English stop smoking services have helped 20,000 to quit, but much variation exists
Stop smoking services across England have had an increasing impact in helping smokers to quit in their first 10 years of operation and have successfully reached disadvantaged groups, finds a study published on bmj.com today.
However, performance across local services has varied considerably and requires attention, say the authors.
In 1998, the UK government established a network of stop smoking services to ensure that every smoker in the country who wanted help with stopping would have access to evidence-based support as well as medication.
Other countries have since followed this model for helping their smokers to stop.
Evidence indicates that, when these services are provided optimally, the proportion of users who stop for four weeks should be around 50%, with 15% lasting 12 months, compared with 15% at four weeks and less than 5% at 12 months if these smokers tried to stop unaided.
So a team led by Robert West, Professor of Health Psychology at University College London, set out to analyse the performance of the service over its first 10 years of operation.
Annual figures were obtained from April 2001 to March 2011 for number of quit dates set (throughput); percentage of biochemically verified abstinence after four weeks (four week quit rate); and the researchers then calculated, using previously published data, the number of four week quitters beyond those who would be estimated to have stopped with medication only (impact).
Information for each smoker including gender, age, ethnic group, type of medication used, and mode of delivery (one-to-one or group based sessions) was also recorded. Variability across local services in throughput, four week quit rates and impact was assessed for 2010/11.
Throughput rose from 227,335 in 2001/02 to 787,527 (8% of all smokers) in 2010/11. The percentage of four week quitters declined slightly from 35% to 34%, with a dip to 31% in 2007/08. This meant that, overall, the total number of four week quitters rose from 79,767 to 269,293.
Impact trebled from 22,933 four week quitters created in 2001/02 to 72,411 in 2010/11 (corresponding to an estimated 21,723 12 month quitters).
The services were also successful in reaching disadvantaged smokers with 54% receiving free prescriptions in 2010/11. However, substantial variation existed across local services in throughput, success rates, and impact.
The Benefits of Quitting Smoking
Within 20 minutes of smoking that last cigarette, the body begins a series of changes that continues for years.
20 MINUTES
Blood pressure drops to normal.
Pulse rate drops to normal.
Body temperature of hands and feet increases to normal.
8 HOURS
Carbon monoxide level in blood drops to normal.
Oxygen level in blood increases to normal.
24 HOURS
Chance of heart attack decreases.
48 HOURS
Nerve endings start regrowing.
Ability to smell and taste is enhanced.
2 WEEKS TO 3 MONTHS
Circulation improves.
Walking becomes easier.
Lung function increases up to 30%.
1 TO 9 MONTHS
Coughing, sinus congestion, fatigue, and shortness of breath decrease.
Cilia regrow in lungs, increasing ability to handle mucus, clean the lungs, and reduce infection.
Body’s overall energy increases.
1 YEAR
Excess risk of coronary heart disease is half that of a smoker.
5 YEARS
Lung cancer death rate for average smoker (one pack a day) decreases by almost half.
Stroke risk is reduced to that of a nonsmoker 5-15 years after quitting.
Risk of cancer of the mouth, throat and esophagus is half that of a smoker’s.
10 YEARS
Lung cancer death rate similar to that of nonsmokers.
Precancerous cells are replaced.
Risk of cancer of the mouth, throat, esophagus, bladder, kidney and pancreas decreases.
15 YEARS
Risk of coronary heart disease is that of a nonsmoker.
In conclusion, the authors say that, over 10 years of operation, the English stop smoking services have increased their reach and impact threefold.
In 2010/11 they were used by some 8% of all smokers, including a high proportion of those with economic disadvantage, and can be estimated to have helped more than 20,000 to achieve long term abstinence, saving almost 25,000 life years.
However, they point to considerable variability in outcomes across local areas, which they say needs further investigation.
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Stephanie Burns
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44-020-738-36920
BMJ-British Medical Journal