Northern Ireland Chest Heart & Stroke
Campaigns and Policies

Every aspect of NICHS work is affected by the work and policy of Government. The health and social care of everyone in Northern Ireland is hugely influenced by the policy decisions and spending priorities of Government – at Stormont, Westminster and beyond.

It is important, therefore, that NICHS seeks to understand and influence government policy on health promotion and disease prevention.

NICHS wants to influence not just how we spend the  health and social care budget in Northern Ireland but also other areas such as diet, activity levels and smoking which impact on obesity and health in general. NICHS lobbies across a wide range of government activity and spending beyond the spending and policies under the control of the Department of Health.

NICHS seeks to act as a voice for all those who wish to improve life for the people of Northern Ireland by preventing and alleviating chest, heart and stroke illnesses and by ensuring those who need treatment and help receive the best possible services.

Our Policies

Northern Ireland Chest Heart & Stroke has a number of public health and other policies which form the backbone of the health promotion and prevention work that we do in the community and at the Northern Ireland Assembly.

We believe that the NI Executive and in particular the Department of Health should increase its focus and the level of resources it devotes to health promotion, protection and prevention.

Health inequalities are particularly marked in NI and in fact have widened in recent years. Past government targets have not been met so it is clear that current policies are not sufficient and new approaches and extra resources are needed.

Our Policy relating to Alcohol

Consumption of alcohol greater than the recommended allowance can have harmful effects on people’s health and well being. For instance, it can cause abnormal heart rhythms, high blood pressure, damage to the heart muscle and lead to other conditions such as stroke, and liver disease. The calorie content in alcohol is also high, which can lead to weight gain, an important point to consider when reviewing levels of obesity within the UK.

NICHS fully support the efforts of the government as they seek to combat the impact of alcohol consumption in the general population and we look forward to the implementation of such strategy in Northern Ireland. We fully support any developments that can help people make better decisions about drinking.

We also believe that based on empirical evidence, a Minimum Unit Price level should be set at 50p per unit of alcohol. We believe this would help combat the issue of the very small number of drinkers who drink extreme amounts of very cheap alcohol.

Our Policy relating to Obesity

Obesity in Northern Ireland

NI Health Survey 2017/18

  • A quarter of adults (27%) were obese with a further two-fifths (37%) classed as overweight.
  • Males – Have a greater tendency to be overweight than females with 46% overweight and 26% obese.
  • The proportion of adults classed as overweight or obese has increased from the level reported in 1997 (57%) to 64% in 2017/18.
  • Three-quarters of children aged 2-10 were classed as either normal weight or underweight, while 18% were classed as overweight and 9% were classed as obese. The proportion of children classified as either overweight or obese has not changed since 2005/06.


It is clear that there is an obesity problem and that as people age this is likely to turn into a ‘time-bomb’ by imposing more and more demands on the health and social care system. Extra weight makes you more likely to have high blood pressure and high cholesterol. Both of those conditions make heart disease or stroke more likely.


We believe in a concerted suite of measures is necessary to combat obesity. NICHS prioritises measures which can be introduced at a regional and local level while supporting a range of measures that need to be brought forward at and UK or even EU level.

This requires a focus on education, public sector provision of food and physical activity: NICHS calls on the NI Executive to act on the following policy areas:

  1. Ensuring that NI’s share of the sugar tax, in excess of £10m, is used to promote physical activity in schools and extend after school opportunities for children.
  2. Including in the next Programme for Government a target of ensuring that by 2021, 70% of primary schools will provide at least two hours of high quality PE each week to all of their pupils.
  3. Ensuring all schools are subject to School Food Standards and ensuring the effective implementation of the cooking and nutritional educations qualification into the curriculum.
  4. Adopting, implementing and monitoring the Government Buying Standards for Food and Catering Services (GBSF) across the public sector in NI including the, local government, schools and health and social care
  5. Ensuring that accredited training in diet and health is routinely delivered to all of those who have opportunities to influence food choices in the catering, fitness and leisure sectors and others within local authorities.
  6. Continuing to raise awareness of concerns around sugar levels in the diet to the public as well as health professionals, employers, the food industry etc., encourage action to reduce intakes and provide practical steps to help people lower their own and their families’ sugar intake
  7. Committing to ambitious targets and sustained investment in active travel; this should be accompanied by guidance to relevant Executive Departments and local government on how to enable active travel at a local level.
  8. Committing to not merely protecting current public health spending but to significant, above inflation, increases as part of a transformation agenda.
  9. Examining the scope for giving greater powers for local authorities to tackle the environment leading to obesity
  10. Early intervention to offer help to families of children affected by obesity and further research into the most effective interventions.

Our Policy relating to Smoking

Smoking is the single greatest cause of preventable illness and premature death in Northern Ireland, killing around 2,300 people each year. NICHS believes it is imperative, therefore, that government takes all reasonable measures possible which it believes may reduce the prevalence of smoking.


Smoking-in-cars-pageSmoking in Cars with Children

Northern Ireland Chest Heart and Stroke commissioned opinion polling in 2014 relating to smoking in cars when children are present. 82% agreed when asked whether they think that the NI Assembly should ban smoking in cars carrying children.

