prevalence and greater tobacco control is an important part of Government's public health policy. The Government consulted on 62 public health indicators for inclusion within the Public Health Outcomes Framework, including one on smoking prevalence, between December 2010 and March 2011. The consultation responses demonstrated overwhelming support for the inclusion of indicators on smoking prevalence. Following further engagement with expert bodies and other stakeholders, the final Outcomes Framework included three indicators relating to smoking prevalence, namely: smoking at time of delivery; smoking at age 15; and adult (over-18s) smoking prevalence.

As responsibility for tackling smoking prevalence is a public health priority, relevant indicators were included within the Public Health Outcomes Framework. However, the Public Health and the NHS Outcomes Frameworks both include indicators on premature mortality rates, which are affected by a number of factors, including smoking prevalence.

It was always envisaged that if Stoptober 2012 was successful, it would be run as an annual event. Early results are encouraging. Subject to results from the full campaign evaluation, budgetary allocation and approvals from the Efficiency and Reform Group, it is our intention to run Stoptober again in 2013.

The Department does not hold data on the numbers of persons working in stop smoking services in each primary care trust area or in England as a whole.

The Department has no plans to issue guidance to clinical commissioning groups (CCGs) on collaboration with local authorities in providing integrated smoking cessation interventions. However, the Department would expect that local authorities and CCGs would

collaborate with the local Stop Smoking Service teams and commissioners to deliver integrated smoking cessation interventions based on best practice.

Local authorities will receive a ring-fenced public health grant. It is the responsibility of each local authority to ensure that they improve their performance against the smoking prevalence indictors in the Public Health Outcomes Framework and to deliver the best cessation opportunities within their area to support progress against the indicators.

The Department published an updated version of its Stop Smoking Service Monitoring and Guidance in September 2012, “Local Stop Smoking Services; key updates to the 2011-12 service delivery and monitoring guidance for 2012-13”, which is designed to support the commissioning of high quality and effective stop smoking services.

The guidance has been placed in the Library.

The National Institute for Health and Clinical Excellence (NICE) has published public health guidance to support smoking cessation in the following areas: brief interventions and referral for smoking cessation (PHI); workplace interventions to promote smoking cessation (PH5); smoking cessation services (PH10); and quitting smoking in pregnancy and following childbirth (PH26).

The guidelines are available at:

www.nice.org.uk

The Department has no plans to issue guidance to clinical commissioning groups (CCGs) on collaboration with local authorities in providing integrated smoking cessation interventions. However, the Department would expect that local authorities and CCGs would

collaborate with the local Stop Smoking Service teams and commissioners to deliver integrated smoking cessation interventions based on best practice.

Local authorities will receive a ring-fenced public health grant. It is the responsibility of each local authority to ensure that they improve their performance against the smoking prevalence indictors in the Public Health Outcomes Framework and to deliver the best cessation opportunities within their area to support progress against the indicators.

The Department published an updated version of its Stop Smoking Service Monitoring and Guidance in September 2012, “Local Stop Smoking Services; key updates to the 2011-12 service delivery and monitoring guidance for 2012-13”, which is designed to support the commissioning of high quality and effective stop smoking services.

The guidance has been placed in the Library.

The National Institute for Health and Clinical Excellence (NICE) has published public health guidance to support smoking cessation in the following areas: brief interventions and referral for smoking cessation (PHI); workplace interventions to promote smoking cessation (PH5); smoking cessation services (PH10); and quitting smoking in pregnancy and following childbirth (PH26).

The guidelines are available at:

www.nice.org.uk

I have been asked to reply on behalf of the Cabinet Office.

The information requested falls within the responsibility of the UK Statistics Authority. I have asked the authority to reply.

Letter from Glen Watson, dated December 2012:

As Director General for the Office for National Statistics, I have been asked to reply to your recent question asking how many deaths have been caused by smoking in each of the last 10 years. (134310)

Deaths due to smoking-related illness cannot be directly estimated, as smoking status is not included on the death certificate. However, research published by the NHS Information Centre for Health and Social Care in August 2012 estimated that one in five deaths were attributable to smoking in England in 2011. The report Statistics on Smoking: England, 2012 is available at:

https://catalogue.ic.nhs.uk/publications/public-health/smoking/smok-eng-2012/smok-eng-2012-rep.pdf

The number of deaths registered in England and Wales each year by sex, age and cause are published annually on the National Statistics website at:

http://www.ons.gov.uk/ons/rel/vsob1/mortality-statistics--deaths-registered-in-england-and-wales--series-dr-/index.html

The Department does not hold data on the numbers of persons working in stop smoking services in each primary care trust area or in England as a whole.

