Hospital based smoking cessation service – more smokers quitting and staying smoke-free .

1. Hospital based smoking cessation service – more smokers quittingand staying smoke-free. Paula Campbell, Regional Officer – Smoking Prevention Ann O’Farrell, Research Officer, Department of Public Health Dr. Nazih Eldin, Regional Manager – Health Promotion

2. Objectives • To provide all smokers in the north east with support for quitting; (North-eastern region includes 4 counties & population of 345,000). • To monitor this service on an ongoing basis; • To develop an annual multi-media campaign promoting smoking cessation and prevention.

3. Cessation Service • The service commenced in December 2000, and is based in 5 acute hospitals. • Referrals come from hospital or community based staff, self-referrals & National Smokers Quitline; • Counsellors available for between 24-39 hours per week in each hospital.

4. Support is free, and is either on a 1-1 basis or group support ; • Group support consists of 6 week Stop Smoking courses which are run in the evening time. • Each hospital runs 2-3 of these courses every year.

5. Advertising the cessation service. • Box advertisements in all 8 regional papers; • Slots (minimum 3 each day) on both regional radio stations; • Flyers to all General Practitioners, pharmacists and Public Health Nurses; • Key dates used for press releases (Jan 1st, Ash Wednesday, World No Tobacco Day); • Notices sent to health care staff via e-mail and the intranet;

6. Health care staff can avail of free nicotine replacement therapy for up to 4 weeks. • All clients who set a quit date are followed-up at 2 weeks, 3 months and 12 months; • UK guidelines adopted for the monitoring system: 3 attempts are made to contact the client; 2 weeks either side of the follow up date at 3 & 12 months can be used during which to follow up a client.

7. Methods Client monitoring data collated on Excel - • Client code number • Date seen • Category of client • Type of support • Demographics • Stage of Change in relation to smoking behaviour (Prochaska & DiClemente) • Quit date (if applicable) • Smoking status 2 weeks, 3 months & 12 months after quit date.

8. Results • Quantitative analysis completed by the Dept of Public Health in August 2004. • n = 7,253 (incl. clients supported from Dec. 2000 - July 2004). • Age range : 14 - 90 years, with median of 47 years.

9. No. of smokers availing of support

10. Gender

11. Type of support

12. Category of client

13. Quit rate results (2002-2004)

14. Results Being quit at 3 months was sig. related to: • Being older (49 years vs. 45 years) • Attending group support • Being a staff member. • No relationship was found between gender and being smoke free at 3 months.

15. Impact of Smoking ban on cessation service(March 29th 2004) 25.7% increase

16. Cost-effectiveness 1. UK cessation services: Stapelton J. (2001) calculated cost per life year saved at: £601 for those aged 35-44 £766 for those aged 45-54 (Based on a cost per patient treated of £209) Compared to: Median cost of £17,000 per life year saved for a range of 310 medical interventions (Tengs et al, 1995).

17. 2. North-Eastern region cessation service: • In 2004, the service costs were approx. €212,000; • 2,851 clients were provided with support that year. • Hence, cost per client treated = €74. Very good value for money!

18. Conclusions • This is an effective service which has helped over 8,500 smokers in their efforts to quit. • Although hospital based, the service is reaching out - % of clients coming from the local community (public) increased from 10% in 2002 to 18% in 2004. • Demands on this service increase each year and crucially, the 12 month quit rate has increased significantly from 9% in 2002 to 12.2 % in 2004.

19. The Good News………Smoking in Adults (SLAN Surveys)

20. Smoking in 12-18 year olds in the north-east