The housing sector can help stub it out

Earlier this month Health and Social Care Secretary Matt Hancock unveiled his Green Paper setting out his long-term strategy for our struggling NHS.

“We need a new 21st century focus on prevention,” he claimed.

With the NHS spending £97billion treating disease, and only £8billion preventing it, it’s pretty obvious that the numbers don’t stack up and we need to re-focus how we invest in health and wellbeing.

And for me, I firmly believe that social housing providers have a key role to play in supporting that change.

Today (Tuesday November 20) Action on Smoking Health (ASH) has published a new report focusing on the effects of smoking in the home.

I was proud to co-chair the report, which should prove a real eye-opener for the sector.

If you live in social housing you’re twice as likely to smoke. Fact.

If you’re a smoker, you risk shortening your life by 10 years. Fact.

There’s an average 10-year life difference between the richest and poorest people in society. Fact.

It’s pretty clear that when it comes to health and wellbeing, our very own tenants are at a huge disadvantage. Tobacco dependency is disproportionately harming the communities we house, and we should ask ourselves what we are doing about it.

There are regional variances as well that exacerbate this disparity.  Smoking rates across Greater Manchester, where my organisation Salix Homes is based, are almost 20% higher than the rest of the country. With one in five homes in the region owned or managed by a social housing provider, you can begin to see the correlation.

This report has highlighted some pretty shocking findings, particularly around the effects of secondhand smoke on children.

We all know about the dangers of passive smoking, but it really brings it home when you realise that children living in social housing are three times more likely to be exposed to secondhand smoke in the home than children in owner-occupied homes.

They’re also more likely to become smokers themselves, locking them into this cycle of disadvantage.

No child should have to be exposed to smoke in the home. Childhood illness caused by exposure to secondhand smoke costs the NHS almost £12million a year, so there’s clearly a role here for social housing providers to play to help protect those children and raise awareness of the harm that’s being done.

Furthermore, smoking is one of the biggest causes of fires in the home, so in today’s post-Grenfell world it’s more crucial than ever that the housing sector does everything in our power to reduce that risk.

But what can we do?

Well, we know that we are not just here to collect the rent and fix the boiler anymore. I believe we could turn our social values on smoking to lead a potentially transformative role as custodians of health – we have an opportunity here to up our game.

As our health secretary pointed out, the answer lies in prevention, and this is where we come in.

As an ex-smoker myself, who started smoking at just 12-years-old, I know first-hand just how hard it is to quit. It was only when I got to 30, and I realised that I’d smoked for longer than I hadn’t, that I knew it was time to ditch the fags.

Smokers in social housing are as equally motivated to quit as anyone else, they’re just half as likely to succeed, but we can help change that.

Salix Homes has recently taken part in a pilot study in Salford with the Greater Manchester Combined Authority to encourage tenants across the city to switch to vaping.

Public Health England say vaping is 95% safer than smoking, so as part of the pilot we engaged with more than 1,000 smokers in our communities and provided them with free e-cigarette starter kits.

The participants were monitored and offered support throughout the trial – and it worked. After four weeks, 63% had ditched the cigs and stuck with vaping, which according to health professionals was a four-fold improvement on what they’d expect with other methods of quitting.

Just from this one piece of work, we’ve got hard evidence that signposting tenants to the right support and tools can yield some very positive results.

Obviously, we can’t talk about reducing the prevalence of smoking in social housing without addressing the elephant in the room – a total ban on smoking in the home.

The 2007 smoking ban has successfully ‘denormalised’ smoking. It’s neither legal, nor socially acceptable, to smoke in a pub, restaurant, aeroplane, train, a car carrying children, or any public place. And in the private rented sector, 84% of properties have a rule prohibiting smoking in the home.

So are we heading to a blanket ban on smoking in social housing? No, I don’t think we are.

Neither this report, nor myself, would advocate a total ban, but the report does provide an opportunity for those challenging questions to be raised and for discussions to take place.

Of course, there are some incidences where a blanket ban is appropriate, and Salix Homes has two such sites. One is a shared-living complex for young people and the other is an apartment block exclusively for medical staff at our local hospital.   

While I can’t see a blanket ban on the horizon, what this report has done is successfully raise awareness of smoking prevalence in the home, highlighted the inequalities of those living in social housing and posed the question to the sector of what role we can play in the Government’s ‘focus on prevention’ and in making tackling this health inequality our business.

Read the full report entitled Smoking in the Home – New Solutions for a Smokefree Generation.