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Kate Gegg Service Manager Gloucestershire Smoking Advice Service

Background to the Service
 Established 2000 following “Smoking Kills “ 1998  Gloucestershire's local NHS Stop Smoking Service  Part of Gloucestershire PCT / Public Health provider arm  Role to develop and deliver tobacco control /smoking cessation services countywide  Experience of meeting targets !

Motivating Smokers to Give up
 70% smokers want to give up BUT only 3-5 % want to give up today  Services need to be provided with ease of access for smokers  Need effective tobacco control policies/strategies to ensure throughput  Need to be tailor made to the needs of the community

LAA Targets
 Local Delivery Plan 2954 quitters 2007-2008 LAA Stretch Targets :Smokers with severe and enduring mental health problems  24 quitters 2007-2008 Smokers within HMP Gloucester  42 quitters 2007-2008  Smokers within top two centiles of deprivation  1591 quitters

Data Collection
 Every smoker who sets a quit date is monitored throughout that quit attempt  Seen up to and beyond 12 weeks but target is for 4 week quitters.  Registered as quitter, non quitter, or lost to follow up  Figures submitted to SHA, PCT quarterly basis  Always a quarter behind as based on quarter smoker sets a quit date  Example:- Quarter 2 if Quit date 30th September then 4 week follow up not until at least first week November therefore DoH date returns for Q2 is 24th November 

Smoking Cessation for Smokers with Severe and Enduring Mental Health Problems
 Higher

prevalence of smoking among people who have severe and enduring mental health problems  80% people with schizophrenia smoke  Smoke more than generic population  Need increased support  Need to work with staff at GPT to encourage them to raise the issue about smoking with all their patients

Service Development to Meet LAA Target
    Working with GPT to finalise smoking policy Will include services to support staff and patients NRT funding from GPCT Ongoing Training continuing for key staff both in brief intervention and intermediate support  Capturing data from Primary Care on smokers on the mental health register  ACHIEVEMENT TO DATE :- 9 set a quit date and 5 quit

Smoking Cessation in Areas of Deprivation
2005 Evaluation of the service showed that targeting smokers from areas of deprivation who were setting a quit date
Quitting at much lower level than smokers from areas of less deprivation  Local picture replicated the national figure  Smokers from these areas need much higher level of support to help them quit

Service Development for these areas
 Training for wide range of staff who work in these areas to ensure signposting  Provision of services within communities i.e Tescos, Pub, Workplace , Neighbourhood Projects  Ease of access to medication through Voucher Scheme  Pharmacy Scheme in areas of deprivation  Social Marketing through Dr Fosters  Regular post code analysis  ACHIEVEMENT TO DATE :- 239 quitters against target of 1591

Smoking Cessation Gloucester Prison
GSAS working with Prison staff in Health Care Unit to deliver weekly clinic 1 Prison Nurse trained to work alongside service specialist NRT funded from GPCT and issued under Patient group Direction

Challenges Working within Prison
 Reliant on support of Prison Nurse to escort prisoners  Lock down!  Mobility of prisoners during treatment  Floods / Evacuation  Culture

Achievments to date
 Weekly clinic to be extended ( last week 16 prisoners seen at weekly session)  ACHIEVEMENT TO DATE Q1 and Q2:-17 prisoners set a quit date  7 quit ( that we know of !)

 Ongoing work as at 4th December /Quarter 3
Prisoners seen 40 since 1st October 9 Transferred or released 8 declined help 19 quitting and 4 quit to date

LDP Target
 This is the generic target for the Service set by the DoH  GSAS always met targets from 2000 but following re-organisation failed to meet target 2006-2007  Following re-structure and increased PCT investment  ACHIEVEMENT TO DATE: Quarter 1 Target 711 quitters achieved 537  Quarter 2 Target 652 quitters achieved 653  Now met 40% annual target

Service Development
      Increase capacity and investment Young People Steering Group New medication Champix Regular Media Campaigns Extended training programmes StopB4theOp Policy

Contact Details
 "It's the constant and determined effort that breaks down resistance, sweeps away all obstacles." -Claude M. Bristol  Kate Gegg  08454 220040 

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