Real world evaluation of three models of NHS smoking cessation service in England

Three local service evaluations were carried out at Bournemouth & Poole Teaching Primary Care Trust (PCT) (PCT1), NHS South East Essex (PCT2) and NHS Warwickshire (PCT3) to describe the structure and outcomes associated with different services.Standardised interviews with key personnel in addition to analysis of data from 400 clients accessing the service after 1st April 2008 in each PCT. The PCTs varied in geography, population size and quit rate (47%-63%). Services were delivered by PCT-led specialist teams (PCT1), community-based healthcare providers (PCT3) and a combination of the two (PCT2) with varying resources and interventions in each.Group support resulted in the highest quit rates (64.3% for closed groups v 42.6% for one-to-one support (PCT1)). Quit rates were higher for PCT (75.0%) v GP (62.0%) and pharmacist-delivered care (41.0%) where all existed in the same model (PCT2). The most-prescribed therapy was NRT (55.8%-65.0%), followed by varenicline (24.5%-34.3%), counselling alone (6.0%-7.8%) and bupropion (2.0%-4.0%).The results suggest that service structure, method of support, healthcare professional involved and pharmacotherapy all play a role in a successful quit. Services must be tailored to support individual needs with patient choice and access to varied services being key factors.The effects of cigarette smoking on individual health [1], the health service [2] and the economy [3] are well-documented. In view of this wide-ranging impact, a previous UK government funded a comprehensive National Health Service (NHS) Stop Smoking Service with a target of reducing the number of adult smokers to 21% or fewer by 2010 [4]. The current Tobacco Control Plan for England includes clear goals to reduce adult smoking prevalence from 21% to 18.5%, smoking rates among 15 year olds from 15% to 12% and smoking in pregnancy from 14% to 11% by 2015 [5]. The NHS is free at the point of delivery and funded by taxation.NHS Stop Smoking Services [4] are now available t