1. Smokefree Greater Glasgow & Clyde Roisin Lynch Health Improvement Senior

2. SmokeFree Community Services SmokeFree Pharmacy Services SmokeFree Hospital Services SmokeFree Pregnancy Services SmokeFree Youth Services

4. Smoking is largest preventable cause of ill health in the world 13,473 deaths in Scotland were attributed to smoking, which equated to 24% of all deaths (2004) One in two regular long-term smokers will die early from a disease related to smoking

5. Smoking prevalence varies across the UK N. Ireland * 23% Wales 21% Scotland 25% England 21% General Household Survey 2006; *Continuous Household Survey 2007/08

6. 21% of UK population smoke 25% in Scotland 30% in Greater Glasgow and Clyde area Over 50% in some of our most deprived areas Local Picture

7. What’s in tobacco? 4000 chemicals, 60 of which are known carcinogens Nicotine: Addictive part Carbon Monoxide (CO): Poisonous gas, binds to haemoglobin Tar: Thick, sticky Arsenic, cyanide, ammonia, acetone, benzene, formaldehyde, cadmium, hydrogen cyanide etc

8. ADDICTION The Nicotine Addiction Cycle Emotional Neurochemical Changes Habit

9. Practice Nurse & Smoking Nurse time is valuable This work can be unrewarding & can lead to feeling disillusioned Health messages need to be re-inforced Issue of smoking always raised & recorded ‘Respectful curiosity’: they are the expert on their smoking

10. SmokeFree Community Services All areas of Glasgow & Clyde Advisors in each area Trained facilitators Approx 1500 people per year Approx 45-50% at 4 weeks Approx 16-20% at a year Chronic relapsing condition

11. SmokeFree Community Services Based on ‘Maudsley’ model 7 week groups – hour per week NRT / Zyban / Champix + group support Weeks 1 & 2 – Information Week 3 – Quit Week Weeks 4 – 7 – Group Support Follow up support from pharmacy service

12. But what is a group actually like? Relaxed & informal Informative Not like a-a!

13. Important messages to ‘sell’ groups One of the most effective ways to quit Twice as effective as brief intervention Key to group success is going through same experience as others Relaxed & informal – good fun!

14. SmokeFree Pharmacy Services Groups don’t suit everyone >300 Pharmacies involved Trained in 1 to 1 counselling 5-10 minutes once a week NRT dispensed weekly for up to 12 weeks Other services link to SF

15. Glasgow University Evaluation Groups shown to be twice as effective as Pharmacy Service (44% vs 20%) Heavier smokers find it harder to quit Smoke within an hour of wakening – intensive support should be recommended All smokers should be assessed & referred to most appropriate service

16. SmokeFree Pregnancy Services Launched May 2004 All pregnant women should be CO monitored at booking in at any GG&C maternity unit Self Reported smoker or CO Level above 3ppm, referred to specialist midwife Up to 12 weeks support + NRT Face to face, phone & text message support

17. Hospital Services Hospital stay likely to trigger a quit attempt All inpatients should be offered help to stop NRT to alleviate withdrawals if not ready to quit If motivated, should be referred to the specialist adviser who supports while in hospital On discharge, referred on to community advisers who will support once patient is home Service in all general hospitals in GG&C, all psychiatric hospitals & the dental hospital

19. Who is this training for? anyone who is able to raise the issue of smoking with individuals.. What will it cover? the purpose, benefits and process of raising the issue of smoking and delivering brief advice. It also covers knowledge around tobacco, smoking and health, communication skills and how to refer people to local stop smoking services for support. How long will it take? The e-learning component of the training takes around one hour to complete in your own time. You will then attend a three and half hour participatory session Rebecca Campbell, Smoke Free Training Services 0141 201 4620 Rebecca.Campbell@ggc.scot.nhs.uk

20. www.nhsggc.org.uk/smoke freeservices 0800 84 84 84