Smoking Cessation Pilot Program

Transcription

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2 Smoking Cessation Pilot Program Alyson Bettega Oral Health Therapist

3 Aim of this session Increased awareness of cigarette smoking statistics Improved knowledge of smoking cessation products and aids How to implement a smoking cessation program

4 Smoke Free at North Richmond Community Health March 2015 City of Yarra grant to provide smoking cessation intervention to those ready to quit Referred by GPs and oral health staff from both Fitzroy and North Richmond Offered free of charge, ongoing one on one counselling sessions Face to face sessions and telephone service offered Pilot program showed promising results Ongoing program for 2016

5 What are your experiences with smoking cessation advice in the health care setting?

6 Every conversation could promote change

7 The World Health Organisation The global tobacco epidemic has now assumed pandemic proportions, with about 1.3 billion tobacco users and 6 million annual deaths from tobacco use. The epidemic also involves substantial healthcare, social, and economic costs across high-, middle-, and low-income countries. (Asma S, Mackay J, Song SY, Zhao L, Morton J, Palipudi KM, et al., The GATS Atlas CDC Foundation, Atlanta, GA.)

8 Tobacco smoking is the single most preventable cause of ill health and death in Australia. Australia s Health AIHW 2010

9 Smoking in Australia; the facts Every person who smokes, regardless of how often or how much have twice relative risk of morbidity. 15,500 Australians die each year from smoking Smokers will lose 10 years of life on average Up to 2 in 3 long-term smokers is killed by smoking 12% of all deaths in Australia are due to smoking 30% of all deaths from cancer are due to smoking The smoker loses an average of 3 months of life or each year quitting smoking is delayed after age 35 Dr Colin Mendelsohn

10 Current Facts and Figures in Australia Plain packaging as of December 2012 Investment into marketing campaigns against smoking 25% tax increase in April 2010 Four increases in tax from December 2013 to September 2016 Reduced duty free concessions

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14 AIHW National Drug Strategy Household Survey

15 Reasons for Smoking Stress relief Socialising Boredom Concentration aid Alertness Weight control Enjoyment

16 Cost and concern for health were the main reasons smokers tried to quit or cut down. AIHW National Drug Strategy Household Survey

17 Brief intervention the 5As Ask Assess Advise Assist Arrange a follow up all clients should be asked about their smoking. all clients should be asked how they feel about their smoking. all clients who smoke should be advised of health effects all clients who smoke should be provided with information and support All clients who smoke should have follow up Smoking Cessation Guidelines for Australian General Practitioners, 2003

18 Brief advice from a health professional can double the rate of quitting Cochrane Collaboration 2008 Every client who smokes should be offered brief opportunistic advice Every client who identifies as ready to quit or attempting to quit should be offered follow up advice or directed to someone who can offer advice Best quit results when Nicotine Replacement Therapy (NRT) and/or pharmacotherapy is combined with support and counselling Pharmacotherapy should be offered to those motivated to quit It can take an average of 8 quit attempts

19 What works Nicotine replacement therapy (NRT) combinations of will increase chance of quitting over single formulations Bupropion (Zyban) Varenicline (Champix) more effective than single NRT or Zyban and just as effective as combinations of NRT

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21 Smoke free at NRCH Program Outline Oral health program integrated with GPs, dietician, diabetes counsellor and social workers Provide a one on one smoking cessation counselling program to 40 people from culturally and linguistically diverse backgrounds Develop improved pathways within NRCH Improved health outcomes

22 Program outcomes Between March and October clients referred 18 clients participated 2-3 visits per person plus telephone discussion 4 clients dropped out 11 clients reduced 3 clients were quit at last follow up 1 gym membership sold

23 Program outcomes Self reported saving of finances Self reported improved confidence to reduce to quit Improved knowledge of smoking cessation products Long term benefit of improved oral health?

24 Changes to the program Increase number of trained counsellors Offer training to the front desk staff in motivational techniques Flexibility with appointment booking Continue to improve upon referral pathways within NRCH, dietician, counselling, diabetes education Consider offering opportunistic counselling to drug and alcohol and mental health clients Charge item number 142 tobacco counselling Consider group sessions

25 Role play activity Think of a behaviour that you would like to change An example: I d like to drink less coffee I d like to eat less sugar I d like to exercise more Ask your partner and record: What do you like about this behaviour? What don t you like? What is most important to you? If there are more dislikes than likes, What could you do about this behaviour?

26 Transferability What is your goal? How will you achieve your goal? Objectives

27 Useful resources Lung Health at the Alfred An ABCD approach to supporting people who smoke: A guide for health services Pharmacotherapy for smoking cessation Online Learning Quit Victoria s free online learning hub National Centre for Smoking Cessation and Training Department of Health

28 Useful resources Australian Association of Smoking Cessation Professionals Victorian Network of Smokefree Healthcare Services

29 Thank you

30 References AIHW National Drug Strategy Household Survey detailed report: Drug statistics series no. 28. Cat. no. PHE 183. Canberra: AIHW. AIHW Tobacco Indicators Baseline Data: Reporting under the National Tobacco Strategy Drug statistics series no. 29. Cat. no. PHE 189. Canberra: AIHW Asma S, Mackay J, Song SY, Zhao L, Morton J, Palipudi KM, et al., The GATS Atlas CDC Foundation, Atlanta, GA. Attar-Zadeh D, Update on smoking cessation medications. Practice Nursing 2015, Vol 26, No6. McEwan A, Gothier L, Smoking Cessation: The Heart of the Matter. Nurse Prescribing 2014, Vol 12, No2. BrittonJ:In defence of helping to stop smoking. The Lancet Vol 373 Feb Dr Colin Mendelsohn McEwan A, Hajek P, McRobbie H, West, R. Manual of Smoking Cessation, A Guide for Counsellors and Practitioners Blackwell Publishing Stead L., Bergson G., Lancaster T. Physician advice for smoking cessation. Cochrane Database Syst Rev 2008; (2): CD Benowitz NL, Nicotine Addiction. N Engl J Med 2010;362:

31 References Australia s Health AIHW 2010 Central Northern Adelaide Health Service and Drug and Alcohol Services of South Australia, The tobacco and mental illness project, Images from the Noun Project: Ryan Choi, Anbileru Adaleru, Trace Lexington Byrd