Smoking cessation

1
Smoking cessation
2
Smoking prevalence in GB National Statistics.
General Household Survey, 2005 and 2003

• In 2005, 24 of adults aged 16 or over smoked
  cigarettes
• Scotland 27, England 24, Wales 22
• 25 men 23 women
• 32 of 20-24yrs 31 25-34yrs 14 over 60yrs

2002/03
In England smoking led to an annual average of
86,500 deaths between 1998 and 2002 NICE Public
Health Guidance 10. Smoking Cessation
Services February 2008
3
Smoking prevalence by income National Statistics.
Health Survey for England 2003
4
Summary Why people smoke and find it difficult
to stopJarvis M. BMJ 2004328277-9Jain A. BMJ
20033271394-5

• Smoking is an addictive habit. It is associated
  with strong cravings, dependency, tolerance, and
  withdrawal symptoms that can last for weeks
• Smoking habits are reinforced by social
  rituals. Craving is only partially relieved by
  administration of pure nicotine
• 70 want to give up, a third try each year, but
  less than 3 are successful. Most make multiple
  attempts
• Most smokers start smoking in adolescence
• Children smoking habits are strongly influenced
  by smoking habits of their family and friends,
  and by advertising

5
How does smoking affect the health of smokers?
Smoking has more than 50 ways of making life a
misery through illness and more than 20 ways of
killing you. ASH Factsheet no2 August 2005
Royal College of Nursing. Clearing the Air 2
6
Smoking according to NICENICE Public Health
Guidance 10. Smoking Cessation Services February
2008

• Smoking remains the leading cause of
  preventable morbidity and premature death in
  England.
• Cigarette smoking causes a wide range of
  diseases, including cancers respiratory
  disease coronary heart and other circulatory
  disease stomach/duodenal ulcer impotence and
  infertility complications of pregnancy and low
  birthweight osteoporosis cataracts and
  age-related macular degeneration peridontitis.
  Following surgery, it contributes to lower
  survival rates, delayed wound healing and
  postoperative respiratory complications.

7
Second-hand smoke Review of evidence from 1998
to 2004Report of Scientific Committee on Tobacco
and Health (SCOTH) 2004
8
Summary The harms of smokingHealth Development
Agency. Smoking Epidemic in England. Nov 2004
Doll R and Hill AB. BMJ 20043281529-33

• Tobacco smoke is carcinogenic and highly toxic
• Smoking is the leading cause of preventable
  morbidity and premature death in the UK lifelong
  smokers can expect to die about 10 years younger
  than never-smokers
• Smoking increases the risk of cancer, CV disease,
  COPD, reproductive disorders, and many other
  diseases e.g.
• 87 of deaths from lung cancers
• 86 of deaths from COPD
• gt50 of deaths from CVD in the 35-54 year age
  group
• 55 of deaths from stomach/duodenal ulcers
• Increasing levels of smoking increase the risk
• The only safe cigarette is the one that is not
  smoked

9
Benefits of quittingCDC 2004 Surgeon Generals
Report. Health Consequences of Smoking

• AFTER
• 20 mins Heart rate drops
• 12 hours Carbon monoxide level in your blood
  drops to normal
• 2 wks to 3 months Heart attack risk begins to
  drop. Lung function begins to improve
• 1 to 9 months Coughing and shortness of
  breath decrease
• 1 year Added risk of CHD is half that of a
  smokers
• 5 years Stroke risk is reduced to that of a
  nonsmokers 5-15 years after quitting
• 10 years Lung cancer death rate is about half
  that of a smokers
• Risk of cancers of the mouth, throat,
  oesophagus, bladder, kidney, and pancreas
  decreases
• 15 years Risk of CHD is back to that of
  a nonsmokers

10
Summary Benefits of stopping smokingCDC 2004
Surgeon Generals Report. Health Consequences of
Smoking NICE Public Health Guidance 10. Smoking
Cessation Services. Feb 2008Lewis S, et al.
Tobacco Control14(4)251-4

• Stopping smoking at any age is beneficial to the
  health of smokers and those people around them
• There is good evidence that stopping smoking
• reduces the risk of all-cause mortality
• reduces the risk of CHD and stroke
• reduces the risk of lung cancer
• improves lung function, and reduces the rate of
  deterioration in COPD
• Reducing smoking prevalence by 1 per year over
  the next 10 years could save about 70,000 lives
• The earlier you stop smoking the better

11
England National smoking targetsDH White Paper,
Smoking Kills 1998

• Reduce the rate of smoking from 1998 to 2010
• (at least)

DH. National standards, local action health and
social care standards and planning Revised target
2004. 1All adults 24 in 2002 to 21 in 2010.
Revised target 2004 2Manual groups 31 in 2002.
No change (26) in 2010
12
NHS Stop Smoking Service Quit Rates Statistics
on NHS Stop Smoking Services in England April 06/
March 07 Annual Report
13
Cost of NHS Stop Smoking ServiceStatistics on
NHS Stop Smoking Services in England April 06/
March 07 Annual Report

• Cost of NHS Stop Smoking Service (exc.
  pharmacotherapy)
• Net Ingredient cost (NIC) of all pharmacotherapy
• April 06- March 07 600,410 people set a quit
  date through NHS Stop Smoking Services 319,720
  (53) successfully quit (four week
  self-reporting CO monitoring suggests 86 of
  self reported are confirmed successful)

14
Cost of pharmacotherapyStatistics on NHS Stop
Smoking Services in England April 06/ March 07
Annual Report

• Pharmacotherapy used for those setting a quit
  date NRT 83 bupropion 5 NRT bupropion 1
  no pharmacotherapy 6 unknown pharmacotherapy 6
• Cost of pharmacotherapy per quitter

15
Who is using the service? Statistics on NHS Stop
Smoking Services in England April 06/ March 07
Annual Report

• Quarter Jan 07 to March 07 produced the largest
  number of quitters since data collection began
  (n 127,193)
• 2006/ 07
• Success at four week follow up increased with
  age lt18yrs 36 gt60yrs 63
• 18,341 pregnant women set a quit date, success
  rate 52
• Ethnic minority groups setting quit date as
  percentage of total quitters

16
Summary Current UK smoking status

• In 2006 approx. 24 of the population smoked
• In 2004 approx. 9 of children 11- 15yrs smoked
• Higher prevalence of smoking is associated with
  areas of socio/economic deprivation and in some
  ethnic groups
• The number of people setting quit dates through
  stop smoking services and who stop smoking in the
  short term has increased over recent years, as
  has the use of smoking cessation aids
• From1998 to 2003 the rate of reduction in the
  number of people smoking was approx. 0.4 per
  year
• Stopping children from smoking, reducing smoking
  in pregnancy, and, reducing smoking amongst the
  most socially deprived people are key national
  priorities