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Stop smoking services could do better, concludes analysis

Stop smoking services have aided over 21,000 people to quit long-term since 2001 finds a new study, but the researchers pointed out that quit rates are still were well short of what would be expected from an ‘optimum service’.

Abstinence rates at stop smoking services have declined slightly in recent years, with around a third of smokers quitting at four weeks, shows the first large scale study of their benefit.

Randomised, controlled trials indicate that when the service is provided optimally, 50% of smokers should stop for four weeks, compared with the 15% expected among those who do not have support.

But this analysis shows that quit rates at four weeks from stop smoking services in England have reduced recently from 35% in 2001/02 to 34% in 2010/11.

The study – published in the BMJ today – showed stop smoking services had effectively reached disadvantaged smokers, with 54% of those on the smoking cessation scheme receiving free prescriptions in 2010/11.

They concluded: ‘Over 10 years of operation, the English stop smoking services have increased their reach and impact threefold.

‘However, considerable variability in outcomes exists across local areas.’

Dr Alex Bobak, a GP in Wandsworth, London and a GPSI in smoking cessation, said that the quit rates found in the study reflect the level of basic training for health professionals in smoking cessation.

He said: ‘Smoking cessation is about the most cost effective and clinically effective intervention in healthcare and yet all too often it is still poorly delivered.

‘The quality of stop smoking advisors is variable and patient pathways to stop smoking and basic knowledge among the medical and nursing profession on smoking cessation tends to be poor.’

‘It needs to be established as a medical speciality as for any other chronic condition with easily accessible, high quality evidence based, specialist care.’

The research comes after GPs were advised they could should offer nicotine replacement therapy (NRT) to smokers who refuse to quit in order to help them cut down the amount they smoke, according to new NICE guidance aimed at helping more people kick the habit.

Readers' comments (4)

  • I find that too many reports like this state that outcomes are too variable and could be improved without 1. Giving p values for such variability and 2. Stating what processes were different rather than merely noting that outcomes were different.

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  • Vinci Ho

    Different models should be compared and then look at the p values e.g. Smoking cessation clinics run by pharmacist , GPs or specialists' centres.....

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  • Maybe smokers could do better...and stop smoking.

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  • Unfortunately, NICE, the MHRA & the Tobacco Control mob along with big Pharma & big Tobacco have attempted to stitch-up what was potentially the best innovation in smoking cessation - the electronic cigarette. There is little research on long-term risks yet but given the components; propylene glycol, aqueous glycerine & nicotine along with food flavourings, and the lack of combustion, it would seem that they are far less harmful than tobacco. The fact that there have been few adverse reaction reports since their use took off in around 2006, indicates that we should be considering these as they appear to be far more effective than NRT.
    Unfortunately, the MHRA did very little research before announcing that they would be medically regulated. The terms the MHRA propose will force the existing self-funded market out of business, give the business to big tobacco and dose-regulate nicotine content with the result that approx. 1.3million existing users will go back to smoking... or to using devices that the MHRA said will be provided on prescription. This is stupidity in the extreme and is likely to place a hefty burden on the NHS.

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