Smoking Prevention and Cessation in Tayside

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Smoking Prevention and Cessation in Tayside

• Andrew Radley and Paul Ballard
• Tayside Public Health Network
• March 2006

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SMOKING CESSATION LANDSCAPE

• White Paper
• Breath of Fresh Air
• 2010 - Smoking

BVR Review

• Lay people
• Smoking in Pregnancy
• Community Pharmacists
• E-referral
• Smoking Cessation Coordinators

Minimum Data Set
NHS Tayside Smoking Policy
Regulation of Smoking in Public Places
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WEDNESDAY 15 FEBRUARY 2006 THE INDEPENDENT
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Smoking Ready Reckoner
Source Harding O, CPHM, ISD Scotland 2005
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Estimated number and percentage of hospital
admissions for diseases attributable in part to
smoking by cause
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Effect of smoke-free workplaces on smoking
behaviour a systematic review
Totally smoke-free workplaces are associated
with reductions in prevalence of smoking of 3.8
(95 CI 2.8 to 4.7)
If this effect was observed in Tayside, then
10,812 people would give up in the first 24
months of the ban
Fichtenberg CM,Glantz SA BMJ 2003 325188
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National Targets
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22 of adults over 16 years by 2010
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11 of young people by 2010
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20 pregnant women by 2010
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33.2 in the most deprived communities
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Outcome Data for Glasgow Project (June 03 Feb
04)
Data analysed on an intention to quit
basis Number at week one 5,578
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Smoking in pregnancyThe Scottish average rate
for mothers who smoke during pregnancy is
currently 23.8The overall Tayside rate for
mothers who smoke during pregnancy is currently
27.8. Over 900 pregnant women choose to smoke
each year.The rate in many of the deprived
postcodes in Dundee is over 40. Over 600
pregnant women who smoke are from Dundee
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Stages of Change- Cochrane Review
Study
Treatment Control Relative
Risk Weight Relative Risk
(Random) 95 Cl ()
(Random) CI Dunkley 1997 46/50
50/50 2.6 0.920.85,
1.00 Solomon 2000 63/77 63/74
1.3
0.96 0.83, 1.11 Strecher 2000 78/88
77/85 2.1
0.98 0.88, 1.08 Thornton 1997
186/209 185/209
3.0 1.01 0.94, 1.08
0.5 0.7
1.5 2
Favours Treatment Favours Control
The Cochrane Collaboration
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Rewards - Cochrane Review
Study Treatment Control
Relative Risk Weight
Relative Risk (Random) 95 Cl
() (Random)
Cl Donatelle 78/112 99/108 1.4
0.76 0.66, 0.87 Sexton
296/463 393/472
2.6 0.77 0.71, 0.83
0.5 0.7
1.5 2
Favours Treatment Favours
Control
The Cochrane Collaboration
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Randomised controlled trial using social support
and financial incentives for high risk pregnant
smokers
?2 18.4 (plt0.0001)
Donatelle R. Tobacco Control 20009 67-69
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ELECTRONIC REFERRAL PATHWAY
GP practice based service one-to-one Support
Group Buddy contact Community Service Community
Pharmacy Service
Details of service Best Guide Ever Practice
leaflet Directions Contact Numbers Blurb about
Service

Enter basic details CHI Demographics Basic
elements of PATH data set

Make appointment on-line? Send contact details to
Service?
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Smoking Cessation Activity Estimated Outcomes
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SMOKING IN PREGNANCY

• Resources of 140,000 p.a. allocated
• Stakeholder Working Group
• Key role for midwives and health visitors
• Community Focus/DHLI
• Referral Pathways
• PGD NRT from Community Pharmacies
• Incentive Scheme

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COMMUNITY PHARMACIES

• Resources of 100,000 p.a.
• 28 Pharmacies already signed up
• Trained Staff
• Inequalities Focus
• PGD NRT
• Commenced 9 January 2006
• 180 quitters in year one

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COMMUNITY APPROACH

• Resources 240,000 p.a.
• Recruit Cessation Co-ordinators and Lay support
  staff
• Commence March 2006
• 270 quitters in year one

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NEW NHS TAYSIDE SMOKING POLICY

• Approved by NHS Tayside Board on 23.2.06
• Commence on 23 November 2006

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NHS TAYSIDE SMOKING POLICYKEY COMPONENTS

• Ban on smoking in NHS grounds for everyone except
  in-patients
• Review of Shelters
• Domiciliary Visits
• Staff Safety
• Smoking Cessation Services

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NEW NHS TAYSIDE SMOKING POLICYRATIONALE

• Development of de-normalising of smoking and
  no-smoking culture
• An incentive for prevention and cessation
• In line with Scottish Executive National Guidance
• Embrace the direction of travel