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Better Help for Smokers to Quit – Tobacco Health Target. Helen Troke-Thomas Tobacco Policy and Implementation Team Ministry of Health. People who smoke want to stop. 72% of 15-19 year-old that smoke would not if they had their life again 69 % tried to quit in last 5 years
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Better Help for Smokers to Quit – Tobacco Health Target • Helen Troke-Thomas Tobacco Policy and Implementation Team Ministry of Health
People who smoke want to stop • 72% of 15-19 year-old that smoke would not if they had their life again • 69% tried to quit in last 5 years • 44% tried to quit at least once in last year • Māori, Pacific and young people are as likely to have tried to quit MoH. NZTUS 2006
Health Effects of Smoking • Cause of approximately 5000 deaths a year in New Zealand • Societal costs, costs to health service, lost productivity • Loss of on average 15 years of life • Second hand smoke • High rates of smoking amongst Maori and Pacific
Why Brief Advice? • Proven efficacy • Relatively small effect (1-3%)* • Useful when delivered to a large population of people that smoke *Silagy C, Stead LF. Physician advice for smoking cessation. Cochrane Database Syst Rev
Health Target -Better help for smokers to quit • 2009/10 - 80% of hospitalised smokers will be provided with advice and help to quit by July 2010 • 2010/11 - 90% of hospitalised smokers will be provided with advice and help to quit by July 2011
But there are Challenges….. The Target requires: Systems Change Behaviour Change
16.6% of hospitalised smokers provided with brief advice and help to quit Quarter 1 2009/10
DHB Activity • Training • Systems development and Implementation • Clinician buy-in • Promotion of ABC
Health Target Results 2009/10 TARGET July 2010
17,800 Smokers offered Brief Advice and or cessation support in Q4 of 2009/10
Progress in 2009/10 • Over 37,400 offers of brief advice in 2009/10. It is estimated that 1 in 40 of these smokers will have a successful quit attempt = approximately 935 successful quit attempts will occur because of this activity. • Note that this is the minimum as many hospitalised smokers will also will receive NRT/cessation support which increases the quit success rate.
Progress in 2009/10 • Behaviour change amongst clinicians and cultural change in the hospital setting. • Change in the profile of smoking status in the hospital setting – a clinical ‘vital sign’. • Significant work and commitment to get systems and processes in place to make this happen.
Considerations • Disclosure and Target Gap • Prevalence – not all smokers identified. • Target Gap – not all smokers that are identified are provided with brief advice and help to quit.
Considerations Cont... • Ethnicity • Vital that all smokers are receiving ABC and that there are not ethnic disparities. • Initial analysis gives us confidence that Maori and Pacific smokers are being offered brief advice as often as others. • Ministry now collecting data from DHBs to undertake further ongoing analysis.
Based on what we have learned from 2009/10……. • ….key predictors of success for health target achievement include: • Commitment and Leadership from Senior Management and Senior Clinicians • Training of staff • Appropriate and accurate systems to record and report results • Sustainability