Approaching smoking cessation in General Practice
Smoking cessation interventions
About two thirds of smokers in the UK (67%) say they want to stop smoking (Office for National Statistics, 2009). Nearly 80% have attempted to stop at least once (Hansbro et al., 1996) with about 30% actively trying to stop each year (West, 1997).
There are a number of methods available to quit smoking, ranging from willpower to more intensive behavioural support and medications, as outlined below (Parrott et al., 1998).
|Method||% abstinent at 6 months or later|
|Brief advice from Physician||5%|
|Nicotine Replacement Therapy (NRT)||6%|
|Smokers’ clinic and NRT||20%|
NOTE: Prescription Only Medicines (POMs) are not included in the above table as they were not available in the UK at the time of the studies.
A description of each method is provided below. Methods include brief intervention; NRT and smoker’s clinic and are outlined in sections 4, 5 and 6 respectively.
All quit attempts require willpower, some smokers will try to give up smoking without any professional support, advice or medication. Willpower alone is the most widely used method; however, it is the least effective with 3% of smokers stopping long term (Parrott et al., 1998).
Self-help materials include audiotapes, videos and booklets and results in 4% success.
Brief advice from a Physician
Brief advice contributes to increasing quit rates, even very brief advice (a few minutes) can result in 2% more smokers stopping (over no intervention), bringing cessation rates up to about 5% (Parrott et al., 1998; Richmond, 1999).
Nicotine Replacement Therapy (NRT)
NRT deals with the physical addiction aspect of stopping smoking and contributes to 6% of successful quit attempts. NRT preparations currently available include: transdermal patches, gums, nasal spray, inhalator, sublingual tablets and lozenges.
The smoker’s clinic, such as the Stop Smoking Wales programme, which offers behavioural support contributes to 10% success rates (when not using NRT).
Smoker’s clinic plus NRT
The use of a pharmacological treatment in combination with some form of motivational support provides better cessation rates (20%) than either component alone and appears to be the most effective way of helping smokers to stop (Parrott et al., 1998).
For further information on the e-learning Brief Intervention training programme, please see Ways to improve practice.