The Pharmacists' Challenges in the Provision of Smoking Cessation Counseling Service Survey Prof. T. H. Lam, Chair Professor and Head, Department of Community Medicine School of Public Health,The University of Hong Kong Dr. Sophia S. C. Chan, Head, Department of Nursing Studies, The University of Hong Kong May 10, 2007

2 Survey Overview Objective To understand the pharmacists' challenges in the provision of smoking cessation counseling services Date April 17 – May 4, 2007 Methodology Questionnaires Target Community pharmacists in Hong Kong (includes two chain pharmacies and other pharmacies) Institute Department of Nursing Studies and Department of Community Medicine, School of Public Health, The University of Hong Kong No. of Sample 2 chain pharmacies: 105 copies Other pharmacies: 350 copies Successful Sample 2 chain pharmacies: 77 copies (73%) Other pharmacies: 50 copies (14%) The response rate of other pharmacies is comparatively low, so the analysis will only be focused on 2 chain pharmacies.

1. HK people’s needs of smoking cessation counseling services

4 All respondents' workplace provides smoking cessation products Q: Does your workplace offer any smoking cessation products ？ Successful sample ： 77

5 About 90% respondents' workplace offers NRT-gum, NRT-spray and NRT- patch Q: What kind of smoking cessation products does your workplace offer? Successful sample ： 77 (multiple answers)

6 In the recent week, on average 4 customers asked respondents about smoking cessation Successful sample ： 77 Q: In the recent week, on average, how many customers asked you about smoking cessation ？ Mean: 4 customers asked

7 In the recent week, on average, 3 customers purchased smoking cessation products from the respondents Successful sample ： 77 Q: In the recent week, on average, how many customers purchased smoking cessation products from you ？ Mean: 3 customers purchased

8 In the recent week, 2 out of every ten customers who purchased smoking cessation products asked respondents about smoking cessation counseling services Successful sample ： 72 Q: In the recent week, how many out of every ten customers who purchased smoking cessation products asked you about smoking cessation counseling services? Mean: 2 customers purchased smoking cessation products asked about smoking cessation counseling services

9 In the recent week, 86% of respondents asked their customers about their smoking habit Successful sample ： 76 Q: In the recent week, have you ever asked your customers about their smoking habit?

10 In the recent week, on average, respondents have asked 3 customers about their smoking habit Successful sample ： 67 Q: (Only for those who asked their customers on their smoking habit) How many customers have you asked in the recent week? Mean: on average, community pharmacists asked 3 customers about their smoking habit

11 88% respondents’ customers asked about the instruction of using smoking cessation products Successful sample ： 74 (multiple answers) Q: What kind of questions did your customers ask about smoking cessation?

12 38% of respondents are often proactive in providing counseling services to customers who purchased smoking cessation products Successful sample ： 76 Q: Are you proactive in providing counseling services to those who purchased smoking cessation products?

13 18% of respondents can identify quitters and are often proactive in providing counseling services Successful sample ： 76 Q: Are you able to identify the potential quitters and proactive in providing counseling services?

14 In recent week, on average, 2 out of every ten respondents’ customers refused to accept counseling services Successful sample ： 54 Q: In the recent week, on average, how many out of ten customers refuse your counseling services? Mean: on average, 2 out of every ten respondents’ customers refused to accept counseling services (Inactive in providing service and no comment is not included)

15 When customers refused listening to their advice, 78% respondents would provide leaflet or additional info Successful sample ： 72 (multiple answers) Q: What would you do when your customers refused listening to your advice?

16 Respondents think the reason for customer not listening to their advice was that customers think they can manage the process themselves Successful Sample ： 69 (multiple answers) Q: Do you know why your customers did not listen to your advice ？

2. The importance of counseling services to smoking cessation outcomes

18 Respondents consider the key driver for successful smoking cessation is: The will power and determination of the quitter (N=77) Q: How important are the following factors in contributing to the success of smoking cessation? (0= completely no impact ， 5=have significant impact) (N=77) (N=75)

3. The mindset of quitters in the smoking cessation process

20 74% Respondents consider the most common perception of smoking cessation amongst quitters are quitting smoking will lead to weight gain Successful sample ： 76 (multiple answers) Q: Which of the following do you think the quitters would agree with?

21 In the recent 3 months, amongst those who was contacted by respondents, 14% of them set a smoking cessation plan Successful sample ： 77 Q: How many of those you have contacted set a smoking cessation plan for themselves? Mean: 14% of customers set a smoking cessation plan

22 In the recent 3 months, amongst those who have contacted by respondents, 65% considered it takes 3 months or less for quitting smoking successfully Successful sample ： 77 Q: In the recent 3 months, amongst those you have contacted, how long do they think they will need to spend in order to quit smoking successfully? Mean: 12 months

23 66% of respondents consider themselves capable of setting a practical plan for the quitters Successful sample ： 77 Q: Do you think if you can help quitters to set a practical plan of smoking cessation?

24 Respondents consider they are 38% successful in helping quitters quit smoking Successful sample ： 74 Q: How successful do you think you are in helping quitters quit smoking? Mean: respondents are 38% successful in helping quitters quit smoking

25 84% of the respondents consider they are more than half confident in helping quitters quit smoking successfully Successful sample ： 74 Q: How confident do you think you are in helping quitters quit smoking? Mean: 84% of the respondents consider they are more than half confident in helping quitters quit smoking successfully

26 50% of the respondents consider they are capable in helping quitters quit smoking successfully Successful sample ： 74 Q: How capable do you think you are in helping quitters quit smoking successfully ？ Mean: respondents consider they are capable in helping quitters quit smoking successfully

Conclusion

28 Low Utilization of Smoking Cessation Counseling The survey was the first such study on pharmacists in Hong Kong. The response rate was 73%, which was good. 90 per cent of pharmacists said that various smoking cessation products such as NRT-gum, NRT-spray and NRT-patch, are being offered in the pharmacies they work. Yet smokers fail to make use of those products as they seldom seek help from pharmacists, who are more than happy to help.

29 Pharmacists Counseling on Smoking Cessation Boost Success Since the 2 mg NRT products are freely accessible over-the-counter, smokers easily by-pass the pharmacists. As such, they miss the chance of getting the best treatment as well as developing an effective smoking cessation plan. Different smokers have different needs. Well-trained pharmacists can provide customized services that are far more effective. Smokers should seek help from pharmacists promptly.

30 NRT + Pharmacist’s Counseling Boost Success It takes determination, usage of NRT, pharmacist assistance, and good planning in order to quit smoking successfully To be effective, quitters should use NRT products continuously for at least eight weeks. In general, the therapy takes around two to three months to complete. Smokers should be on their guard not to smoke again afterwards. As the Kong Kong Council on Smoking and Health says, “Don’t be defeated by the cigarette!”

Respondents Profile

32 Gender Successful sample ： 74

33 Age Successful sample ： 74 Mean Age: 37

34 Professional Qualifications Successful sample ： 74

35 Duration of Practice Successful sample ： 74 Mean Duration of Practice: 7 years

36 Smoking Habit Successful sample ： 74