ASH Scotland’s Inequalities Development Lead Tracey Rogers looks at raising the issue of smoking in discussions around finances and highlights new work showing how this can be done.
We know smoking is considered a coping mechanism for those facing social and environmental challenges – compounded for some by welfare reforms leaving many struggling with debt, homelessness and unemployment. An increase in stress during such times can have a significant impact on physical health, mental wellbeing and ability to cope. Whilst we accept smoking is not the direct cause of poverty, it is closely linked to it and exacerbates it.
NHS Greater Glasgow and Clyde and ASH Scotland recently launched an evaluation report which looks at ‘The role of stopping smoking in money advice – putting health and economic benefits together’. This pilot was based on work by North Lanarkshire Councils Debt Advisory Service in partnership with local Smokefree Services. There they piloted tailored training uniquely aimed at money advice staff on raising the issue of smoking with clients seeking financial support.
When we canvassed views on running a similar pilot with staff at money advice services, there were some reservations. Feedback included:
- it could harm relationship with those in need accessing their service
- it wasn’t their role,
- they felt uncomfortable raising the issue, or
- they simply didn’t have time as more urgent discussions need to be prioritised
Yet results from the project evaluation show the ‘raising the issue of smoking’ training really did challenge these perceptions by demonstrating clear relevance and benefits in relation to finances. This approach offers increased opportunities to broaden reach and engage with stop smoking services. The pilot also helped to enhance and reinforce the work of staff in money advice services when using the Common Financial Tool to identify possible savings through stopping smoking.
Whilst there was support from the pilot sites involved we also recognise the type of advice being sought and the urgency for this to be carefully and sensitively handled. Staff therefore can and should use their skills and experience to judge the timing of these conversations and raise the issue of smoking at future appointments. One launch attendee’s comment resonates with the evaluation findings
“Advisors are being asked to do a lot and there is a lot to remember that we need to look at … strategically we [advisory services] need to think what are the [clients] priorities [right now]?”
Another delegate offered a different perspective…
“sometimes there is never a good time or right time… the aspiration therefore might be to routinely raise the issue and ask those questions”
(NHS GG&C Health Improvement Lead)
Discussions at the launch surrounding the report findings were highly positive with speaker Fiona Moss rallying her support.
“smoking cessation is a route to addressing income maximisation”
We are pleased that the team in Glasgow are keen to support the six recommendations locally and we will be seeking support nationally to influence practice within financial advice settings.
The recommendations are applicable to other areas and can be replicated by any service providing some form of financial advice as well as with other areas of health improvement and inequalities. Karen Carrick, Manager on the Money Advice Outcome Project at the Improvement Service said
“what is happening here is a fantastic example of good practice”
So can we see this good practice work its way into the fabric to become an integral part of money advice? Whilst poverty remains one of the single biggest factors contributing to public health concerns surely raising the issue of smoking in such settings is one piece in the puzzle that shouldn’t be discarded.