NICHS launched a campaign to urge the Health Minister to add an additional clause or clauses to the Health (Miscellaneous Provisions) Bill (NI) to facilitate a ban.

We were delighted when the Minister agreed to amend the Health (Miscellaneous Provisions) Bill and this legislation was subsequently passed by the Assembly.



E – cigarettes

We recognise that some smokers may choose to use e–cigarettes to help them cut down and/or quit.

E–cigarettes are certainly safer than using normal cigarettes. Are they 100% safe? We don’t know, which is why we need further research into their long–term effects. In the meantime if you are planning to quit smoking, especially if you have a lung condition such as chronic obstructive pulmonary disease, we recommend that you use the currently approved smoking cessation programmes, products and medicines. You may choose to use e–cigarettes too – that is your choice.

NICHS supported the NI Executive’s plan to ban on the sale of e–cigarettes to under 18 year olds but we currently do not support a ban on the use of e–cigarettes in buildings and places where a ban on smoking is in operation


Smoking Cessation Services

We believe that smokers should be offered a comprehensive range of services to help them quit.


Illegal Cigarettes

We believe illegal cigarettes are undermining efforts both to persuade people to quit and the efforts to prevent people taking up smoking in the first place. We urge NI Executive and HMRC to increase the resources devoted to combating this issue.


Tobacco Tax Escalator

We strongly support the ‘escalator’ by which tobacco tax and increased every year ahead of inflation. There is strong evidence that this cuts the number of people smoking.


Tobacco Retailers Act (Northern Ireland) 2014

We supported this Act which creates a register of all tobacco retailers and introduces new sanctions for those found guilty of selling to children. We worked closely with the Assembly in support of amendments to strengthen the Act. The Act includes changes such as making “proxy buying” (buying cigarettes on behalf of a person under 18 years old) an offence.

Our Policy relating to Cardiopulmonary resuscitation (CPR) and Defibrillators

NICHS strongly encourages people to undergo CPR training, but does not itself provides training.

NICHS supports the provision of life–saving equipment in the community, but does not itself provide equipment.

Where organisations decide to fundraise to buy equipment such as defibrillators, and we are able to suggest suppliers of the equipment and associated training services. NICHS STRONGLY encourages clubs to set aside money for both CPR training and then the initial and recurrent training of members of staff of the club in the use of any equipment. While individuals who have not been trained can still use the equipment on someone who has had a cardiac arrest, it is much more sensible to provide training initially and on a recurring basis.

Our Policy Relating to Atrial Fibrillation

Atrial fibrillation (AF), is one of the most common types of irregular heart rhythm

  • 37,000 people are on the AF register – many more are not diagnosed.
  • It is a condition which is estimated to affect over 50,000 people in Northern Ireland, is a significant contributor to premature death and disability.
  • AF increases your likelihood of having a stroke by five times.
  • People over 40 have at least a one in four risk of developing AF, and in Northern Ireland the rates are likely to increase due to an ageing population.

An AF-related stroke is more disabling, debilitating and more likely to be fatal than any other type of stroke. In the UK each year around 12,500 people suffer a stroke due to AF, and yet at least one third of these could have been prevented if AF had been detected and managed earlier. The sudden nature of AF-related strokes leaves survivors and their families devastated and handling a very different life and outlook. In addition many patients who have been identified as having AF and at risk of having a stroke are currently received no treatment or inappropriate treatment.

The prevalence of AF roughly doubles with each advancing decade of age, from 0.5% at age 50–59 years to almost 9% at age 80–89 years. The number of people aged 65 and over in Northern Ireland is expected to increase by 25% by 2026. The incidence of AF is, therefore, likely to increase markedly with a proportionate impact on stroke risk.

It is clear that detecting and treating AF is a major health issue in Northern Ireland.

We are campaigning to improve services in this area as we believe it can help save lives and reduce disability from AF-related strokes. We are;

  • seeking to raise general awareness amongst health professionals and people of NI of what AF is and how it can be prevented or detected.
  • asking government to ensure that all those who are on the Atrial Fibrillation Register are regularly reviewed to ensure that they are receiving appropriate treatment.
  • asking government to ensure that patients in Northern Ireland have access to the latest NICE approved treatments, including medicines as soon as possible.
  • exploring the methods by which patients could be cost effectively screened AF – and adding AF to the list of conditions we look for during our Health Checks
  • investigating the rationale and logistics of a programme of opportunistic testing for AF aimed at specific population cohorts.
  • investigating how patients can be better educated about their condition in particular to explore how medicine adherence can be improved.

FH Screening Campaign


The success of Northern Ireland Chest Heart and Stroke’s campaign to establish a screening service for Familial Hypercholesterolaemia (FH) means that hundreds of lives will be changed and many lives saved across Northern Ireland.

Around one in 500 people has Familial Hypercholesterolaemia (FH), an inherited condition that increases cholesterol levels from birth. Most people are unaware that they have it, but if left untreated around half of men affected will develop heart disease by age 50 and approximately 30% of women by age 60.

The project – run by the Public Health Agency – has been developed and funded in partnership with Northern Ireland Chest Heart & Stroke and the Health and Social Care Board.