SMOKING CESSATION
WHILE THE LATEST SMOKING CESSATION STATISTICS FROM ISD SCOTLAND SHOW A DROP IN THE NUMBER OF QUIT ATTEMPTS, COMMUNITY PHARMACY STILL DELIVERS AROUND 70 PER CENT OF ALL NHS STOP SMOKING ATTEMPTS IN SCOTLAND. SP TAKES A CLOSER LOOK…..
SMOKING CESSATION SERVICES NEED ‘FIRED UP’ T
he statistics show that the number of quit attempts made with the help of NHS smoking cessation services in 2016/17 fell for the fi fth consecutive year to 59,767. This represents an eight per cent decrease from 2015/16 and an alarming 51 per cent decrease since 2011/12.
A variety of reasons have been suggested for the fall in quit attempts, with a combination of factors, including increasing use of electronic cigarettes, now viewed as a more favourable and successful step towards quitting.
Among ISD Scotland’s fi ndings are:
SUCCESS OF QUIT ATTEMPTS IN 2016/17
• Thirty-eight per cent (22,784) of those making a quit attempt reported that they were still not smoking at four weeks. This fi gure fell to 23 per cent (13,506) at twelve weeks.
• Of the 22,784 self-reported four-week quits, 64 per cent (14,483) were confi rmed on carbon monoxide (CO) testing, two per cent (492) were confi rmed as smoking, and 34 per cent (7,809) had no CO reading taken or the result was unknown.
• In 2016/17, the percentage of successful quit attempts at both four and twelve weeks increased by one percentage point from 2015/16.
6 - SCOTTISH PHARMACIST
2016/17, 62 per cent were made in pharmacy, while of the 13,506 twelve-week quits, 57 per cent were made in pharmacy services.
DRUG TREATMENT TYPES In terms of drug treatment, 42943 (72 per cent) of quit attempts involved the use of nicotine replacement therapy (NRT) either as a single product (13,362, 22 per cent), or as part of a combination of more than one NRT product (29,572, 49 per cent).
There has been a decline in the number of quit attempts using NRT as a single product, with its percentage of overall usage in quit attempts now a third of what it was in 2009/10, whereas the percentage of overall usage of combination of more than one NRT product has increased fi ve-fold since 2009/10, remaining around the 50 per cent mark over the last two years.
In terms of performance against the 2016/17 Local Delivery Plan Standard, there were 7,842 successful twelve-week quits in the most deprived areas. This is below the annual local delivery plan standard of 9,404. On a more positive note, three of the fourteen NHS Boards met their individual standard.
PHARMACY’S CONTRIBUTION According to the ISD Scotland statistics, pharmacy smoking cessation services accounted for 41,803 (70 per cent) of quit attempts made in Scotland in 2016/17. The split of pharmacy and non-pharmacy services to support quit attempts varied among NHS Boards, from six per cent pharmacy and 94 per cent specialist services in NHS Western Isles to 94 per cent pharmacy and six per cent specialist services in NHS Grampian.
Of the 22,784 four-week quits in SCOTLAND BORDERS
DUMFRIES & GALLOWAY FIFE
2009/10 45,011
AYRSHIRE & ARRAN 2,957 955 563
FORTH VALLEY GRAMPIAN
GREATER GLASGOW & CLYDE
HIGHLAND
LANARKSHIRE LOTHIAN ORKNEY
SHETLAND TAYSIDE
WESTERN ISLES
1,286 1,016 4,943
18,789 862
7,325 3,466 6
57
2,782 4
There is, however, better news on varenicline, the prescription medication that was specifi cally developed to help smokers quit. First licensed in the UK in December 2006, varenicline’s use as a smoking cessation product has been generally variable over time – falling from its previous high of eleven per cent in 2009/10 to its lowest of seven per cent in 2012/13. ISD Scotland’s latest fi gures, however, show that varenicline reached a new high of twelve per cent in 2016/17.
BOARD SUCCESS One of the Boards, which achieved a higher number of ‘successful quits’ than in the previous year was NHS Borders.
During 2016/17, 951 people approached NHS Borders’ Quit4Good Service for support to help them stop smoking, 271 of whom (28 per cent) went on to have successfully
2010/11 2011/12 59,469 4,518 1,002 814
89,895 6,661 1,465 1,223
2,265 1,664 6,168
24,142
1,173 9,028 4,415 9
53
4,214 4
3,722 3,603 9,843
30,977 2,569
14,692 6,858 28 56
8,173 25
2012/13 88,528 5,766 1,293 1,426
4,314 4,239 8,947
29,937 2,567
13,430 8,364 61
131
8,052 1
2013/14 69,352 4,572 1,081 954
3,657 3,030 8,471
22,546
2,039 9,521 6,984 68 64
6,364 1
quit twelve weeks later. This is a fi ve per cent increase on the previous year, and is above the Scottish average of 22.9 per cent.
The number of successful twelve- week quits in the 40 per cent most deprived areas of the Borders also increased marginally, from 131 in 2015/16 to 140 in 2016/17, but this fi gure still, unfortunately, missed the standard set of 173.
As with many other Boards and pharmacies across Scotland, NHS Borders opted to ‘spread the word’ more widely through social media, such as Facebook, and through radio advertising campaigns. The local Smoking Cessation Co-ordinator, Catriona Davies, redistributed stop smoking clinic provision for areas where smoking rates are higher, while a drop-in clinic was established at the Chest, Heart and Stroke Community Hub in Hawick. To date, this has been really well attended. A range of training has also been offered, including motivational interviewing designed specifi cally for supporting a quit attempt, and support for pharmacists in prescribing varenicline.
‘Overall,’ said Fiona Doig, Strategic Lead for the Alcohol and Drug Partnership and Health Improvement at NHS Borders, ‘although the number of people who are attempting to stop smoking is reducing across Scotland, those who are seeking support to make the positive behaviour change are achieving better success rates, which is great news for everyone concerned.
‘The evidence clearly shows that people who access our Quit4Good service, either through their local community pharmacy, or through our network of specialist advisors, are four times more likely to succeed.’ •
2014/15 47,779 3,810 701 583
2,292 2,122 5,845
14,575
1,585 7,187 4,533 35 65
4,438 8
2015/16 45,656 3,798 685 561
2,287 2,110 5,580
12,526
1,681 7,098 4,718 27 63
4,499 23
2016/17 41,803 3,080 590 511
2,092 1,954 5,406
11,468
1,511 6,555 4,080 14 38
4,494 10
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