Advising smokers to stop is successful, says NICE
Brief chats with smokers about quitting are both successful in encouraging them to stop and cost-effective, the National Institute for Health and Clinical Excellence says in its first public
health intervention guidance published last week.
“We found unequivocal evidence that these interventions make a
difference to behaviour,” said Matt Kearney, a GP and member of
the independent Public Health Advisory Committee that formulated the
recommendations.
Brief interventions may include simple advice to stop, an assessment
of the patient’s commitment to quit, an offer of pharmacotherapy
and behavioural support, and provision of self-help material or referral
to more intensive support.
The guidance states that GPs and nurses should advise all smokers to
quit. Pharmacists, it says, should refer people who smoke to an intensive
support service such as the NHS Stop Smoking Service, or if appropriate
to themselves. If the smoker is unwilling or unable to accept this referral,
a pharmacist with suitable training should offer treatment and additional
support.
The guidance has attracted a lukewarm response from the public health
charity PharmacyHealthLink, which says that the guidance fails to reflect
the role of pharmacists in smoking cessation.
Miriam Armstrong, chief executive of PharmacyHealthLink, said: “We
are extremely disappointed for two main reasons. First, the new guidance
could be interpreted as suggesting that pharmacists should refrain from
opportunistically advising smokers to stop. Secondly, PharmacyHealthLink
specifically advised NICE on the relevance of the new pharmacy contract
to their public health guidance. In particular, we suggested that, as
pharmacists are already required to provide opportunistic brief advice,
as well as prescription-linked brief advice under the essential services
element of the new contract, this would need to be reflected in the new
guidance.”
However, it was clear at the launch of the guidance that NICE believes
all health professionals have a role to play in helping smokers to quit.
Mike Kelly, director of the NICE Centre for Public Health Excellence,
said that all health professionals should actively engage in brief discussions
during consultations. Pharmacists should give opportunistic advice to
smokers, he said. “If a patient asks about nicotine replacement
therapy that is the moment that pharmacists should be taking it forward,” he
added.
To coincide with the launch, public health minister Caroline Flint announced
an amendment to the “Standards for better health”, which
reinforces the status of NICE public health guidance and allows the Healthcare
Commission to assess the progress of NHS organisations towards implementing
it.
NICE guidance on the optimal provision of smoking cessation services
is currently under development and is due to be published in summer 2007.
Guidance can be accessed at www.nice.org.uk |
The
Pharmaceutical Journal
Acrobat
Reader