Tackling health inequalities and the HAZ Smoking Cessation Programme: The perfect match?

This paper provides a critique of the present organization of the UK government's smoking cessation programme, examining the impact of policy on smoking cessation services. Using a case study of a new cessation service that was set up as a Health Action Zone (HAZ) programme, it argues that HAZ-based cessation services that have developed in light of the Smoking Kills White Paper fail to prioritize the needs of the most disadvantaged in society and, hence, may actually serve to exacerbate health inequalities. Attention is directed to two particular concerns. First, the Department of Health guidelines for smoking cessation provide quite prescriptive directions as to the nature of service implementation, restricting the ability of services to develop service models to meet the needs of disadvantaged groups. Second, although supposedly intended to promote locally innovative solutions to tackle health problems such as smoking, the imposition of government controls in HAZ programmes has militated against such innovation. As a result, whilst there is little available evidence as to which approaches to smoking cessation may be most effective specifically in disadvantaged communities, there is little scope for experimentation in this area and a clear opportunity is being missed both to develop local creativity in addressing health concerns and to specifically address the needs of the disadvantaged groups.