Meeting Notes
Short Life Working Group:
Smoking amongst 16 – 24 year olds
14.00 to 16.00, Wednesday 26thApril,
Meeting attendees
Heather Bath, Health Improvement Senior – Tobacco, NHSGGC Smokefree Services
Lesley Brogan, West Lothian Drugs and Alcohol Service
Lynda Irvine, Skills Development Scotland
Jacqueline Kirkland, Health Promotion Specialist, NHS Lothian Health Promotion Service
Fiona Lockett, Tobacco Prevention Officer, NHS Fife
Lesley Mackay, Healthy Working Lives Advisor, Healthy Working Lives – Lanarkshire
Alastair MacKinnon, Chief Executive, Fast Forward
Sandra McIntyre, National Development Manager, Youthlink Scotland
Emma Papakyriakou, Development Lead (Children and Young People) ASH Scotland
David Robertson, STA Coordinator, ASH Scotland
Rebecca Smith, Health Improvement Senior (Assist Project) NHSGGC Smokefree Services
John Watson, Dept CE, ASH Scotland
Apologies
Amanda Amos, Professor of Health Promotion, Univerisity of Edinbrugh
Katie Gowing, Student Health Campaign Coordinator, NUS Scotland
Kevin Leslie, Smoking Advice Service Coordinator, NHS Grampion
Colin Lumsdaine, Senior Health Promotion Specialist (Tobacco and Young People), NHS Lothian
Brian Pringle, West Lothian Drugs and Alcohol Service
Purpose
This meeting intended to identify clear actions for the coming months to inform
discussions around the next national tobacco strategy. We discussed and identified:

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John Watson
introduction
the extent to which health and wellbeing is a priority within employability
provider service level agreements and what requirements there are for creating
a health promoting environment in these establishments,
how we might scope the needs of employability providers, in line with the
issues young people present with, and equip them to integrate tobacco into
their work?
how to help the sector make the connections between smoking and other
health behaviours, physical and mental health, financial wealth and
employability, at an operational and strategic level.
John reflected back on the presentation Amanda Amos provided at the 7th December
meeting illustrate the prevalence of smoking in the 16 to 24 age group.
It was noted that in the last 10 years there has been a fall in prevalence rates among
teens to the lowest level ever. While this is encouraging, progress has been slower for
the older age group. The biggest increase in smoking rates comes between the 9%
rate for 15 year-olds and 21% for the 16-24 age groups.
How smoking rate changes with
age in Scotland
30
20
10
0
13
15
16-24 25-34 35-44 45-54 55-64 65-74
75+
CRUK research project, Young Adults, Inequalities and Smoking in Scotland (Amanda Amos,
Stephen Hinchliffe, and Andy MacGregor – unpublished/pending summer 2017).
Smoking is not uniform across 16 – 24 year olds. Smoking rates in older young people
are higher for those in work compared with those in full-time education and higher still
for that Not in Employment Education or Training (over 40% 16 to 24’s).
One important fact is that the prevalence in SIMD 1 it continues to rise into the 20’s
and 30s while in more advantaged groups it peaks and then begins to fall
40
20
0
SIMD 5 SIMD 4 SIMD 3 SIMD 2 SIMD 1
16-19
20-24
25+
CRUK research project, Young Adults, Inequalities and Smoking in Scotland (Amanda Amos,
Stephen Hinchliffe, and Andy MacGregor – unpublished/pending summer 2017).
This is the motivation for this group to explore carefully what can be done to reduce
the obvious health inequality manifest in the statistics.
Emma
Papakyriakou,
Development
Lead Children
and Young
People
Emma highlighted the key action in the current strategy which enlists the support of
further and higher education and training providers to help young people navigate
decisions about tobacco.
Emma highlighted the importance of this group exploring what opportunities exist to
support employability providers to help young people make positive HEALTHY
transitions in to learning, training and work.
Headlines from a few weeks ago were encouraging, showing a record number of
young people moving to a ‘positive destination’ and an increase in those from the most
deprived areas. A ‘positive destination’ is classified as higher and further education,
training, voluntary work, employment and engagement with Activity Agreements.
We know there is a link between smoking and aspirations. The SALSUS shows 15
year olds who smoke are less likely to aspire to go to university compared with their
non-smoking peers. Smoking prevalence is higher amongst 16 – 24 year olds who are
at work compared to 16 – 24 year olds at further or higher education and even greater
still for those not engaged in learning or training.
While smoking does not cause disengagement it is an unhealthy risk behaviour or
coping mechanism which goes along with other significant factors experienced by
disadvantaged young people.
