Hospital based smoking cessation service – more smokers quitting and staying smoke-free. Paula Campbell, Regional Officer – Smoking Prevention Ann O’Farrell, Research Officer, Department of Public Health Dr. Nazih Eldin, Regional Manager – Health Promotion

Objectives To provide all smokers in the north east with support for quitting; (North-eastern region includes 4 counties & population of 345,000). To monitor this service on an ongoing basis; To develop an annual multi-media campaign promoting smoking cessation and prevention.

Cessation Service The service commenced in December 2000, and is based in 5 acute hospitals. Referrals come from hospital or community based staff, self-referrals & National Smokers Quitline; Counsellors available for between hours per week in each hospital.

Support is free, and is either on a 1-1 basis or group support ; Group support consists of 6 week Stop Smoking courses which are run in the evening time. Each hospital runs 2-3 of these courses every year.

Advertising the cessation service. Box advertisements in all 8 regional papers; Slots (minimum 3 each day) on both regional radio stations; Flyers to all General Practitioners, pharmacists and Public Health Nurses; Key dates used for press releases (Jan 1st, Ash Wednesday, World No Tobacco Day); Notices sent to health care staff via and the intranet;

Health care staff can avail of free nicotine replacement therapy for up to 4 weeks. All clients who set a quit date are followed-up at 2 weeks, 3 months and 12 months; UK guidelines adopted for the monitoring system: 3 attempts are made to contact the client; 2 weeks either side of the follow up date at 3 & 12 months can be used during which to follow up a client.

Methods Client monitoring data collated on Excel - Client code number Date seen Category of client Type of support Demographics Stage of Change in relation to smoking behaviour (Prochaska & DiClemente) Quit date (if applicable) Smoking status 2 weeks, 3 months & 12 months after quit date.

Results Quantitative analysis completed by the Dept of Public Health in August n = 7,253 (incl. clients supported from Dec July 2004). Age range : years, with median of 47 years.

No. of smokers availing of support

Gender

Type of support

C ategory of client

Q uit rate results ( )

Results Being quit at 3 months was sig. related to: Being older (49 years vs. 45 years) Attending group support Being a staff member. No relationship was found between gender and being smoke free at 3 months.

Impact of Smoking ban on cessation service (March 29 th 2004) 25.7% increase

Cost-effectiveness 1. UK cessation services: Stapelton J. (2001) calculated cost per life year saved at: £601 for those aged £766 for those aged (Based on a cost per patient treated of £209) Compared to: Median cost of £17,000 per life year saved for a range of 310 medical interventions (Tengs et al, 1995).

2. North-Eastern region cessation service: In 2004, the service costs were approx. €212,000; 2,851 clients were provided with support that year. Hence, cost per client treated = €74. Very good value for money!

Conclusions This is an effective service which has helped over 8,500 smokers in their efforts to quit. Although hospital based, the service is reaching out - % of clients coming from the local community (public) increased from 10% in 2002 to 18% in Demands on this service increase each year and crucially, the 12 month quit rate has increased significantly from 9% in 2002 to 12.2 % in 2004.

The Good News……… Smoking in Adults (SLAN Surveys)

Smoking in year olds in the north-east