Stop-smoking advice to focus on deprived areas
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Community pharmacists have a big role to play in helping people
give up smoking |
Help for people living in deprived areas to give up smoking is at the heart of new public
health guidance from the National Institute for Health and Clinical Excellence. The ability of pharmacists and their staff to reach smokers in the community was highlighted this week at a press conference to launch the guidance.
Christine Owens, from the Roy Castle Cancer Foundation and a member of
NICE’s development group for the guidance, said: “Those people
who are in the most socially deprived communities — people who
can least afford to smoke — actually have the least support. If
you are working in a population where it is the norm to smoke it is much
harder to break out of that and become a non-smoker.”
“Community pharmacists have a big role to play,” she also
pointed out, “because they are there in the community and there
is no need to book an appointment to see the pharmacist.” Ms Owens
added that pharmacists have good existing relationships with many people
within
their local communities.
However, in its guidance NICE does not make explicit recommendations
that primary care trusts and other commissioning bodies should invest
in pharmacy stop-smoking services. Ms Owens commented: “It certainly
runs through the guidance — the
role that community pharmacists can play — and one of the important
members of the [development group] was a community pharmacist.” She
was referring to Liverpool City councillor and pharmacist Ron Gould.
She
explained that the guidance looks at what PCTs can do to reach out to
people within their particular populations who smoke, rather than
being prescriptive, but she acknowledged: “If you were a commissioner
looking at how you do that, then community pharmacists have got to be
part of that mix.”
The need for renewed focus on educating pregnant women who smoke, particularly
those in their teens, as well as their families, was also highlighted
at the briefing.
What the NICE guidance says
Nicotine replacement therapy, varenicline
or bupropion are recommended by NICE as treatment options for
people who are planning to stop
smoking on a particular date — prescribed alongside advice
or referral to a smoking cessation service. According to the
guidance, subsequent supplies of medicines should only be given
to people
who have demonstrated that their quit attempt is ongoing when
assessed.
NICE says that no one medicine should be favoured. Rather the
clinician and patient should make a joint decision as to which
might be most
likely to succeed, based on the patient’s personal preferences.
The guidance states that people under 18 years of age, and women
who are pregnant or breastfeeding, should not be offered varenicline
or bupropion.
The document supersedes NICE’s “Guidance on the use
of nicotine replacement therapy and bupropion for smoking cessation” and
links in with other NICE guidance on smoking.
It is available online |
Other NICE guidance
Other new
guidance issued by NICE this month covers:
• Irritable bowel syndrome
• Osteoarthritis
• Prostate cancer
• Use of grommets for glue-ear
• Use of rituximab in follicular
non-Hodgkin’s lymphoma
• Community engagement as a public health intervention
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