The Department does not directly fund stop smoking service activity. Funding that was allocated in 2012-13 for services was allocated by primary care trusts. Funding for 2013-14 will be allocated by the local authority from the ring fenced public health budget.

The Department does not hold data on the numbers of persons working in stop smoking services in each primary care trust area or in England as a whole.

The Department does not directly fund stop smoking service activity. Funding that was allocated in 2012-13 for services was allocated by primary care trusts. Funding for 2013-14 will be allocated by the local authority from the ring fenced public health budget.

The Survey of Smoking, Drinking and Drug Use Among Young People showed that 23% of children aged 15 in England were regular smokers in 1999. It is possible to gain some insight into the proportion that have remained smokers using information from the 2010 General Lifestyles Survey, by looking at the current smoking status of those who said they started smoking regularly when they were 15 or younger. As the sample contains an insufficient number of 26-year-olds (who would have been 15 in 1999), it is necessary to use a broader age range. Of those 24 to 28-year-olds in England who said they started smoking regularly when they were 15 or younger, 71% said that they currently smoked cigarettes.

How schools choose to address issues regarding smoking is a local decision and the Department for Education does not provide specific funding for anti-smoking initiatives. Pupils are taught about the effects of tobacco on health as part of the national curriculum for science. In addition, teachers can cover the facts about, and consequences of, smoking in non-statutory personal, social, health and economic (PSHE) education.

The 2011 “Smoking, drinking and drug use among young people in England” survey found that a quarter of 11 to 15-year-olds had smoked at least once, the lowest proportion since the survey began in 1982. In 2011, 5% of pupils smoked at least one cigarette a week, half the level of 2001.

Regional data for the incidence of smoking for pupils in Lancashire is not available. However, data for the North West region is available from the above survey programme. 5% of pupils in the North West smoked at least one cigarette a week in 2011. The Department does not collect statistics on the incidence of smoking on school premises.

How schools choose to address issues regarding smoking is a local decision and the Department for Education does not provide specific funding for anti-smoking initiatives. Pupils are taught about the effects of tobacco on health as part of the national curriculum for science. In addition, teachers can cover the facts about, and consequences of, smoking in non-statutory personal, social, health and economic (PSHE) education.

The 2011 “Smoking, drinking and drug use among young people in England” survey found that a quarter of 11 to 15-year-olds had smoked at least once, the lowest proportion since the survey began in 1982. In 2011, 5% of pupils smoked at least one cigarette a week, half the level of 2001.

Regional data for the incidence of smoking for pupils in Lancashire is not available. However, data for the North West region is available from the above survey programme. 5% of pupils in the North West smoked at least one cigarette a week in 2011. The Department does not collect statistics on the incidence of smoking on school premises.

How schools choose to address issues regarding smoking is a local decision and the Department for Education does not provide specific funding for anti-smoking initiatives. Pupils are taught about the effects of tobacco on health as part of the national curriculum for science. In addition, teachers can cover the facts about, and consequences of, smoking in non-statutory personal, social, health and economic (PSHE) education.

The 2011 “Smoking, drinking and drug use among young people in England” survey found that a quarter of 11 to 15-year-olds had smoked at least once, the lowest proportion since the survey began in 1982. In 2011, 5% of pupils smoked at least one cigarette a week, half the level of 2001.

Regional data for the incidence of smoking for pupils in Lancashire is not available. However, data for the North West region is available from the above survey programme. 5% of pupils in the North West smoked at least one cigarette a week in 2011. The Department does not collect statistics on the incidence of smoking on school premises.

How schools choose to address issues regarding smoking is a local decision and the Department for Education does not provide specific funding for anti-smoking initiatives. Pupils are taught about the effects of tobacco on health as part of the national curriculum for science. In addition, teachers can cover the facts about, and consequences of, smoking in non-statutory personal, social, health and economic (PSHE) education.