We need to consider the environment at the ‘positive destination’ which young people
are transitioning into and help providers change the culture around smoking in these
destinations by developing health promoting policies.
Lynda Irvine,
Skills
Development
Scotland
Skills Development Scotland




SDS provides customers with a comprehensive range of careers information,
advice and guidance services in schools and post-school. SDS also has digital
channels including My World of Work and Apprenticeships.scot
SDS offers support for pupils, parents/carers and teachers from Primary 5 to S6 in
schools
SDS has revised its post school offer for delivering services to post school
customers. The Next Steps Offer customers are school leavers aged 15-18.5
without a positive destination, 15-18.5 years old unemployed customers and 15-26
years old care experienced customers.
Professionally qualified careers staff provide face to face guidance for customers
in school and post school.
For more information on the range of Information, support and guidance offered by
Skills Development Scotland
Key discussion points:
 Integrating health and wellbeing into My World of Work
 SDS Careers staff have a referral approach for a young person experiencing
mental health or issues around drug or alcohol problems however any intervention
around smoking is unlikely.
 Possible opportunities to explore CPD on raising the issue/referral pathways for
smoking were raised.
 Beyond careers staff we should be focusing our efforts on Employment Fund
providers and Modern Apprenticeship workplaces. Trusted Professionals also
support young people engaged with Activity Agreements.
 Understanding what is being delivered locally through the Youth Employability
Activity Plan (YEAP) which is linked to Outcome Agreements (SOA). Each Local
Authority should have a YEAP outlining which organisations are delivering the
different stages of the Employability Pipeline (the jobseekers journey stages 1 – 5).
Key actions:
 Lynda to provide the contact person from Partnership Development and
Integration regarding My World of Work.
 Lynda to provide further contacts to explore options around CPD opportunities for
SDS Career staff.
 Emma to arrange to meet Sandra to explore more around YouthLink Scotland’s
work with the Activity Agreements
 All – access to local YEAP plans seem to be available online. Here is a thorough
example from Dundee.
Lesley Mackay
Healthy
Working Lives
Advisor,
Lanarkshire
What the project involves?
A collaboration between Healthy Working Lives, NHS Lanarkshire Health Promotion
and Landed Project delivering a ‘test of change’ pilot project aimed at employers and
training providers.
The project aims to:
 raise awareness of staff on ‘social’ and cannabis smoking and increase awareness
of stop smoking support in Lanarkshire,




raises awareness of the dangers of ‘social’ & cannabis smoking with young people
in employability schemes,
increase referrals to stop smoking support in Lanarkshire via employability
organisations,
increase referrals to other health improvement agencies as part of quit attempt,
develop a toolkit with which to empower employability staff to identify and support
cannabis users to become smoke-free & positive role models (FLO telehealth
resource)
Lanarkshire has also been encouraging local organisations and workplaces to sign the
Charter for a Tobacco-free Generation and make pledges that will help address
tobacco use in workplaces. This helps to open the door to further activity. (Healthy
Working Lives Charter Flyer attached in the email)
Key discussion point:
 Benefits of involving Healthy Working Lives are part of a partnership approach to
engage employability providers to addressing smoking from a workplace safety
and wellbeing angle.
 Use of the Charter for a Tobacco-free Generation to get buy-in from a range of
organisations.
Key actions:
 Sandra offered to link Lesley with the Hub Activity Agreement team in Lanarkshire
to progress this work.
 ALL - Consider the merit of promoting the Charter for a Tobacco-free Generation
help engage employability providers locally.
 Emma/David to explore example promotional leaflet based on Lanarkshire’s leaflet
designed by Connie.
Jacqueline
Kirkland,
Health
Promotion
Specialist, NHS
Lothian Health
Promotion
Service
What the project involves?
Engagement with employability providers working with 16 – 24 year olds. The project
delivers:
 workshops to young people - mix of prevention and cessation elements for young
people including vaping and cannabis. 21 workshops delivered and evaluated well.
 cessation referral for young people - 4 referrals, one client still engaging with SSS.
 staff training - Two organisations received staff training, which evaluated well.
 smoke-free policy development - There has been no uptake by Providers.
Key discussion point:
 Engagement of staff and the available time to access training and schedule
delivery workshops is challenging for smoking prevention/cessation.
 Provider’s remit and funding constraints limit what will be covered to meet the
service level agreement for 6 – 8 week programmes.
 Other competing priorities and limited time to cover issues such as diet, exercise,
alcohol and drugs which impacts on the priority placed on smoking prevention.
 Reluctance of to develop smoke-free policies beyond existing smoke-free
legislation.
