Bmj: stop smoking service saved 25,000 years of life


Bmj: stop smoking service saved 25,000 years of life

Researchers have analyzed the benefit of government-led "stop smoking" services to encourage people to quit cigarettes for good.

The study, published in the BMJ, analyzed the performance of English stop smoking services between April 2001 and March 2011.

In 1998, the UK government decided to establish a network of stop smoking services.

All smokers in England have free access to local National Health Service (NHS) stop smoking services. This means smokers can visit a local health center for free support, receive a free stop smoking kit, and access to a stop smoking helpline. Similar services are offered across the whole of the UK.

As background to their work, the researchers from University College London cited evidence showing that when these services are provided successfully, the proportion of users who are still not smoking after four weeks should be around 50%, with 15% lasting for 12 months. By comparison, for smokers who had no support to stop, the estimates were that 15% lasted four weeks, and less than 5% lasted 12 months.

For the study, the researchers gathered personal information about the smokers and how they tried to stop, including:

  • Age
  • Gender
  • Ethnic group
  • Medication used
  • Type of support (one-to-one or group-based stop-smoking sessions).

Additionally, the researchers obtained annual figures over the ten-year period for:

  • Number of "quit smoking" dates set (throughput)
  • Percentage of people who quit smoking after four weeks.

England's stop smoking services helped over 20,000 people over the past decade to quit long-term.

They used the previous published data to calculate and compare numbers of people with no support who quit for more than four weeks.

The findings

Overall, results of the analysis revealed that in 2010/11, the services were used by 8% of all smokers in England.

The services are estimated to have helped more than 20,000 people to quit smoking long-term, and have saved almost 25,000 years of life.

The numbers of people setting "quit smoking" dates rose between the years 2001/02 to 2010/111 - at the beginning of the decade, 227,335 people set a date, rising to 787,527 in 2010/11.

The percentage of people who quit at four weeks remained steady, falling only slightly from 35% in the early years of the new millennium, to 34% in 2010/11. But while this proportion did not change much, the total absolute numbers of four-week quitters rose - from 79,767 to 269,293.

The researchers found that the services were also successful in reaching smokers who were disadvantaged, with 54% receiving free prescriptions in 2010/11.

Other countries have since followed the UK's footsteps in developing ways to encourage people to quit smoking. In 2010, The World Health Organization set up guidelines for the implementation of the WHO Framework Convention on Tobacco Control to encourage countries to adopt ways to help smokers to quit, as well as reduce tobacco exposure.

In the US currently, there are no government-led stop smoking services similar to those in the UK. However, there are individual programs targeted at smokers to help them quit.

For example, the American Lung Association offers a program called Freedom From Smoking. This is a group clinic made up of eight sessions providing information in a step-by-step plan to help smokers quit for good.

Alternative methods are also being used in the US - under the Patient Protection and Affordable Care Act (PPACA), those who smoke are now required to pay a 50% surcharge for their health insurance.

According to Professor John Banzhaf of the George Washington University Law School, this surcharge is already encouraging people to quit smoking, with many employers reporting that it has halved smoking rates in the workplace.

However, the researchers of the English study say that other countries could learn from the positive results that English stop smoking services have had. The study authors say:

"Other countries that have national services, or regions that have regional ones, can be reassured that providing this kind of individual level public health intervention at a population level is possible."

The authors continue: "However, they can also learn lessons from the English services about the need to pay close attention to variability in performance, and the importance of rigorous monitoring and finding ways of fostering good practice."

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