Community pharmacist Dave Edwards — the first community pharmacist to provide smoking cessation services contracted by Hywel Dda University Health Board in Wales — says running the services can be time-consuming with little financial incentive, but the professional rewards are huge.
Edwards, who has a 60% success rate in persuading smokers to quit, says: “There’s not a lot of money in [smoking cessation services] — it works out at about £12 an hour per patient. We also don’t get any money through the drug tariff for the nicotine replacement therapy.
“But then, isn’t smoking cessation what we should be doing as community pharmacists, which is to help people lead more healthy lifestyles? I really enjoy it — you get to talk to your customers and you share in their success — it’s very tangible.”
Edwards is one of 33 community pharmacists in the Hywel Dda University Health Board’s district who has signed up to the level three service since it was introduced in 2014. There are 99 community pharmacists in the district in total.
These 33 pharmacists treated 249 smokers between April 2015 and March 2016 and, according to board statistics, 40% of smokers who signed up for the smoking cessation service had quit by September 2016.
The top quit rate of 60% was reached by two pharmacies, one of which was the Boots pharmacy in Whitland, where Edwards is store manager.
The success of the Hywel Dda service emerges as the UK deadline for new packaging restrictions on cigarettes passed on 20 May 2017 — just 11 days before World No Smoking Day on 31 May 2017.
The packaging changes reflect new regulations — the Standardised Packaging of Tobacco Products Regulations 2015 and the revised EU Tobacco Products Directive (2014/40/EU).
The new regulations say that it is illegal to use bright colours on cigarettes and tobacco packaging.
Instead, all packaging must be coloured the same, drab green with large graphic images on the front and back, highlighting the health effects of smoking. Health warnings must also appear on the top of all packs.
Edwards, a former smoker, believes the new regulations are important in the battle against tobacco. He says: “It’s a good idea because I think there is a lot of kudos attached to the brand of cigarette you smoke. If you take away the kudos, say, of smoking a Marlboro, and everyone has this green, dull packaging, it may help.”
Source: MAG / The Pharmaceutical Journal
The introduction of standardised tobacco packaging was welcomed by Robbie Turner, director for England at the Royal Pharmaceutical Society, who says that smoking cessation is “one of the most widely commissioned services through community pharmacies”.
“We help people to reduce or quit smoking every day. Any measure which seeks to reduce the number of people smoking and acts as a further prompt to quit will be welcomed by all health professionals,” he says.
“Unfortunately, smoking cessation services are now being decommissioned from pharmacies in areas which have previously demonstrated great success. The support offered by pharmacists to their communities is vital and must continue to be resourced.”
In a statement issued on 19 May 2017, Parveen Kumar, professor of medicine and education at Barts and the London School of Medicine and Dentistry and chair of the board of science at the British Medical Association (BMA), said introducing standardised tobacco packaging “is a significant step forward and will save lives”.
She added: “Standardised packaging will help to eradicate this marketing power for tobacco companies, and will increase the impact of health warnings.”
The BMA is campaigning for a tobacco-free society by 2035 and wants the next government to introduce a revised ‘Tobacco control plan’ that would include a levy on tobacco companies. Kumar says the ‘polluter pays’ levy would fund more smoking cessation services with more people quitting.
The UK is only the second country in the world to legislate on standardising tobacco product packaging, following the example set by Australia.
Deborah Arnott, chief executive of health charity Action on Smoking and Health, says the UK is a “global leader in tobacco control”.
She explains: “We now have among the fastest-declining smoking rates in the world thanks to decades of sound policy, but smoking rates among the poorest and most disadvantaged remain high. If this is to change, then a priority for the next government must be to publish a new tobacco control plan with tough new targets, focused on tackling health inequalities.”
The deadline for new packaging controls came in as new research published in The BMJ
(online, 22 May 2017) revealed that targeting smokers who want to give up with multiple automated tailored emails can “significantly” improve quit rates.
The researchers discovered that those smokers who received 27 tailored emails had a 34.0% quit rate compared with the 25.8% quit rate among another group of smokers who received a single non-tailored email.
They found no difference in the quit rates of a third group who received three to four emails (30.8%) and the single email group (P =0.13).
“Stand-alone tailored, multiple emails providing support, motivation and information during a quit attempt are an easily deployable, inexpensive mode of providing effective cessation assistance to large numbers of smokers planning to quit,” they conclude.
 Westmaas JL, Bontemps-Jones J, Hendricks PS et al. Randomised controlled trial of stand-alone tailored emails for smoking cessation. BMJ Online First: May 22 2017. doi: 10.1136/tobaccocontrol-2016-053056