Brief Intervention

for smoking cessation

Jayne Wright
Health & Wellbeing Lead

The Need to Refocus

Standing on the shore of a fast flowing river I hear the cry of a drowning man. I jump into the river, save him and give artificial respiration. Just when he begins to breathe, there is another cry for help. Again, I jump in and rescue him. Just as he begins to breathe, another cry for help. Without end the sequence continues. I am so busy rescuing, I have no time to see what is happening upstream causing them to fall in. [McKinlay,1979]

Smoking-related Costs to the NHS (2008/09) Estimated cost of treating illness and disease associated with smoking was 5.2 billion
These costs are rising as admission rates increase

Stop Smoking Services cost 74 million Pharmacotherapies cost 57 million

Reduction in the Prevalence of Smoking

50%
Source: www.ic.nhs.uk, 2009

25%

22%

0%

1980

2006

2009

21%

The percentage of over 16s who smoke has virtually halved since 1980

39%

You cannot make someone stop smoking

You must stop

But..

Cycle of Change
Making Changes

Stable Safer Lifestyle Im a non smoker

Ready/Preparing to Change How do I go about it?

Ive set a quit date

Maintaining Change I am an exsmoker

Not Sure/Thinking About Change

I have heard about a new treatment to stop smoking

Relapsing I have learnt a lot and when I am ready I will try again

I am not interested in stopping smoking

Source: 2005,Sutherland.G, Stapleton,J. Maudsley Hospital Smoking Cessation Clinic, Institute of Psychiatry

Effectiveness of Brief Intervention

Quit Rates in Primary Care

20%

10%

0%
BI BI & NRT BI, NRT & Behavioural Support

However these rates are not reflected in present quit rates for hospital referrals

5%

10%

20%

Effective Delivery

ASK ADVISE ACT

Brief Intervention for smoking cessation is delivered effectively using the

3As

ASK ADVISE ACT

Ask and record a patients smoking status

ASK ADVISE ACT

Advise patients that CGH & WUTH are smoke free environments
How do they feel about that? Is this a time to help them to quit? Have they tried to quit before? May we discuss the benefits of quitting and the support available?

ASK ADVISE ACT

Advice is more effective when delivered in a sensitive, appropriate, non-confrontational manner [NICE,2006]

ASK ADVISE ACT

Prompt referral to Stop Smoking Service (SSS) via PCIS/Cerna - do not wait until an in-patient Inform patient of support for smoking cessation and success rates of Champix, Zyban, Nicotine Replacement Therapy and motivational support

Offer booklets to patient

For acute or unstable cardiac patients

If NRT is contra-indicated then

still offer

behavioural support supporting literature referral to SSS

Follow on support is essential to support quit

attempt

Document responses to 3As in the Smoker Assessment form

Smoker
Requires NRT

yes/no
yes/no

If yes, amount per day?

Referral to Stop Smoking service

yes/no refused Date:

Assessing Nurse signature:

Whats in tobacco smoke?

Nicotine Tar Carbon Monoxide 4,000 other harmful chemicals

Your support can really make the

difference!
Remember 66% of smokers want to quit

Benefits of quitting smoking

Patients will be more motivated if they define their own perceived benefits themselves Quitting smoking is the single most effective health promoting intervention Quitting pre-op reduces post-op respiratory complications and promotes wound healing Improving patients health, fewer hospital admissions

Barriers
Fear of changing relationship with patient Not my job No time Lack of knowledge Personal lifestyle choices

Benefits to you?

The Satisfaction of Making the

Difference!

Questions

Thank you.
Please help yourself to a 3As booklet and keep it in your pocket!