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Open Access Highly Accessed Research article

Real world evaluation of three models of NHS smoking cessation service in England

Tony Mardle1, Shirley Merrett2, Jane Wright3, Fran Percival4* and Ian Lockhart5

Author Affiliations

1 South East Essex PCT, South Essex Stop Smoking Service, Mapline House, 14 Bull Lane, Rayleigh, Essex SS6 8JD, UK

2 Formerly of: Bournemouth and Poole Teaching PCT, Canford House, Discovery Court Business Centre, 551-553 Wallisdown Road, Poole, Dorset BH12 5AG, UK

3 Warwickshire PCT, Westgate House, Market Street, Warwick CV34 4DE, UK

4 pH Associates, Derwent House, Dedmere Road, Marlow SL7 1PG, UK

5 Pfizer Ltd, Walton Oaks, Dorking Road, Tadworth, Surrey KT20 7NS, UK

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BMC Research Notes 2012, 5:9  doi:10.1186/1756-0500-5-9

Published: 6 January 2012

Abstract

Background

NHS Stop Smoking Services provide various options for support and counselling. Most services have evolved to suit local needs without any retrospective evaluation of their efficiency.

Three local service evaluations were carried out at Bournemouth & Poole Teaching Primary Care Trust (PCT) (PCT1), NHS South East Essex (PCT2) and NHS Warwickshire (PCT3) to describe the structure and outcomes associated with different services.

Result

Standardised interviews with key personnel in addition to analysis of data from 400 clients accessing the service after 1st April 2008 in each PCT. The PCTs varied in geography, population size and quit rate (47%-63%). Services were delivered by PCT-led specialist teams (PCT1), community-based healthcare providers (PCT3) and a combination of the two (PCT2) with varying resources and interventions in each.

Group support resulted in the highest quit rates (64.3% for closed groups v 42.6% for one-to-one support (PCT1)). Quit rates were higher for PCT (75.0%) v GP (62.0%) and pharmacist-delivered care (41.0%) where all existed in the same model (PCT2). The most-prescribed therapy was NRT (55.8%-65.0%), followed by varenicline (24.5%-34.3%), counselling alone (6.0%-7.8%) and bupropion (2.0%-4.0%).

Conclusion

The results suggest that service structure, method of support, healthcare professional involved and pharmacotherapy all play a role in a successful quit. Services must be tailored to support individual needs with patient choice and access to varied services being key factors.

Keywords:
Smoking cessation; Service structure; Service development; Nicotine replacement therapy; Varenicline; Bupropion