Your SlideShare is downloading. ×
0
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Core Competencies – Health Professionals and Tobacco
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Core Competencies – Health Professionals and Tobacco

649

Published on

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
649
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
2
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide
  • Slide 49 - The role of the health care professional - what prompted an attempt to stop smoking? Objective : To demonstrate the important role health care professionals play in helping and encouraging smokers to quit Key Communication Messages : Quitting smoking is more of a process carried out over time, rather than a one off event. This graph illustrates all the elements that play an important role in increasing a smokers’ motivation to quit, and in triggering a cessation attempt 1 It demonstrates the important role of the health care professional in helping smokers quit. Offering advice may act as a trigger to stopping smoking and as a means of support, when making a quit attempt 1 Reference : 1. West R. Getting Serious About Stopping Smoking. 1997: A Report for No Smoking Day
  • Smokers die earlier than non-smokers. The estimated gain in life expectancy from quitting at given ages is clinically significant at all ages. If the pension age goes up to 70, then most male smokers will die before they collect their pension. ________________ Taylor DH, Jr., Hasselblad V, Henley SJ, Thun MJ, Sloan FA. Benefits of smoking cessation for longevity. Am J Public Health 2002; 92 :990-6
  • Tammemagi – effect was not explained by sociodemographic or environmental exposures, adverse symptoms, histology, stage co-morbidity or treatment. HR was 1.30-7-8 when covariates were controlled for for current smoking. It was 1.29 for Squamous, 1.13 for adeno, 1.32 in small cell Lung cancer symptom scale was used – 9 items; visual analog scale.current/persistent smoker – smoking at dx and fup. 18% never smokers 58% former smokers 24% current smokers At fup: 95% were abstinent Current smokers – 70% had quit at follwup but 30% continued to smoke persistently through treatment. No dose trends noted. Components worse were appetite, fatigue, cough, shortness of breath, lung cancer symptoms, illness affecting normal activities and overall score.
  • Smoking can be overlooked by staff and carers working with people with mental health difficulties, but they have equal rights to help with smoking cessation. Reasons for higher smoking rates may include socio-economic deprivation, smoking as a coping mechanism or a form of self-medication, the environment and culture of mental health services - those living in psychiatric institutions have higher rates of smoking than those with similar illnesses living at home. Suggestions as to why so many patients in psychiatric hospitals smoke include boredom and lack of recreational activities, smoking as a social activity, the use of cigarettes as incentives, staff smoking and lack of smoking policies. To continue to make exemptions for people experiencing mental health difficulties is discriminatory and will continue the risk of smoking related disease in this community. Further information from a useful ASH fact sheet - www.ash.org.uk/html/factsheets/html/fact15.html
  • False – over two thirds of smokers would like to quit smoking False – the most effective way is intensive behavioural support combined with pharmacotherapy. True False – and in fact may be more harmful as roll ups may not have filters.
  • Transcript

