SMOKING
cORE SmOkINg cESSatION SERVIcE wIthIN NORthERN IRElaNd: what IS thE cURRENt SItUatION aNd what aRE wE dOINg aBOUt It?
By kurtis moffatt a
s smoking continues to be one of the main contributors to major health complications
in Northern Ireland, with a market of products that continues to grow, and advice available at our fingertips, do patients still look to their community pharmacists for the most up-to-date and reliable advice on how to quit?
cigarette smoking still remains the single largest cause of preventable illness and early death in the United kingdom (Uk), leading to approximately 102,000 related deaths and ailments annually, which, consequently, have a direct impact on other vital health care services costing an estimated £5.2 billion to the NhS annually. the eradication of smoking from the Uk would result in vast health benefits, particularly for the most deprived sectors of society, and, while the prevalence of smoking has substantially fallen in the Uk since first publication of the health risks associated with smoking, it now appears to be stabilising at approximately one in five adults.
despite awareness of the health implications of smoking continually in the public eye, and a surplus of alternative options to aid in an
20 - PhaRmacy IN fOcUS
attempt to quit at our disposal - including Nicotine Replacement therapy (NRt) - we need to look at why participation rates are gradually decreasing within the core smoking cessation service in Northern Ireland, and consider what we can do to reverse this decline. therefore, we need to ask ourselves - as pharmacists, what are we doing to address and combat this ever growing issue?
the aim of the core service is to deliver a pharmacy-based, one-stop specialist smoking cessation service to smokers, which is evaluated and monitored in line with dhSSPS standards. the regional service offers smokers a twelve-week programme of behavioural support and permits the weekly supply of NRt if required.
NRt is a manageable and effective pharmacological aid to stopping smoking and has been an integral part of pharmacy smoking cessation services for many years. Evidence has also shown that the combination of high quality behavioural support and counselling, along with the supply of NRt, can increase a smoker’s chance of quitting up to four fold compared to quitting alone.
the most recent report, which was conducted by the dhSSPSNI this
September, showed that, within the 2015-2016 timeframe, a total of 21,285 people had set a quit date through smoking cessation services. while a seemingly large figure, this was actually a decrease of 494 (two per cent) on the same period of the previous year of those setting a quit date. Of those that set a quit date, one per cent were under 18 years of age, 33 per cent were aged 18-34, 22 per cent were aged 35-44, 28 per cent were aged 45-59, and fifteen per cent were aged 60 and over.
from this report it was apparent that community pharmacy was still the most popular outlet for those wishing to participate in a smoking cessation service with a healthcare professional, as of the 21.285 that had set a quit date, 14,719 (69 per cent) were through a community pharmacist setting, compared to 1,439 (seven per cent) who set a quit date through a gP practice. an additional outcome of this report showed that NRt was the most popular therapeutic intervention, with 74 per cent of those having used this therapy.
the results from this report reiterated that pharmacists are at the forefront of smoking cessation services and best positioned to provide patients with the behavioural advice and pharmacological aids to quit.
Speaking with community pharmacists involved in the service, and also those working behind the scenes, they shared their thoughts and opinions on the service and also what is needed to maximise participation and produce results; stating that improvements are needed going forward to improve the programme for both patients and pharmacists alike.
james griffiths (health care development manager for Nicorette at johnson & johnson) believes that the service limitations may need to be addressed in order to enhance the scheme.
'while in terms of maximising participation in the service, the majority of pharmacies already display visual aids which advertise the programme,' james said, 'more encouragement is needed with staff to engage smokers and increase their awareness of the free programme using the ask, advise assist model to provide brief advice and interventions.
'In terms of moving the service forward, as highlighted by the dhSSPSNI report, there is a slight but definite decline in participation in the scheme, so, in order to reverse this, the service needs to become more >
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