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How to optimise your smoking cessation service

Two contractors talk to Saša Jankovic about how they are making the most of their smoking cessation services

Smoking cessation services have been a popular advanced service for many years now, helping patients to quit smoking while offering community pharmacies a way to bolster their bottom lines.

Pharmacies across England have been able to offer an advanced smoking cessation service (SCS) since March 2022, although similar services continue to be commissioned locally, such as Smokefree City and Hackney in east London. 

Read more: Pharmacy smoking cessation service set for slow start, PSNC anticipates

Pharmacy smoking cessation services have also been commissioned across Scotland and Northern Ireland and the Welsh national smoking cessation service Help Me Quit launched in 2017

Pharmacy-based smoking cessation services offer smokers advice and products that can help them to kick the habit, with individual fees differing from service to service.

 

What does the service entail?

 

The SCS allows patients who started their smoking cessation treatment in hospital – and who consent to be part of the ongoing service – to be referred to a participating pharmacy of their choice for continued support in the community.

Under the Help Me Quit service, pharmacies can offer quitters nicotine replacement therapy (NRT), consultations and advice.

Meanwhile, Smokefree City & Hackney offers smokers aged 18 or over who are looking to quit 12 weeks of free support from a pharmacy-based stop smoking advisor, as well as access to certain medications.

Read more: Plan to scrap London stop smoking service is ‘short sighted’

Pharmacist Jatin Damani at Safedale Pharmacy in Haringey, London, says he started offering a smoking cessation service about 15 years ago.

In order to offer the service, he and his team had to receive training, which was provided by Smokefree City and Hackney. Mr Damani and his dispenser completed the highest level of training.

The pharmacy also had to be certified by the National Centre for Smoking Cessation Training (NCSCT). His counter staff have also undertaken NCSCT training to allow them to approach patients about stopping smoking. 

Mr Damani says that smoking in his area is "very prevalent” so it is “quite a big health priority”, with “plenty of people to help”.

Under the service, quitters have weekly appointments with a stop smoking advisor. Working under patient group directions (PGDs) issued by Smokefree City & Hackney, the pharmacy can offer advice, encouragement and smoking cessation products. 

 

How much are pharmacies paid?

 

The fees pharmacies can claim for offering a smoking cessation service vary depending on each service specification.

Under the Smokefree City & Hackney model, pharmacies, GP hubs and community clinics are paid £6.25 for setting a quit date with a patient, with an additional fee if the patient is still on the programme after four weeks.

Meanwhile, those offering the Help Me Quit service can claim for a raft of fees including £4.98 per NRT item, £14.95 for an initial consultation and £11.69 for each patient who is confirmed to have quit after five consultations.

Read more: Pharmacies selling vapes should offer ‘behavioural support’ to users

Under the SCS, contractors can claim a £1,000 set-up fee as well as £30 for a first consultation, £10 for an interim consultation and £40 for a final consultation.

Mr Damani says his pharmacy offers patients various products under the service.

These include NRT, nicotine patches, gum, lozenges, inhalators, mouth spray and microtabs.

E-cigarettes “may be an option eventually”, too, he adds. However, at the moment the team can only advise patients that they could be useful in helping them quit, he explains.

The most important thing is providing “behavioural support plus the medication to go with it”, he notes. This is because “if a smoker says [they] want to give up and you just sell [them] the patches and say, 'There you go, bye," they are very likely to relapse or not succeed”, he adds.

 

How to target patients

 

Mr Damani says the pharmacy has put “posters in the window” to promote the service and the entire team tries to “target patients at every opportunity”.

He adds that looking at what sort of purchases customers are making over the counter (OTC) has often been a way in to the conversation as well.

For example, if a patient has come in for cough mixture because they are coughing a lot, the team doesn't ask directly if they smoke, but do ask whether anyone in the patient's family does.

This has often prompted the patient to admit that they are a smoker, giving the team a way to promote the pharmacy's smoking cessation service and “trigger" the patient's interest in the service, Mr Daman says.

Knowing the pharmacy's patient demographic has also been really helpful, he notes.

Read more: The latest on smoking cessation in community pharmacy

Smoking is prevalent in the local Turkish population so the team made a Turkish version of the smoking cessation form and “captured a lot of patients” that way, he explains.

Carys Spencer is a pharmacist and manager of Pontyclun Pharmacy in south Wales – which is one of five pharmacies in the Llanharan Pharmacy Ltd portfolio of pharmacies.

She says she has kept community engagement high with the pharmacy's smoking cessation service by promoting the annual stop smoking campaigns with a dedicated window display and promotional material near the counter.

The team also tries to refer any patients looking to buy NRT over the counter. “My staff and I know the community so well so we can have those conversations,” she adds.

Like Mr Damani, Ms Spencer says she and her team try to pick up on anybody trying to buy cough medicine and if she or the team thinks someone might be a smoker, they try to build information about the service into the conversation.

She provides both level 2 and level 3 components of the Help Me Quit service, which consists of a 12-week supervised programme, behavioural support and NRT.

 

Footfall picking up

 

Mr Damani says his pharmacy saw between five and 10 patients a week between two advisors for the service pre-COVID-19 and it is just picking up again now.

He finds it really satisfying helping people in this way, particularly as he is a recent ex-smoker himself and can put himself in their shoes.

Mr Damani makes it clear to patients that “we will hold [their] hand all the way through”, which “makes them feel they have someone to talk to and aren’t alone”, he adds.

However, the offer of help isn't limited to a one-off period of 12 weeks – another 12 weeks of support can be provided if necessary.

Meanwhile, Ms Spencer says that, on average, her pharmacy's smoking cessation service helps three or four patients per month, although she notes that the new year is a "busier" period.

 

Working with others

 

Pharmacies can also join public health campaigns such as Stoptober to help their patients stop smoking.

Ms Spencer says she has taken her smoking cessation knowledge further afield and has tried to take best practice from non-pharmacy organisations as well.

Having heard that Action on Smoking and Health (ASH) Wales was looking for pharmacists to help support its awareness sessions, Ms Spencer hosted “a couple of sessions in Bridgend College targeting younger people who were smoking”, she says.

She hosted a similar session at Amazon's Swansea distribution centre, "where people were working shifts so [were] not regular users of community pharmacy”.

If ASH Wales thought a patient was suitable, it would signpost them to their nearest pharmacy offering smoking cessation “if [they were] interested in quitting”, says Ms Spencer.

For example, she says she spoke to a young pregnant woman in Bridgend, who was unsure as to whether she could use NRT. Speaking with the woman meant "I could encourage her to get it sorted”, she explains.

Read more: Three new community pharmacy services to be piloted 'by spring'

Working with local GP surgeries is also really important, according to Mr Damani.

Three tips for boosting profits

  • Ask GPs to signpost patients to your service.

  • Create leaflets in languages used in your local area to reach more potential quitters.

  • Consider off-site engagement opportunities to capture people who may not be regular users of your pharmacy. 

Many GP surgeries no longer offer their own smoking cessation services, and so they signpost patients to other advisors in the community “like us”, he says. 

Mr Damani recommends leaving referral forms in local GP surgeries, which is an approach he has taken.

If anyone does want to quit smoking, they can fill the form in with their name and number and the surgery “passes [those] on to us in the pharmacy”, he says.

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