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Wednesday, October 30, 2013 - 11:03
Data analysis

English stop smoking services have helped 20,000 to quit, but much variation exists. Stop smoking services across England have had an increasing impact in helping smokers to quit in their first 10 years of operation and have successfully reached disadvantaged groups, finds a study published on bmj.com today.
However, performance across local services has varied considerably and requires attention, say the authors.
In 1998, the UK government established a network of stop smoking services to ensure that every smoker in the country who wanted help with stopping would have access to evidence-based support as well as medication.

Other countries have since followed this model for helping their smokers to stop.
Evidence indicates that, when these services are provided optimally, the proportion of users who stop for four weeks should be around 50%, with 15% lasting 12 months, compared with 15% at four weeks and less than 5% at 12 months if these smokers tried to stop unaided.
So a team led by Robert West, Professor of Health Psychology at University College London, set out to analyse the performance of the service over its first 10 years of operation.
Annual figures were obtained from April 2001 to March 2011 for number of quit dates set (throughput); percentage of biochemically verified abstinence after four weeks (four week quit rate); and the researchers then calculated, using previously published data, the number of four week quitters beyond those who would be estimated to have stopped with medication only (impact).
Information for each smoker including gender, age, ethnic group, type of medication used, and mode of delivery (one-to-one or group based sessions) was also recorded. Variability across local services in throughput, four week quit rates and impact was assessed for 2010/11.
Throughput rose from 227,335 in 2001/02 to 787,527 (8% of all smokers) in 2010/11. The percentage of four week quitters declined slightly from 35% to 34%, with a dip to 31% in 2007/08. This meant that, overall, the total number of four week quitters rose from 79,767 to 269,293.
Impact trebled from 22,933 four week quitters created in 2001/02 to 72,411 in 2010/11 (corresponding to an estimated 21,723 12 month quitters).
The services were also successful in reaching disadvantaged smokers with 54% receiving free prescriptions in 2010/11. However, substantial variation existed across local services in throughput, success rates, and impact.
In conclusion, the authors say that, over 10 years of operation, the English stop smoking services have increased their reach and impact threefold.
In 2010/11 they were used by some 8% of all smokers, including a high proportion of those with economic disadvantage, and can be estimated to have helped more than 20,000 to achieve long term abstinence, saving almost 25,000 life years.
However, they point to considerable variability in outcomes across local areas, which they say needs further investigation.
Robert West, Professor of Health Psychology, Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, UK
Mobile: +44 (0)7813 916 681
Email: robert.west@ucl.ac.uk
Embargoed link to full paper: http://press.psprings.co.uk/bmj/august/smokingservice.pdf
Public link once embargo lifts: http://www.bmj.com/cgi/doi/10.1136/bmj.f4921
“Why I blew the whistle on the government’s disability assessments” from former Navy doctor
Personal View: I blew the whistle on the government’s disability assessments
A former Navy Doctor and disability analyst at Atos reveals why he chose to blow the whistle on the government work capability assessment, on bmj.com today.
Dr Greg Wood explains that he made the decision to publicise his concerns about the Atos work capability assessment (WCA) because of interference with reports which he felt “encroached on my professional autonomy and crossed ethical boundaries”, in his BMJ opinion piece.
The system’s implementation, he says, makes it unduly hard for claimants to quality for benefits and therefore overlooks a number of limiting factors of the assessment method that might suggest otherwise.
Dr Wood argues that reports were finalised despite one in five lacking key written evidence, and also reveals that Atos auditors instructed clinicians to change their reports without having examined the patient themselves.
Contrary to the purpose of the WCA – to save money from the taxpayer being awarded in benefits to those who are in fact capable of working – Dr. Wood believes that the cost of successful tribunal appeals against the DWP from those unjustly forced to work was an additional waste of taxpayer money.
“Medical knowledge was being twisted [and] misery was being heaped on people with real disabilities”, he argues.
Since Dr Wood blew the whistle, the DWP made the decision to retrain all Atos assessors and call in external auditors to ensure accurate work capability assessments would take place in the future. (Dr. Greg Wood, Former Naval Doctor and Atos Disability Analyst, can be contaced on: Tel: +44 (0)7770 613434 or Email: dr.greg.wood.wca@gmail.com

Australia experience

Meanwhile, in July, the UK government announced that there would be a delay on the decision on plain packaging, until findings from Australia emerge. The first study from Australia published since plain packaging came into effect found that smokers who used plain packs perceived their cigarettes to be “less satisfying and poorer quality” and “were more supportive of plain packaging and more likely to think about and to prioritise quitting”.
Past research shows that desire to quit is a “reliable predictor” of whether someone tries to stop smoking with studies showing that high motivation is an important factor in quitting.
Moodie draws on the findings from the Australian study which he says supports one of the UK Government’s public health policy priorities, namely to encourage smokers to quit, but questions whether they are enough to influence UK policy. He says that there is a “rapidly growing body of evidence on this issue” which is consistent in its findings: plain packaging would reduce appeal; increase the effectiveness of health warnings and reduce the ability of packaging to mislead consumers about the harmful effects of smoking.

Copyright © Insurance Times and Investments® Vol:26.8 1st August, 2013
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