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Gold, incentives and meh

Stop smoking clinics fail to lower quit rates

GPs are wasting their time with intensive programmes of behavioural support in trying to help patients give up smoking, according to researchers.

Their randomised, controlled trial compared basic support with an approach whereby participants were contacted weekly. The basic support group received three visits and one telephone call over the first month whereas the weekly support group received four visits and three telephone calls.

But the additional support made no difference to the numbers of patients who stopped smoking in both groups – with 105 quitting in the basic support group and 102 in the added support group.

Dr Paul Aveyard, senior lecturer in primary care and general practice at the University of Birmingham and lead author of the study, said GPs should focus on providing medication and sufficient support for smokers wanting to quit, but that smokers needing additional support should be referred to a specialist.

‘Most trials on smoking cessation are by speciality clinics and they seem to achieve higher quit rates,' said Dr Aveyard. ‘The least effective use of GPs' resourcess is to set up a stop smoking clinic.'

But Dr Alex Bobak, a GPSI in smoking cessation in Wandsworth, south London, questioned the authors' conclusions. ‘It is not about quantity but quality. I don't think that it is good enough to just say that the support we provide in primary care is not effective, so we shouldn't worry about it; we should be improving the support we give,' he said.

The research was published in the latest edition of Thorax.


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