Longer term outcomes & S top smoking services

1. Longer term outcomes &Stop smoking services

3. Acknowledgements This project was funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme (project number 09/161/101) and will be published in full in Health Technology Assessment. The views and opinions expressed are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health. Thanks to the UK Centre for Tobacco and Alcohol Studies, North51, National Centre for Smoking Cessation and Training, participating Stop Smoking Services, PCRN/CLRN, TNS-BMRB.

4. Outline Background to the study – Evaluating Longer-term Outcomes from NHS Stop Smoking Services (ELONS) Overall results: 4 and 52 week quit rates 4 and 52 weeks quit rates by key variables ELONS compared with previous studies Impact

5. Aim and objectives • The study aimed to: • explore the factors that determine longer term abstinence from smoking following intervention by NHS stop smoking services. • Objectives were to: • examine the effectiveness of NHS stop smoking services by PCT and intervention type using routine data • explore the reach of services by identifying what proportion of the local population set a quit date with services using routine data • describe the factors that determine longer term abstinence from smoking or relapse to smoking • examine the relationship between client characteristics, adherence to treatment, intervention type received, and longer term abstinence

6. Study design • Observational study • Part 1 - Secondary analysis of routine data collected by SSSs using the North51 database – completed Spring 2012 • Part 2 - Prospective study of clients from 9 Stop Smoking Services in England examining different types of behavioural support: • closed groups • rolling groups • one to one drop-in • one to one sessions with a specialist advisor • one to one sessions with a sessional advisor (i.e. practice nurse or pharmacist)

7. Prospective study • Baseline • Stop Smoking Advisors collected additional monitoring data and saliva samples (at or around the time a quit date was set ) • 4 weeks post quit date via N51 QuitManager database • Self reported abstinence and CO measurement • Client satisfaction survey • Record of pharmacotherapy taken and session attendance • 52 weeks post quit date via TNS-BMRB • Self reported abstinence and CO measurement (CO measurements taken during a home visit for those who report they have quit) • Collection of saliva samples

8. Prospective study analysis • Final achieved sample was 3075 • Weights created to improve the representativeness of the data (for the nine study sites) • 2 stages of analysis: • Bivariate descriptive analysis • Multivariate logistic regression

9. CO validated quit rates (n=3057) * Weighted for behavioural support, location, age, gender, SES.

10. Participant characteristics

11. Smoking-related characteristics

12. Service and timing

13. Comparison with previous studies

14. Comparison with monitoring: UK

15. Impact • 724,247 quit attempts with services in England April 2012 to March 2013 • 373,872 quit at 4 weeks (265,140 CO validated) • 55,767 estimated quit at 12 months from ELONS data • 879,458 quit attempts with services across the UK April 2012 to March 2013 • 67,718 estimated quit at 12 months if we assume similar outcomes to ELONS

16. Impact Best estimates suggest that the lifetime risk of relapse to smoking after one year is 35% On this basis if we use the ELONS results, around 44,000 adults in England who used the services in 2012/2013 stopped smoking for good. This means many premature deaths from smoking-related diseases were prevented.

17. Thank you Linda.Bauld@stir.ac.uk