New challenges for an effective secondary care stop smoking service
Author(s)
Julie Browne, Dr. Myra Stern and Verena Thompson
Presenter(s)
Julie Browne Stop Smoking Specialist Secondary Care, Whittington Health, London
Abstract
INTRODUCTION
The Whittington Hospital,Central London serves a large population with a very high smoking prevalence (28% compared to 22% UK). 40%morbidity and 20% of mortality is smoking related. A comprehensive SS service has been developed for inpatients,outpatients,antenatal clinics, surgery and staff. While this kind of service should be rolled out nationally, the specific challenges of helping sick smokers to stop are larely undocumented.
METHOD
Based on a gradual increase in SS through secondment of a community SS specialist a business plan attracted funding for a Band 7 SS Specialist from the community. Clear referral pathways for inpatients and outpatients were developed and NRT made available on the wards.
RESULTS
Since May 2009 410 outpatients and 46 inpatients set quit dates, with a 4 week quit rate of 39%. Many of those who quit took longer than is usual to reach their quit date, over a month in some cases, and the length of treatment was usually much longer than 12 weeks, with on-going relapse prevention often for longer than a year which creates a demanding caseload for the specialist.
CONCLUSIONS
Urgent definition of this type of service is required, specifically the intensity , length of treatment , extra NRT and the counselling support needed for these patients to stop smoking. This has important implications for targets, levels of service, and the level of training and support necessary for the Specialist treating patients with long term conditions and complex needs.
