Page last updated at 14:47 GMT, Thursday, 18 September 2008 15:47 UK

Public health goes to the street

Smokers are offered on-the-spot checks for carbon monoxide in their lungs

By Adam Brimelow
Health correspondent, BBC News

Some health trusts in London are resorting to "direct action" to encourage people to stop smoking and to look after their mental and sexual health.

Not content with warnings for smokers in adverts, posters and on cigarette packets, they are employing people to confront them in the street as they step out for a few quiet puffs.

They say it is cost-effective, and enables them to raise awareness about their local services.

But some see it as a breach of civil liberties.

The proportion of people who get annoyed is very low
Joe Wade
Don't Panic

For the next six weeks, smokers in Ealing in west London who want to step onto the street for a quick, quiet drag may find there is nowhere to hide.

The local primary care trust has recruited a marketing firm to approach them directly and put them in touch with stop smoking services.

Their manner is friendly and polite. No one is forced to talk. But some smokers and other passers by are clearly prepared to chat, and to do an on-the-spot check for carbon monoxide in the lungs.

You might expect a lot of people would resent being stopped in their tracks like this, but those who do seem to walk away.

"This will really help me," said one smoker - a man who had become a chain-smoker in the last year after becoming depressed.

"This should be done in other areas as well. This is going to make a big difference."

Sexual issues

Of course, smoking is one thing, but last week some of these workers were out in another part of London talking to teenagers about chlamydia and asking them for urine samples for screening.

Healthy living advice is given out

One of the team, Annie Taylor, acknowledged that that was not so easy.

"It was quite challenging to actually get to the point where you were in a conversation with somebody," she said.

"A lot of people were quite friendly, but a lot of people said no, I'm not even going to take a flyer from you."

She works for the marketing firm "Don't Panic", which has also done this type of work for other London health trusts.

The company started out in events-promotion, and has brought techniques from that business to public health.

Polite approach

Its director Joe Wade says it is working well: "The proportion of people who get annoyed is very low, because we're taking a peer to peer approach in that we pick people who are aren't going to hector people.

"They are going to be direct but really polite. They are also the same sort of demographic as the people they are talking to. "

Stephen Pound MP
Lets spread a bit of happiness and make a bit of a nuisance of ourselves on the highways and byways of west London
Stephen Pound
Ealing MP

This exercise is just the biggest of its kind so far.

Phil Robinson, from Ealing PCT, says the basic problem is that people are not aware of the services that are offered.

So, he says, this gives them the choice to use what is available to them.

But it raises the question of how far to intrude into peoples' lives, even with good intentions.

James Gubb, health director of the think tank Civitas, says this is a big step too far.

"I think this is just another road on a very slippery slope.

"What are you going to be doing next? Are you going to be coming up to people in the street and saying why are you overweight? Or why are you standing there and not walking?"

New phenomenon

The local Labour MP in Ealing, Stephen Pound, famously kicked his cigarette habit of 40 years after voting to back the ban on smoking in enclosed public places.

He is all for going after smokers on the street.

"You've now got this new phenomenon. These self-affirming groups of outlaws huddled around, outside buildings, and what they do is reinforcing their addiction more and more.

"So I think we need to confront - which is not too harsh a word.

"People are happier having given up smoking, therefore lets spread a bit of happiness and make a bit of a nuisance of ourselves on the highways and byways of west London."


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