 Service level agreements could include health and wellbeing more prominently. If
training contracts are drawn up with a requirement to cover the impact of lifestyle
choices/risk behaviours on interview success and future employability, providers
may see the merit of doing more around these areas.
Key actions:
 Emma to scope further with Skills Development Scotland the criteria for provider’s
service level agreements of the Employability Fund (and Modern Apprenticeships)
and opportunities to challenge how health and welling features across the
employability pipeline stages including establishment policies.
Jacqueline’s Prezi is linked to here
Rebecca Smith,
Health
Improvement
Senior (Assist
Project)
NHSGGC
Smokefree
Services
free Services,
NHS GGC
What the project involves? Inverclyde Health Employability Working Group
developed a training directory for employability to access training on health and
wellbeing. A working group was set up and included trainers and young people. The
report is available but may be out of date (attached in the email).
Future opportunities across NHS Greater Glasgow and Clyde: Previously NHS
GG&C developed an action plan around the 16 – 24 agenda but it proved very
challenging to take forward as it was so broad. Parts of the strategy are out of date
now but it could be useful to look at as a starting point. (Plan attached in email)
Possible actions for NHS Greater Glasgow and Clyde may include:
1.
re-establishment of a board wide 16 – 24 working group
2.
scoping exercise to determine existing links/ areas of work with 16 – 24
3.
support development of tobacco policy in relevant settings e.g. schools,
FE/HE, workplaces, training centres, NEET, other groups such as prison,
homeless etc.)
4.
link information between Tobacco Control Sub Group and the Tobacco Control
Practitioners Forum on existing work/ links with employability providers.
5.
Young People and Tobacco training could be tailored and delivered to identify
stakeholders such as training providers.
Any efforts should be part of a multiple risk approach as growing evidence highlights
co-occurring risk behaviours.
Action: Emma to circulate the developed directory from Inverclyde and the NHS GGC
action plan on 16 – 24.
Employability
Provider Views
gathered by
Rebecca Smith
and Jacqueline
Kirkland
Employability Provider in Glasgow area – (Rebecca Smith, NHS GGC)
The staff that Rebecca met with said that smoking is still a priority but that they have
noticed a reduction in the number of participants that smoke over recent years. They
advised that they feel cannabis is a big problem. Participants may not smoke
cigarettes but do smoke cannabis. (Multiple risk approach).
They highlighted the effect smoking can have on young people’s participation in
employability services e.g. more likely to be off sick, implications of going for
interviews/ going into workplaces smelling of smoke, financial implications of smoking,
need for more breaks etc.
The two members of staff that Rebecca spoke to said they would be interested in
training opportunities around health issues such as tobacco but they may have trouble
finding time to attend such training. Any training or awareness raising would have to
be free as there is very rarely a budget available. They highlighted that some staff
members would not want to be trained on health issues as they weren’t comfortable
delivering these topics and would rather have ‘experts’ come in and talk to their young
people.
Part of the reasons that time is so tight for staff in training centres is that they now
have to have gone through the qualification themselves before they are allowed to
offer it to participants.
The provider gives further insight into the expectations for delivering on the
Employability Fund, managed by Skills Development Scotland (SDS). SDS allocates
local areas with target figures each year. Training providers are financially rewarded
for outcomes achieved by their participants. For example they are rewarded for the
number of young people they have starting a programme, the number gaining a
qualification and the number entering a positive destination following participation in
the programme. They are highly rewarded for a participant going into employment
(can be approx. £1000).
Training providers have to send Employability Fund fact sheets in to SDS detailing
what stage the group will be working at (Stage 2, 3 or 4) and what they are planning to
cover with their participants.
Stage 2 was when they would most likely have time to address health issues such as
smoking. (Rebecca mentioned her previous role providing sexual health inputs with
one stage 2 employability provider in Inverclyde. These inputs decreased dramatically
when the provider changed to offer stage 3 instead.)
Stage 2 provision has to be completed within 12 weeks and has 3 key elements:
1.
Induction and Pastoral Support (dedicated key worker, development of
personal support/ development plans)
2.
Accredited Personal Development and Employability skills at SCQF Level 3
(Minimum 18 SCQF Credits)
3.
Work Experience – e.g. community challenge or work taster
The provider mentioned they offer 2 modules on wellbeing that count towards the 18
credits - ‘Exploring Wellbeing’ and ‘Improving Wellbeing’. Participants are asked to
pick at least 2 influences on health and wellbeing. If participants chose tobacco they
would carry out some research on the topic and present their findings. In rare
occasions these modules can be offered at stage 3.
Note: Not all providers receive the Employability Fund - The Scottish Government is
the Managing Authority for the European Regional Development Fund (ERDF)
and European Social Fund (ESF) programmes in Scotland. It has overall responsibility
for the implementation, management and effectiveness of funds distributed through
the programmes.
