Evaluating NHS Stop Smoking Service engagement in community pharmacies using simulated smokers: fidelity assessment of a theory-based intervention

ObjectivesSmokers are more likely to quit if they use the National Health Service (NHS) Stop Smoking Service (SSS). However, community pharmacies experience low service uptake. The Smoking Treatment Optimisation in Pharmacies (STOP) programme aims to address this problem by enhancing staff training using a theory-based intervention. In this study, we evaluated intervention fidelity using simulated smokers (actors) to assess smoker engagement and enactment of key intervention components by STOP trained staff.DesignAn observational pilot study.SettingsFive community pharmacies in North East London with an NHS SSS.MethodsSix actors, representative of East London’s population, were recruited and trained to complete intervention fidelity assessments. Consenting pharmacy staff from five participating pharmacies received STOP Intervention training. Four weeks after the staff training, the actors visited the participating pharmacies posing as smokers eligible for smoking cessation support. Engagement behaviour by pharmacy staff and enactment of intervention components was assessed using a scoring tool derived from the STOP logic model (scoring range of 0–36), and contemporaneous field notes taken by actors.Results18 of 30 completed assessments were with STOP trained staff (10/18 were counter assistants). Mean score for smoker engagement was 24.4 (SD 9.0) points for trained and 16.9 (SD 7.8) for untrained staff, respectively. NHS SSS leaflets (27/30) were the most common smoking cessation materials seen on pharmacy visits. Most trained counter staff engaged with smokers using leaflets and a few proactively offered appointments with their cessation advisors. Appropriate use of body language was reported on 26/30 occasions alongside the use of key phrases from the STOP training session (n=8). Very few pharmacy staff wore STOP promotional badges (4/30).ConclusionsSTOP training may change client engagement behaviour in pharmacy staff and could improve the uptake of the NHS SSS. A cluster randomised controlled trial is currently in progress to evaluate its effectiveness and cost-effectiveness.Trial registration numberISRCTN16351033.

Stop Smoking Practitioners’ understanding of e-cigarettes’ use and efficacy with particular reference to vapers’ socioeconomic status

Introduction: We have undertaken four online surveys of Stop Smoking Service (SSS) practitioners in England, between 2011 and 2016, in order to enhance our understanding of e-cigarettes: a fast moving new phenomenon. It is important to understand whether e-cigarettes can ameliorate or exacerbate health inequalities given that smoking is one of the most serious causes of excessive mortality and morbidity among disadvantaged groups globally.Aims: To update findings of previous surveys and examine socioeconomic status differences in e-cigarette use and efficacy.Methods: Analysis was undertaken of electronic surveys, particularly, the most recent 2016 survey (n = 514) and 2015/16 SSS client routine monitoring data.Results: SSS practitioners were becoming more positive about e-cigarettes: 42% agreed that e-cigarettes were a good thing compared with 15% in 2011. Reported use of e-cigarettes among SSS clients was low (about 3%) despite higher quit rates (63% of clients reported being quit at four week follow-up, compared with 51% overall). Where socioeconomic differences in e-cigarettes’ efficacy for quitting were identified, affluent and working smokers were advantaged.Conclusions: Low use of e-cigarettes by clients and practitioner opinions suggest that further education of SSS staff is needed if they are to adopt the current service recommendations about e-cigarettes.

Opinions of women from deprived communities on the NHS stop smoking service in England - person-centered perspectives.

Background In most European countries, women are relatively more susceptible to smoking-related diseases, find it more difficult to quit and more likely to relapse than men. With the aim to improve understanding of women’s needs from smoking cessation services, this qualitative study examines perceptions of women from deprived communities on the National Health Service Stop Smoking Service in England.Methods A qualitative study of 11 women, smokers and ex-smokers, who had used Stop Smoking Services located in disadvantaged communities in East Sussex, England. Data were collected through focus group and semi-structured interviews, and were subjected to thematic analysis.Results Women felt that services tailored to their needs would improve cessation rates. They expect smoking cessation facilitators to be non-judgemental and to offer psychological insight into addiction. However, women’s opinions differed on the importance for facilitators to be female or ex-smokers, and on the preference of group or one-to-one services, some women expressed a preference for women only groups. The women praised the continuity of care, capacity for peer support, flexibility of time and location and free cessation aids offered. Conversely, the women felt that services were poorly advertised, that access was not universally good, and that services at work place and drop-in groups would improve access for working women and women with young children.Conclusion Flexible services that are tailored towards the needs of individual smokers and better dissemination of information regarding the range of services available could facilitate greater uptake of smoking cessation services for women in deprived communities.