A prospective investigation of the predictors of intervention effects of the NHS smoking cessation programme
Camille Alexis-Garsee, Lecturer, Middlesex University, London, UK

Abstract
Background: The government has invested NHS Stop Smoking Services to help smokers quit. However, less than 5% of smokers use these services and approximately half of these fail to successfully complete the programme and over 75% of quitters relapse within six months. The factors relating to this short-term failure are unclear. It is important to determine the factors related to smoking status from the NHS Stop Smoking programme as this would help cessation advisors identify at-risk smokers at the start of the intervention, which would aid in the more appropriate use and allocation of resources and help identify factors by which interventions can be tailored. The aim of the study was to assess the extent to which the Transtheoretical model could provide a framework for understanding smoking behaviour in the context of the NHS stop smoking programme.

Methods: Smokers were recruited at the point of entry to stop smoking services based at GP surgeries across Avon and the West Midlands. In order to determine the factors important in smoking cessation and to identify those at risk at the start of the programme, smokers completed questionnaires on entry to the programme and four weeks later, at the end of the programme.

Results: Participants were on average 39 years old, were smoking 21 cigarettes a day for approximately 21 years. Of the 183 smokers recruited, 43.5% quit at the end of the programme. Female participants were 2.3 times more likely to drop-out than males, OR=2.34 (1.11, 4.93) and those living with other smokers were 2.4 times more likely to drop out of the programme, OR=2.37 (1.08, 5.21). Only three variables predicted smoking status; weight, p=0.001; sessions attended, p<0.001; maladaptive cognitions, p=0.008. The addition of the TTM variables did not significantly improve the model.

Conclusion: The results highlighted important characteristics of those enrolling on the NHS Stop Smoking programme and provided an insight into those at risk of dropping out of the programme. However the predictive ability of the TTM variables was not demonstrated and thus these variables may not be useful for participants enrolling on these programmes.