Primary care urged to do more to help patients quit smoking

An overloaded health system, lack of smoking cessation services and insufficient training are preventing primary care practitioners from using evidence based interventions to help patients to quit smoking.

This is the finding of the first UK-wide survey of health practitioners to examine smoking cessation inventions in primary care, conducted by Cancer Research UK.

It reveals that only half (53%) of GPs and practice nurses give patients Very Brief Advice (VBA) about their smoking.

The number of practitioners who regularly prescribe pharmacotherapy to help patients stop smoking is also low: 22% for nicotine replacement therapy, 16% for varenicline and 4% bupropion. Only 27% recommend e-cigarettes as a tool to quit.

Other barriers preventing health practitioners initiating conversations about smoking cessation were: patients having too many issues to address in a consultation (59%), perceptions that patients were unreceptive to smoking cessation advice (40%) and negative patient reactions (15%).

Cancer Research recommends:

• Primary care health practitioners complete training in VBA and use it and pharmacotherapy to help patients to quit smoking, refer patients to specialist stop smoking services in their area and support the use of e-cigarettes as an aid to stop smoking.
• Primary care service commissioners and planners prioritise smoking cessation and tobacco control in regional plans, signpost to and/or provide primary care practitioners with training to deliver VBA, and ensure pharmacotherapy and advice about e-cigarettes is provided to patients who wish to quit.

Dr Richard Roope, Clinical Champion for Cancer Royal College of General Physicians and Cancer Research UK, says: “With smoking remaining the largest preventable cause of ill-health and premature death across the UK, primary care must make every contact count,” he said.

PCRS Executive Chair Dr Noel Baxter, comments: “VBA is not just a chat. It is a complex intervention made simple to learn and when done right by everyone as often as possible it is proven to have an impact. Make sure everyone around you is trained to have this conversation.”

Healthcare professionals will find the latest evidence based guidance on how to routinely identify smokers, encourage and support a quit attempt in the new PCRS Guide to Diagnosing and Managing Tobacco Dependency .