Editor—Lancaster et al reported that advice from general practitioners and structured interventions from nurses are effective in helping people stop smoking.1 They did not mention the potential contribution of other members of the primary healthcare team.
Pharmacists and their staff are well placed to support people wanting to stop smoking. They can provide advice over the counter or, for those pharmacies with consultation facilities, in a more formal clinic setting. Many people entering a pharmacy for help with stopping smoking will be considering purchasing nicotine replacement therapy as part of a serious attempt to stop. Suitably trained pharmacy staff can increase the effectiveness of nicotine replacement therapy by offering brief counselling at the point of sale.
We have shown the efficacy2 and cost effectiveness3 of such an approach. We commissioned a two hour smoking cessation training package, based on the stage of change model, for community pharmacists and their staff and evaluated its effect in a randomised controlled trial.
Pharmacy customers who were starting a new attempt to stop smoking were recruited, and were followed up after one, four, and nine months. We assumed that non-respondents were continuing smokers. One month point prevalence of abstinence was claimed by 30% of intervention customers and 24% of controls (P=0.12); four months' continuous abstinence was claimed by 16% of intervention customers and 11% of controls (P=0.094); and nine months' continuous abstinence was claimed by 12% of intervention customers and 7% of controls (P=0.089). These trends in outcome were not affected by potential confounders or by clustering at the pharmacy level. The intervention was also associated with increased and more highly rated counselling.
Pharmacy staff working on their own can make a large contribution to smoking cessation. Much more could be achieved through a coordinated approach to intervention that uses all members of the primary care team.4
References
- 1.Lancaster T, Stead L, Silagy C, Sowden A. Effectiveness of interventions to help people stop smoking: findings from the Cochrane Library. BMJ. 2000;321:355–358. doi: 10.1136/bmj.321.7257.355. . (5 August.) [DOI] [PMC free article] [PubMed] [Google Scholar]
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