Stop Smoking Wales Quarterly Report 1 January to
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1 Quarterly Report 1 January to 31 March Regional Smoking Cessation Co-ordinator Date: 23/06/09 Version: 1 Status: Final Intended Audience: WAG / Public (Internet) / NHS Wales (Intranet) / NPHS (Intranet) / Team (Specify) Strategic Management Group: Health Improvement Meeting Date: N/A Review Date: N/A Relevant Previous Documents: N/A Sponsor: Andrew Jones Director of Health Improvement Purpose and Summary of Document: To provide an update on activity and outcomes between 1 January 2009 and 31 March Publication/Distribution: Publication in NPHS Document Database (Specify Database) Link from NPHS e-bulletin Link from Stakeholder e-newsletter Other distribution/publication (specify) Version: 1 Page: 1 of 10 Intended Audience: WAG
2 Contents Page 1 Executive Summary 3 2 Results 4 3 Appendices 6 Version: 1 Page: 2 of 10 Intended Audience: WAG
3 1. Executive Summary This report summarises activities of between 1 January and 31 March It does not include any data from any smoking cessation activity occurring within primary, secondary or tertiary care. During the period 1 January to 31 March 2009: 5167 clients contacted Of those 5167 clients, 2414 clients were treated smokers Of those 2414 clients, 1500 had successfully quit post quit date Of those 1500 clients, 1002 clients were validated by carbon monoxide monitoring and confirmed as not smoking 1321 clients were eligible for 12 month follow up during this period Of those 1321 clients, 486 remained stopped at 12 months Version: 1 Page: 3 of 10 Intended Audience: WAG
4 2. Results It should be noted that is in the process of upgrading the data collection and recording methods used, therefore caution should be exercised when comparing the results presented in this report with previous reports produced by the service. There continues to be variations across Wales in contacts and results at LHB area level and the service is working to more fully understand these differences and to implement action plans to address variation. The activity and outcomes of between 1 January and 31 March 2009 are provided in Appendix One. These can be summarised as follows: Activity and outcome at four weeks by LHB and region: There were a total of 5167 contacts to the service. Mid and West Wales experienced a proportionately higher number of contacts partly due to the level two pharmacy scheme that is in operation in Swansea. It is acknowledged that the number of clients contacting the service from the Vale of Glamorgan, Ceredigion, Gwynedd and Monmouthshire is low and this is being addressed. Of all contacts to the service 46.7 per cent became treated smokers, whilst 22.1 per cent only attended an assessment session and 31.2 per cent failed to attend an appointment. There were variations across Wales in the number of contacts who become treated smokers. The rates ranged between 64.8 per cent in Ceredigion to 33.9 per cent in Carmarthenshire. Across Wales 89.6 per cent of treated smokers were successfully followed up post quit date. Of a total of 2414 treated smokers, 62.1 per cent ed abstinence, the rates varied across Wales and work is underway to understand the reasons for this. The total number of treated smokers who were verified as not smoking at four weeks post quit date by CO monitoring was 1002 which represents 66.8 per cent of those who ed abstinence. It should be noted that it is only possible to CO validate those clients who attend a week six session as this coincides with four weeks post quit date, it is therefore only possible to provide the ed status for clients not attending week six. Of the total number of treated smokers 41.5 per cent were CO verified as abstinent at four weeks post quit date. Activity and outcomes at four weeks by age, gender and ethnicity: The highest numbers of contacts in the reporting period were from females aged between 35 and 59 who accounted for 25.2 per cent of all contacts. The least contacts were received from males aged under 18 (0.6 per cent). Overall a higher proportion of females (56.6 per cent) contacted the service than males (43.4 per cent). For both males and females the highest proportion of contacts were aged between 35 and 59 (43.5 per cent) and the lowest from those aged under 18 (1.4 per cent). Males aged 60 years or over had the highest proportion of contacts who became treated smokers (57.0 per cent). Overall more females (47.2 per cent) became treated smokers compared to males (46.0 per cent). For both males and females the highest age group to Version: 1 Page: 4 of 10 Intended Audience: WAG