Skills Development Scotland manages the Employability Fund.
Employability Providers Edinburgh wide (two respondents) (Jacqueline
Kirkland, NHS Lothian).
1.
The health and wellbeing aspect of your funding (what it looks like at
different stages)
Organisation 1: We try to include as diverse a range of health and wellbeing delivery
as possible within each group. This is more in depth at Stage 1 and 2 as the young
people are further away from being work ready than other programmes and often have
the most chaotic lifestyles. They are also with us for a longer duration which means we
have more time to dedicate to these issues.
We are heavily reliant on NHS Lothian for smoking cessation workshops and
appreciative of the excellent service they provide us with consistently. We also have a
cannabis awareness contact as this is an issue we are seeing increasingly amongst
young people. We deliver a wellbeing SQA to young people at stages 2 and 3 which
considers a holistic approach to wellbeing overall. This includes a personal project
which can centre on something of the young person’s choosing but typically entails
improving diet, health and fitness or reducing substance misuse. At stage 4 there is far
less focus on health and wellbeing as we only have the groups for a very limited
duration which is mainly focused on employment specific training. We also link in with
Violent Offenders Watch and Aid and Abet who deliver sessions on making positive
life choices and support some of our young people to move away from offending
behaviours.
Organisation 2: In terms of health and wellbeing we are targeted to improve one’s
confidence, social awareness and to reduce alcohol/drugs consumption. We therefore
have utilised organisations including NHS, Edinburgh Leisure and Drug and Alcohol
agencies to deliver workshops as well as seeing learners on a 1-1 basis. Because we
run a rolling programme we don’t have different stages we use particular services. It’s
very much person centred.
2.
What are the key challenges to including health and wellbeing (All
aspects not just tobacco)
Organisation 1: Our main challenge is always the limited amount of time we have with
young people where we can get specialist services in to deliver sessions. It would be
great to see more of this if we are able to secure the time.
Organisation 2: The key challenges for utilising these services are getting young
people to engage in particular services. Because we work with vulnerable young
people there are huge barriers including housing issues, care responsibilities,
addictions, family problems etc. that can have issues with learners attending sessions
and 1-1’s. Many learners also find it difficult to confront certain issues and it can take
some time to build trusting relationships due to a learner’s history of not having
trusting relationships/role models.
3.
What are the key issues facing your young people (Doesn’t have to be
tobacco related, could be mental health/income etc.)
Organisation 1: Substance misuse (including tobacco, cannabis and various other
drugs); alcohol misuse, mental health, social anxiety, depression, anger management
difficulties, lack of income within the family as a whole, offending behaviours,
homelessness, literacy and numeracy issues, dependency from others for caring
responsibilities and criminal convictions. As many of our young people are under 18,
this also causes some challenges with employment opportunities.
Organisation 2: Very much the above. We work mainly with young people at Stage 1
of the pipeline who comes with a variety of different barriers and expectations about
what is suitable in society.
Other key
discussion
points and
actions for
consideration
Employability provider’s views so far suggest that stage 1 & 2 is most appropriate for
lifestyle coaching/health and wellbeing.
Limited time to offer session on any one health behaviour issues is a challenge with a
growing need to address issues and multi-risk behaviours together (mental health and
cannabis). Limited time to access CDP beyond core training modules is challenging
and needs to be more accessible e.g. eLearning modules. Knowledge of what
services are available appears to be a gap.
Actions: Members were keen to explore provider’s views and needs in more depth.
 Emma to design a draft survey aimed at those delivering stages of the
employability pipeline, Modern Apprenticeships and Activities Agreement.
 Group members to contribute to the final survey design and disseminate to local
contacts/providers.
 Findings of the survey to inform discussions at the STA Learning Day 20th
September (focus on recommendation for the next national strategy).
There still remains a gap on how best to raise the profile of smoking at a more
strategic level. The group acknowledged that it would be difficult to approach this
without advocating for a multi issues/ multi-risk behaviour approach.
Action:
 Emma continue to explore Skills Development Scotland contacts to scope the
criteria on the Employability Fund and Modern Apprenticeship schemes regarding
health and wellbeing and health promoting polices for establishments.
 John will continue discussions with Morris Fraser, Scottish Government around
this area of work, input into the Sub group of the Ministerial Tobacco Prevention
Group and look to engage with Jamie Hepburn, Minister of Employability and
Training and Skills Development Scotland.

John/Emma identify/scope other national organisations concerned with 16 – 24
health and wellbeing/risk behaviours to support future action.