    • 1. Core Competencies – Health Professionals and Tobacco Elin Roddy BASSP September 2007
    • 2. Aims and Objectives
      • To ensure that all NHS staff directly involved with patient care meet a basic set of core competencies to enable them to identify and support smokers who want to stop smoking
      • http://www.brit-thoracic.org.uk/cessationcompetencies
    • 3. Where this fits – NICE guidance
      • Brief chats between people who smoke and health professionals about stopping smoking are both effective and cost effective in helping people to stop smoking.
      • All health professionals should advise all smokers to stop smoking, not just those who are already ill
      • Advice should be sensitive to individual needs.
      NICE public health guidance: focus on smoking cessation and physical activity http:// www.nice.org.uk/page.aspx?o =300139
    • 4. The role of the health care professional - what prompted an attempt to stop smoking? % Base: 672 smokers currently trying to stop or made attempt to stop in past year. West R. Getting Serious About Stopping Smoking. A Report for No Smoking Day 1997
    • 5. Aims and Objectives
      • Knowledge
      • Skills
      • Attitudes
      • Additional competencies for prescribers
    • 6. Knowledge
      • Effects of smoking on health
      • Implications of addiction to nicotine
      • Cessation strategies available to help smokers to quit
      • Local smoking cessation services available
    • 7. Benefits of quitting smoking Taylor et al, AM J Public Health 2002;92:990-6 Men Women Life expectancy Extra years compared to smokers Life expectancy Extra years compared to smokers Smoked until death 69.3 73.8 Never smoked 78.2 8.9 81.2 7.4 Quit at age 35 76.2 6.9 79.9 6.1 Quit at age 45 74.9 5.6 79.4 5.6 Quit at age 55 72.7 3.4 78.0 4.2 Quit at age 65 70.7 1.4 76.5 2.7
    • 8. Speakers notes: Smokers die earlier than non-smokers. The estimated gain in life expectancy from quitting at given ages is clinically significant at all ages. If the pension age goes up to 70, then most male smokers will die before they collect their pension. ________________ Taylor DH, Jr., Hasselblad V, Henley SJ, Thun MJ, Sloan FA. Benefits of smoking cessation for longevity. Am J Public Health 2002; 92 :990-6
    • 9. Skills
      • Identifying all smokers
      • Delivering brief opportunistic smoking cessation advice to all smokers
      • Assessment of patient’s commitment to quit
      • Referring to local specialist smoking cessation services
    • 10. Understanding smoking behaviour
      • Health effects of nicotine/ smoke
      • Withdrawal syndrome
      • Address misconceptions around quitting:
      • ‘ Smoking helps me deal with stress’
      • ‘ I’ll put on weight’
      • ‘ The odd one won’t hurt’
      • ‘ I’ve switched to roll ups’
    • 11. Attitudes
      • Non-judgemental approach to smokers
      • Acknowledge role of addiction and importance of support
      • Most smokers do not choose to smoke but do so because they are addicted
      • Most smokers will not be able to give up without support
      • Smokers have equal rights too
    • 12. Additional slides – specialty specific health effects and additional competencies for prescribers
    • 13. Smoking Cessation by specialty
      • Respiratory
      • Oncology
      • Cardiology
      • Gastroenterology
      • Rheumatology
      • Surgery
      • Psychiatry
      • Paediatrics
      • Pregnancy
    • 14. QOL and Survival in Lung Cancer
      • Current smoking is predictor of shortened lung cancer survival*
      • May be mediated by biologic effects
      • Graces et al: Persistent smoking negatively impacted QOL scores
      *Tammemagi, CHEST January 2004
    • 15. Effects of smoking on health - Psychiatry
      • Studies on people with mental illness living in the community show high smoking rates - 70% in people with schizophrenia, 56% with depression (vs. 28% of population)
      • People with severe mental illness tend to smoke more cigarettes per day and have a high morbidity and mortality from cardiovascular and respiratory disease
      • However, mental health problems do not undermine the ability to stop smoking.
      • Stopping smoking does not appear to exacerbate psychotic symptoms and that experience of depression does not affect quit rates.
      • Patients with mental health problems need equality of access to smoking cessation support.
    • 16. Additional skills for prescribers
      • Knowledge of indications for and side-effects of nicotine replacement therapy and bupropion
      • Skills in prescribing the above treatments to support a quit attempt
    • 17. Speed of nicotine delivery
    • 18. Cut Down Then Stop (CDTS)
      • New indication for NRT
      • Using NRT to reduce number of cigarettes by 50% leads to long-term cessation
      • Nicorette gum and inhalator now licensed for this indication
      • Useful for eg. smoke-free hospitals, where patients may not want to quit but need to reduce number of cigarettes smoked
    • 19. Assessment Questions
      • Questions have four stems each of which may be true or false, apart from Question 4 where only one stem is correct
      • Answers can be found in the speakers notes accompanying each question
    • 20. Question 3 – Cessation strategies
      • Half of smokers would like to stop smoking
      • Willpower alone is the most effective way to stop smoking
      • Around a quarter of those smokers trying to quit do so because of advice from a health professional
      • Switching to roll-ups is less harmful than smoking cigarettes
    • 21. Summary
      • A free and (hopefully) useful resource
      • Available via the BTS website at
      • http://www.brit-thoracic.org.uk/cessationcompetencies
      • Comprehensive speaker’s notes enable ‘non-experts’ to teach on tobacco
      • Overall aim is to broaden the reach of smoking cessation advice
    • 22. Acknowledgements
      • British Thoracic Society Tobacco Committee
      • David Ross
      • Angela Hurlstone, Chris Routh, Sheila Edwards
    • 23.  

    ×