Smoking - triggering the quit attempt
Smoking cessation services can be a useful addition to any community pharmacy. We review the NCST's Ask, Advise, Act process for providing support to people who want to give up their tobacco habit
Commissioned pharmacy smoking cessation services have reduced in number in recent years, but Andy McEwen, director of the National Centre for Smoking Cessation and Training believes that community pharmacies continue to have an important role to play in guiding people towards making a quit attempt, and offering support to those who want to stop.
“The advice on smoking cessation training is always changing,” he says. “The NCSCT Training has been available since 2010 and available through CPPE since 2011. We updated the training this year and we’re always adapting to new learning and research.”
The training module offered to pharmacies and health and social care practitioners is designed to give anybody involved in helping smokers to stop the core competencies required to give ‘brief advice’ to aspiring non-smokers. It uses a method developed by the NCSCT designed to identify effective behaviour-change techniques for smoking cessation, and uses the ASK, ADVISE, ACT model:
- Assess current and past smoking behaviour – ASK
- Provide information on consequences of smoking and smoking cessation – ADVISE
- Provide options for later/additional support – ACT
- Advise on stop smoking medications – ACT.
“Taking the NCSCT training through the CPPE platform can give pharmacy staff increasing power to work with smokers to improve quit rates,” Mr McEwen advises, “and helps to keep them up to date on any new approaches.”
Anyone who offers smoking cessation services should be NCSCT-certified, according to guidelines from the DH, NICE and Public Health England and, encouragingly, in the four years since the module has been made available free of charge to health and social care practitioners, over 27,000 certificates have been issued. The training is useful for pharmacy staff who want to be able to trigger quit attempts in smokers – they can then signpost to local stop smoking services if necessary.
Around two-thirds of quit attempts are initiated through contact with a pharmacy or a practice nurse
According to figures from the Health & Social Care Information Centre (HSCIC) around twothirds of quit attempts are initiated through contact with a pharmacy or a practice nurse. Community pharmacies have the potential to become big players in the smoking cessation market – their main advantage being the fact that their reach extends into the community, bringing staff into contact with smokers on a daily basis and opening up channels of communication.
“Smokers are used to being asked whether they smoke,” says Mr McEwen. “In fact, they expect it. If they weren’t asked all the time by healthcare professionals, they’d start to think it was OK! Pharmacy staff are in a good position to be able to offer advice to customers who come in for cough medication or a prescription for antibiotics.”
“Smoking is a complex addiction – it’s not an easy one to give up,” he adds. “Smokers already know that it’s not doing their health any good; just telling them that alone isn’t going to make any difference. There are ways that pharmacy staff can give advice, things that you can do and say that have been proved to be helpful.”
Once you’ve triggered the quit attempt, you’re in a position to be able to recommend effective medication. “An attempt to stop smoking is four times more likely to be successful if supported with the right medication and guidance than just going ‘cold turkey’,” he comments.
Mr McEwen’s final advice for pharmacies wanting to support smokers in their quit attempts is to offer advice whenever possible. “Keep on keeping on. Not everyone will be able to stop on the first attempt and people need to know that they can come back to you if they don’t succeed the first time. You’re giving smokers genuine, lifesaving interventions and if you help just one person to give up it can be very rewarding.”
Work through a customer consultation to determine the possible cause of stinging, gritty eyes and recommend an effective treatment to help ease these symptoms.