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Author(s)
H. McRobbie 1, S. Snuggs 1, K. Myers 1, A. McNeil 2, S. Agboola 2, P. Hajek 1
1. Wolfson Institute of Preventive Medicine and UK Center for Tobacco Control Studies, Queen Mary University London, London
2. UK Centre for Tobacco Control Studies, Nottingham University, Nottingham, United Kingdom
Presenter(s)
Dr Hayden McRobbie Reader in Public Health Interventions, Queen Mary University of London, Barts & The London School of Medicine and Dentistry
Abstract
Background:The UK NHS Stop Smoking Service (NHS-SSS) helps approximately half of all clients to quit for four weeks. However most will relapse back to smoking within six months. Relapse prevention interventions can work in two ways. First they can prevent lapses from occurring and secondly they can prevent a lapse progressing to relapse. Unfortunately most lapses lead to relapse, but this might be mitigated if clients could be encouraged to seek advice and medication if a lapse occurs. SMS text-based messages provide a simple way to deliver relapse prevention messages.
Methods:A relapse prevention service (RPS) was designed by the project team in collaboration with the local NHS-SSS and input from clients. The service was offered to 202 clients who were continuously abstinent for two weeks at four weeks after their quit date between September 2010 and July 2011. Those accepting the offer received one motivational message per week for the first 12 weeks and then one message per fortnight for up to six months. Clients were asked to respond to nine messages and those who lapsed were encouraged to re-attend the NHS-SSS. They were also offered a supply of 20 nicotine mini lozenges two, eight and 14 weeks after they finished treatment. Clients were followed up at six months and self reported abstinence was verified by measuring carbon monoxide (CO) in expired breath. They were also invited to provide specific feedback regarding the helpfulness of the RPS.
Results:The RPS was easy to implement into the NHS-SSS where good client records were available. 202 clients enrolled into the RPS and the text messages were generally well received, with 70% of clients stating that the RPS was helpful. Most (85%) clients responded to at least one of the interactive messages and 84 (42%) clients accepted at least one of the three offers of NRT ‘Minis’. Seventy-seven clients (38% of the total, 56% of those we managed to contact) remained abstinent at 6-months. Eighteen clients who relapsed back to smoking used RPS to re-engage with the NHS-SSS and 10 successfully re-established abstinence.
Conclusions:A text-based RPS is a low-cost option for maintaining contact and motivation with clients of the NHS-SSS. Such an RPS can be easily implemented within the current NHS-SSS systems, but successful implementation requires the availability of ‘up-to-date’ client records. The RPS was well received by clients, but a controlled trial is now needed to determine if this type of intervention has a significant effect in reducing relapse rates.
Source of funding: This pilot was funded by the Department of Health.
