A specialist stop smoking clinic in a general practice
Simon Galton, Senior Stop Smoking Specialist, Smokefree Camden, St Pancras Hospital, London, UK

Abstract
Lack of time is often cited as a major barrier to having an effective stop smoking service in a General Practice setting. Since January 2006 a Level 3 trained Stop Smoking advisor has run a weekly three-hour clinic in a GP practice. Clients were seen for a minimum of seven sessions the first being 20 minutes and subsequent sessions 10 minutes, although cancelled sessions allowed greater time for attendees than allocated. The GPs prescribed both nicotine replacement therapy (including dual therapy) and varenicline on recommendation.

Of those booked into the service an average of 7 smokers (60%) attended each week. Over a two-year period 311 patients were referred; 189 entered treatment and 80 quit. Of those attending the first session 43% became four week quitters; those who attended the quit date had a success rate of 62%. Based on an average practice nurse hourly rate of £30 this represents a very cost effective £117 per quitter.

This has shown that a half-day GP practice based clinic can be successful and effective. The service is appreciated by the staff and has become integrated into the surgery alongside other interventions such as brief counseling and sensible drinking.