1. Better Help for Smokers to Quit – Tobacco Health Target Helen Troke-Thomas Tobacco Policy and Implementation Team Ministry of Health

2. People who smoke want to stop 72% of 15-19 year-old that smoke would not if they had their life again 69 % tried to quit in last 5 years 44% tried to quit at least once in last year M ā ori, Pacific and young people are as likely to have tried to quit MoH. NZTUS 2006

3. Health Effects of Smoking Cause of approximately 5000 deaths a year in New Zealand Societal costs, costs to health service, lost productivity Loss of on average 15 years of life Second hand smoke High rates of smoking amongst Maori and Pacific

4. Why Brief Advice? Proven efficacy Relatively small effect (1-3%)* Useful when delivered to a large population of people that smoke *Silagy C, Stead LF. Physician advice for smoking cessation. Cochrane Database Syst Rev

5. Health Target - Better help for smokers to quit 2009/10 - 80% of hospitalised smokers will be provided with advice and help to quit by July 2010 2010/11 - 90% of hospitalised smokers will be provided with advice and help to quit by July 2011

6. Health Target - Better help for smokers to quit

7. But there are Challenges….. The Target requires: Systems Change Behaviour Change

8. 16.6% of hospitalised smokers provided with brief advice and help to quit Quarter 1 2009/10

9. DHB Activity Training Systems development and Implementation Clinician buy-in Promotion of ABC

10. Health Target Results 2009/10 TARGET July 2010

11. 17,800 Smokers offered Brief Advice and or cessation support in Q4 of 2009/10

12. Progress in 2009/10 Over 37,400 offers of brief advice in 2009/10. It is estimated that 1 in 40 of these smokers will have a successful quit attempt = approximately 935 successful quit attempts will occur because of this activity. Note that this is the minimum as many hospitalised smokers will also will receive NRT/cessation support which increases the quit success rate.

13. Progress in 2009/10 Behaviour change amongst clinicians and cultural change in the hospital setting. Change in the profile of smoking status in the hospital setting – a clinical ‘vital sign’. Significant work and commitment to get systems and processes in place to make this happen.

14. Considerations Disclosure and Target Gap Prevalence – not all smokers identified. Target Gap – not all smokers that are identified are provided with brief advice and help to quit.

15. Considerations Cont... Ethnicity Vital that all smokers are receiving ABC and that there are not ethnic disparities. Initial analysis gives us confidence that Maori and Pacific smokers are being offered brief advice as often as others. Ministry now collecting data from DHBs to undertake further ongoing analysis.

16. Based on what we have learned from 2009/10……. ….key predictors of success for health target achievement include: Commitment and Leadership from Senior Management and Senior Clinicians Training of staff Appropriate and accurate systems to record and report results Sustainability

17. Smoking is too BIG to ignore