Tobacco use is the single biggest preventable cause of ill-health and premature death in Scotland. Scotland's implementation of comprehensive smokefree public places legislation in March 2006 made it the fifth country in the world to become smoke-free. This article highlights recent activity vis-a-vis smoking cessation and tobacco issues in Lothian in a bid to reduce the 1506 annual deaths1 and 8875 NHS admissions2 in Lothian.

In September 2006, "No Ifs, No Butts: A Tobacco Strategy for NHS Lothian 2006-2010" was launched. This strategy provides the targeted, strategic approach to tobacco control in Lothian. It focuses on a broad range of issues comprising tobacco prevention and protection, and smoking cessation (see Box 1). The strategy was developed by the NHS in partnership with local authorities and the voluntary sector. The NHS Lothian Tobacco Strategy Project Board was developed to oversee the implementation of the strategy via local tobacco alliances in Lothian.

Existing links between NHS Lothian and appropriate departments of the local authorities have been strengthened in the past year. The feasibility of a local tobacco alliance for Edinburgh is currently being revisited.

A major area of work in the past year included the development of the NHS Lothian Tobacco Policy in order to protect the health of staff and service users on NHS Lothian's premises. A new stop smoking service specifically for NHS Lothian staff was also started. In the run-up to the smokefree legislation, assisting workplaces and local authorities with no smoking policy development and stop smoking support for their staff was commonplace.

The Communications Team and the NHS Lothian Smoking Cessation Co-ordinator worked closely together on the "No Ifs, No Butts" campaign in order to promote the benefits of the smokefree legislation. Stop smoking services have continued to be publicised via regular articles in the local media and across NHS Lothian.

Increased funding for smoking cessation services - now known as 'stop smoking services' in Lothian - to enable all Community Health Partnerships and main hospital sites in Lothian to have stop smoking specialist facilitators, has resulted in widespread provision of services to the general public. In particular, lowincome/deprived groups were targeted, thanks to the Prevention 2010/Keep Well investment in Edinburgh, with specific services for pregnant women and young people in many areas. This is in addition to the existing staff who have been trained to provide the same evidence-based in-depth stop smoking support within their own organisations. One such example is the LGBT Centre for Health & Wellbeing which runs regular stop smoking groups for the lesbian, gay, bisexual and transgender community. Where successful, smoking cessation pilot initiatives have been encouraged to integrate with their respective Community Health Partnerships in order to enable continued funding. In addition to this, new projects and initiatives have been able to be set up targeting other priority groups, for example people with mental health problems and black and other minority ethnic groups.

As a result of increased funding, long waiting-lists for stop smoking services are now largely confined to the past. 11,260 smokers in Lothian had been through the stop smoking services between January 2001 and July 2005 and approximately 3,500 smokers went through the services between July 2005 and July 2006. Stop smoking services in Edinburgh are currently being streamlined with a view to more integrated stop smoking support service provision throughout the city.

Stop smoking services double the chances of quitting whilst using what are called pharmacotherapies, for example nicotine replacement therapy (NRT) or Zyban (bupropion) increases further the success rate for people who quit. To maximise chances of successfully quitting, smokers who are ready to stop should use the available stop smoking services in conjunction with prescriptions for NRT or Zyban where indicated.


1. Peto, Lopez et al (1992, 1994). Applying attributable deaths calculated for the UK in 2000 (in Mortality from Smoking in Developed Countries 1950-2000 (2nd edition: data updated 23 August 2004); to the number of deaths in 2002 GROS. Accessed 5 September 2005.

2. Royal College of Physicians (2004). Applying attributable admissions estimated in Nicotine Addiction in Britain, Royal College of Physicians ( books/nicotine/1-overview.htm) to the number of admissions for smoking related diseases SMR01 2003-2004, ISD (Scotland). Accessed 5 September 2005.