5 become treated smokers was 60 years and over (56.7 per cent); the lowest age group was under 18 (31.9 per cent). With regards to quit status at four weeks males aged between 35 and 59 had the highest success rate (71.6 per cent). Overall 64.0 per cent of males ed that they had successfully quit compared to 60.8 per cent of females. For both females and males, those aged between 35 and 59 had the highest quit rate overall; 67.0 per cent compared to 43.5 per cent of under 18s. Males aged 60 years and over had the highest CO validated quit rate (51.3 per cent). Data is not presented for number of contacts by ethnic group as it is not currently collected when the client first contacts the service by telephone; therefore the ethnic group is only known if a client attends an appointment and completes the service questionnaire. A majority of treated smokers were in the White category (98.9 per cent). The highest rate of ed quitters is in the Asian category (75.0 per cent) compared with the lowest rate of 49.5 per cent in the White category. However, caution should be applied when interpreting these figures due to the low numbers involved. Outcomes at 12 months by LHB and region: Of those clients eligible to be followed up at 12 months, 76.5 per cent were successfully contacted. The follow up rate ranged from 82.5 per cent in North Wales to 72.3 per cent in Mid and West Wales. The overall quit rate at 12 months was 36.8 per cent, this ranged from 42.9 per cent in North Wales to 34.1 per cent in South East Wales. At an LHB level the quit rates ranged from 62.1 per cent in Anglesey to 16.9 per cent in Newport. Outcomes at 12 months by age, gender and ethnicity: Males aged 60 years and over had the highest ed quit rate at 12 month when excluding those aged under 18. Males overall had a higher ed quit rate (38.0 per cent) than females (35.8 per cent) at 12 months post quit date. Females aged between 34 and 59 and males aged 60 years and over ed the highest abstinence at 12 months, when excluding female under 18. The least successful age to quit at 12 months were under 18s (14.3 per cent). Version: 1 Page: 5 of 10 Intended Audience: WAG
6 Table 1: Activity and outcome by health area Health Area Local Authority No. of contacts Attended info session only Treate d smokers No. followed up No. quit %. quit No. quit CO validated % quit CO validated North Wales Anglesey Conwy Denbighshire Flintshire Gwynedd Wrexham Mid and West Wales Bridgend Carmarthenshire Ceredigion Neath Port Talbot Pembrokeshire Powys Swansea South East Wales Blaenau Gwent Cardiff Caerphilly Merthyr Tydfil Monmouthshire Newport Rhondda Cynon Taff Torfaen Vale of Glamorgan Wales Version: 1 Page: 6 of 10 Intended Audience: WAG
7 Table 2: Activity and outcomes by age, gender and ethnicity Gender Age band No. of contacts Attended info session only Treated smokers No. followed up No. quit %. quit No. quit CO validated % quit CO validated Female All ages under Male All ages under Persons All ages under Persons All persons White Mixed Asian Black Other includes age not given 2 includes ethnic group not given Version: 1 Page: 7 of 10 Intended Audience: WAG
8 Table 3: Outcomes at 12 months by health area Region Local Authority No. eligible to be followed up at 12 months No. followed up No. quit at 12 months % quit at 12 months North Wales Anglesey Conwy Denbighshire Flintshire Gwynedd Wrexham Mid and West Wales Bridgend Carmarthenshire Ceredigion Neath Port Talbot Pembrokeshire Powys Swansea South East Wales Blaenau Gwent Cardiff Caerphilly Merthyr Tydfil Monmouthshire Newport RCT Torfaen Vale of Glamorgan Wales Version: 1 Page: 8 of 10 Intended Audience: WAG
9 Table 4: Outcomes at 12 months by age, gender and ethnicity Gender Age band No. eligible to be followed up No. followed up No. quit at 12 months self report %. quit at 12 months Female All ages under Male All ages under Persons All ages under Persons White Mixed Asian Black Other includes age not given Version: 1 Page: 9 of 10 Intended Audience: WAG
10 APPENDIX 2: Calculations of Service Outcome 1. The Russell Standard (Clinical) is widely accepted as the leading standard for calculating outcomes in smoking cessation services. 2. The following definitions from the Russell Standard have been used to produce the service outcomes for 2006/7: i. Treated Smoker A smoker who undergoes at least one treatment session. Smokers who attend an initial information session but fail to attend thereafter are not counted. ii. 4 Week Quitter (self-reported) A smoker is counted as a 4 week quitter (self- report) if s/he is a treated smoker, who is assessed (face-to-face, by postal questionnaire or by telephone), 4 weeks after the designated quit date and declares that he/she has not smoked even a single puff of a cigarette in the past 2 weeks. iii. 4 Week Quitter (Carbon Monoxide (CO)-verified) A smoker is counted as a 4 week quitter (CO-verified) if s/he is a self-reported 4-week quitter and his/her expired air CO is assessed 4 weeks after the designated quit date and found to be less than 10ppm. iv. Lost to Follow Up A treated smoker is counted as lost to follow-up if, on attempting to determine the 4 week quit status, s/he cannot be contacted. v. 52 Week Quitters A smoker is counted as a 52 week quitter if they are a 4 week quitter (self-report) and if when contacted at 52 weeks (face-to face, by postal questionnaire or by telephone) report that they have smoke no more than 5 cigarettes over the past 50 weeks. Version: 1 Page: 10 of 10 Intended Audience: WAG
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