Publication
Encouraging smokers to stop: what you can do
| Contents: | How to use this guide Flow chart Why your role is so important What you can do: a step-by-step guide Medications Smoking cessation services and further help The health risks References Why it is worth stopping |
Why your role is so important
By raising the issue of smoking and referring smokers who want to stop to the local treatment services‚ you will be offering them the best chance of succeeding in stopping. They can now get help from a network of evidence-based smoking cessation services across Scotland‚ where specialist staff offer intensive‚ expert support.
Your intervention is extremely worthwhile.
This is because‚ firstly‚ smoking cessation is effective in preserving life.
The Smoking Cessation Guidelines for Scotland: 2004 Update ‚ based on systematic reviews of the evidence‚ show that the more support smokers are given in stopping‚ the higher the success rates (see diagram). Brief opportunistic advice‚ normally taking less than three minutes‚ results in about 2% stopping long term‚ over and above those who would have stopped anyway without help. Although this might sound rather low‚ it is very cost effective. However‚ the main effect of brief advice is to trigger a quit attempt and so its real value will be if it can persuade smokers to seek support from the smoking cessation services.
Face-to-face behavioural support helps about 8% of smokers stop long term (over and above those who would have stopped anyway). These cessation rates are approximately doubled by adding support from nicotine replacement therapy (NRT) or bupropion (Zyban®).
Treatment is also very cost effective. Most smoking cessation treatments cost less than £1‚000 per life year gained. The median cost per life year gained of 300 life-saving medical interventions has been estimated in one review as £17‚000(2)
Approximate percentage of quit attempts achieving at least six months of continuous abstinence as a function of treatment(1)
In 2002 the Health Technology Board for Scotland (HTBS) (now part of Quality Improvement Scotland) advised that the guidance on NRT and Zyban® from the National Institute for Clinical Excellence (NICE) in England was valid for Scotland(3). It concluded that NRT and Zyban® are among the most cost effective of all healthcare interventions and should be recommended to smokers who want to stop . Smoking cessation thus provides outstanding value for money (2).
This means that even low cessation rates produce health gains far more cheaply than most medical interventions. Helping smokers stop is therefore an excellent investment which will‚ in the medium to longer term‚ save money and release it for other interventions.
The figures above show that a worthwhile intervention need only take a few minutes of your time.