NHS Health Scotland
 
Outcome Indicators
 
3.3. Activity: provision of effective smoking cessation services in key settings including pharmacotherapies; brief interventions and referral to smoking cessation services

Impact on outcomes

Possible gaps in evidence

Sources

Impact on short term and intermediate outcomes

There is review level evidence supporting:

  • brief interventions (especially physician and nurse-structured advice) [1,2,3], including referral to smoking cessation services [1]
  • 1:1 interventions [1,5,6]
  • group support (approx double the changes of quitting in comparison with self-help interventions alone or other less intensive interventions or no support) [1,5,7]
  • pharmacotherapy (NRT, Varenicline or Bupropion) [1,2,5,8,9]
  • all commercially available forms of NRT, Varenicline or Bupropion (and the provision of all of these pharmacotherapies) for those planning to stop smoking, and that advice, encouragement and support including referral to smoking cessation services be offered to help them in their quit attempt [1]
  • intensive interventions such as those being offered by the NHS as being effective in the short-term and reasonably effective in the long-term [1,5]
  • the provision of a combination of treatments proven to be effective, and that tailored advice and support be provided to clients from minority ethnic and disadvantaged groups in particular [1]
  • the accessibility of services to smokers from minority ethnic and disadvantaged groups, and encouragement to use them rather than tailoring of interventions alone [1]
  • self-help materials [1]
  • pharmacy-delivered interventions [1,5]
  • primary care-delivered interventions [1,2]
  • smoking cessation interventions among inpatients (especially highly-intensive ones beginning in hospital and including follow-up support for at least 1+ month post-discharge) [1,4,5,11]
  • smoking cessation services in reaching deprived groups [1,5]
  • workplace interventions [1,12]
  • the cost-effectiveness of effective smoking cessation aides and services [1,13]

Gaps in the evidence include:

  • certain groups (e.g. pregnant women, deprived groups, minority ethnic groups, and those living in institutions), and particular sites/settings [1], for whom a fuller picture is required on the effectiveness of services [1]
  • although some commercial smoking cessation treatments may be effective, there is little or no evidence of effectiveness from high quality, comparative trials [1]
  • the relative effectiveness of particular psychological components of group support [7]
  • the longer-term effectiveness of workplace interventions [1]
  • the mixed evidence on the effectiveness of NRT in helping women to stop during pregnancy [14]

 

Source:
1. NICE (2008). Public Health Guidance 10 – Smoking cessation services in primary care, pharmacies, local authorities and workplaces, particularly for manual working groups, pregnant women and hard-to-reach communities.  NICE, London

2. Stead LF, Bergson G, and Lancaster T. Physician advice for smoking cessation. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD000165. DOI: 10.1002/14651858.CD000165.pub3

3. Rice VH and Stead LF. Nursing interventions for smoking cessation. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD001188. DOI: 10.1002/14651858.CD001188.pub3

5. Bell, K., McCullough, L., Greaves, L., et al, on behalf of the British Colombia Centre for Excellence for Women’s Health, Vancouver. Rapid Review: The Effectiveness of National Health Service Intensive Treatments for Smoking Cessation in England (2006, updated 2007). For National Institute for Health and Clinical Excellence (NICE): Public Health Programme Guidance 10. NICE, London

6. Lancaster T, and Stead LF. Individual behavioural counselling for smoking cessation. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD001292. DOI: 10.1002/14651858.CD001292.pub2 [re-assessed as up-to-date in 2008]

7. Stead LF, Lancaster T. Group behaviour therapy programmes for smoking cessation. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD001007. DOI: 10.1002/14651858.CD001007.pub2 [re-assessed as up-to-date in 2008]

8. Hughes JR, Stead LF, Lancaster T. Antidepressants for smoking cessation. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD000031. DOI: 10.1002/14651858.CD000031.pub3 [re-assessed as up-to-date in 2009]

9. Cahill K, Stead LF, Lancaster T. Nicotine receptor partial agonists for smoking cessation. Cochrane Database of Systematic Reviews 2011, Issue 2. Art. No.: CD006103. DOI: 10.1002/14651858.CD006103.pub5 [re-assessed as up-to-date in October 2010]

10. Sinclair HK, Bond CM, Stead LF. Community pharmacy personnel interventions for smoking cessation. Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD003698. DOI: 10.1002/14651858.CD003698.pub2 [re-assessed as up-to-date in 2007]

11. Rigotti N, Munafo MR, Stead LF. Interventions for smoking cessation in hospitalised patients. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD001837. DOI: 10.1002/14651858.CD001837.pub2

12. Bell, K. McCullough, L., De Vries K. et al, on behalf of British Colombia Centre for Excellence for Women’s Health, Vancouver (2006). Workplace policies for Smoking Cessation: Final Draft. For National Institute for Health and Clinical Excellence (NICE): Public Health Programme Guidance 10. NICE, London

13. Flack, S., Taylor, M. and Trueman, P., on behalf of York Health Economics Consortium (2007). Cost-effectiveness of Interventions for Smoking cessation: Final Report. For National Institute for Health and Clinical Excellence (NICE): Public Health Programme Guidance 10. NICE, London

14. NICE (2010). Public Health Guidance 26 – How to stop smoking in pregnancy and following childbirth.  NICE, London

 

 

 

 

 

 

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