The 2011 “Smoking, drinking and drug use among young people in England” survey found that a quarter of 11 to 15-year-olds had smoked at least once, the lowest proportion since the survey began in 1982. In 2011, 5% of pupils smoked at least one cigarette a week, half the level of 2001.

Regional data for the incidence of smoking for pupils in Lancashire is not available. However, data for the North West region is available from the above survey programme. 5% of pupils in the North West smoked at least one cigarette a week in 2011. The Department does not collect statistics on the incidence of smoking on school premises.

The Government does not assess anti-smoking initiatives in schools.

Pupils are taught about effect of tobacco on health as part of the National Curriculum for Science. In addition teachers can cover the facts about, and consequences of, smoking in non-statutory Personal, Social, Health and Economic (PSHE) education.

The Government takes seriously the need to reduce the take up of smoking by young people and to help those that do smoke to stop. The Government's comprehensive, evidence-based strategy to reduce tobacco use in England over the five years until 2015, in the context of the new public health system, is set out in ‘Healthy Lives, Healthy People: A Tobacco Control Plan for England’ (published March 2011). A copy has already been placed in the Library

One of three national ambitions in the Tobacco Control Plan, to be achieved by 2015, is focused on reducing smoking prevalence among young people. The Plan sets out a range of initiatives to achieve this ambition which apply at national level across England, including in South Yorkshire and Barnsley. For example, tobacco sales from vending machines stopped on 1 October 2011, so removing an easily accessible and often unsupervised, source of under-age sales of cigarettes. Since 6 April 2012, permanent, eye-catching, displays of tobacco products that evidence shows can promote smoking by young people, came to an end in supermarkets and other large stores, and will stop in all other shops in April 2015. Also, a number of national marketing campaigns have targeted behaviour around smoking, such as the effect on children of second hand smoke from smoking in homes and cars.

In addition, the Government has recently carried out a consultation on standardised packaging of tobacco products (from 16 April until 10 August), which attracted many thousands of replies. We want to understand whether policy action on tobacco packaging has the potential to bring additional public health benefits, over and above those expected to accrue from existing tobacco control initiatives. Any decisions to take further policy action on tobacco packaging will be taken only after full consideration is given to all the consultation responses, evidence and other information.

The Tobacco Control Plan for England also promotes and encourages local areas to adopt similarly comprehensive local strategies. The new approach to public health delivery in England means that local areas will decide their own priorities and ways of improving health in their communities, according to local circumstances

and evidence, and supported by dedicated ring-fenced funding. The Department does not hold centrally, detailed information about the tobacco control initiatives pursued by each local area. However, information about the smoking behaviour of children aged 11 to 15 is available by region in England for the year 2010-11 and the years 2006 to 2008 combined. Copies of ‘Smoking, drinking and drug use among young people in England’ have already been placed in the Library.

‘Smoking, drinking and drug use among young people in England’, findings by region 2006 to 2008 has been placed in the Library.

In the three year period from 1 April 2009 to 31 March 2012, 39% of lung transplants were from donors with a past history of smoking. All lungs are carefully evaluated before, during and after retrieval as every effort is made to ensure that a donated organ does not go to waste if clinically viable and there is someone who could benefit.

Specialist nurses in organ donation take a smoking history from the donor's family and medical notes. This information is provided to the transplant team to make a clinical decision as to whether to accept the offered organs for an individual patient on their waiting list. A recent NHS Blood and Transplant (NHSBT) study published in The Lancet in May 2012 has shown that due to the shortage of organs, the patient's probability of survival is greater if lungs from smokers are accepted than if they are declined and the patient chooses to wait for a potential transplant from a donor who has no smoking history.

Guidelines for consent for solid organ transplantation, developed by NHSBT and the British Transplant Society aims to standardise practice for consent for adults across the United Kingdom. The guidelines state that the transplant team should explain to the potential recipient the risks associated with accepting the organ in the short and long term before obtaining consent and that the potential recipient has the right to specify the characteristics of the organ they would wish to receive.

We are constantly seeking to generate awareness of organ donation and to encourage people to add their name to the NHS Organ Donor Register. Registration does not require confirmation that a proposed donor who is a smoker will be disqualified from donating lungs.