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.
Core Competencies – Health Professionals and Tobacco Elin Roddy BASSP September 2007
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
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
Cessation strategies available to help smokers to quit
Local smoking cessation services available
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
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