Real world evaluation of three models of NHS smoking cessation service in England.
BACKGROUND
NHS Stop Smoking Services provide various options for support and counselling. Most services have evolved to suit local needs without any retrospective evaluation of their efficiency.Three local service evaluations were carried out at Bournemouth & Poole Teaching Primary Care Trust (PCT) (PCT1), NHS South East Essex (PCT2) and NHS Warwickshire (PCT3) to describe the structure and outcomes associated with different services.


RESULTS
Standardised interviews with key personnel in addition to analysis of data from 400 clients accessing the service after 1st April 2008 in each PCT. The PCTs varied in geography, population size and quit rate (47%-63%). Services were delivered by PCT-led specialist teams (PCT1), community-based healthcare providers (PCT3) and a combination of the two (PCT2) with varying resources and interventions in each.Group support resulted in the highest quit rates (64.3% for closed groups v 42.6% for one-to-one support (PCT1)). Quit rates were higher for PCT (75.0%) v GP (62.0%) and pharmacist-delivered care (41.0%) where all existed in the same model (PCT2). The most-prescribed therapy was NRT (55.8%-65.0%), followed by varenicline (24.5%-34.3%), counselling alone (6.0%-7.8%) and bupropion (2.0%-4.0%).


CONCLUSIONS
The results suggest that service structure, method of support, healthcare professional involved and pharmacotherapy all play a role in a successful quit. Services must be tailored to support individual needs with patient choice and access to varied services being key factors.
South East Essex PCT, South Essex Stop Smoking Service, Mapline House, 14Bull Lane, Rayleigh, Essex SS6 8JD, UK.
Tony
T
Mardle
Shirley
S
Merrett
Jane
J
Wright
Fran
F
Percival
Ian
I
Lockhart
D000293:Adolescent; D000328:Adult; D001552:Benzazepines / Q000494:pharmacology / Q000627:therapeutic use*; D016642:Bupropion / Q000494:pharmacology / Q000627:therapeutic use*; D003153:Community Health Services; D003376:Counseling; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D018722:Nicotinic Agonists / Q000494:pharmacology / Q000627:therapeutic use*; D011247:Pregnancy; D015397:Program Evaluation; D011810:Quinoxalines / Q000494:pharmacology / Q000627:therapeutic use*; D012907:Smoking; D016540:Smoking Cessation / Q000379:methods*; D013222:State Medicine; D011795:Surveys and Questionnaires; D061485:Tobacco Use Cessation Devices; D016896:Treatment Outcome; D000068580:Varenicline
D001552:Benzazepines; D018722:Nicotinic Agonists; D011810:Quinoxalines; D016642:Bupropion; D000068580:Varenicline