1. Hospital based smoking cessation service – more smokers quitting and staying smoke-free. Paula Campbell, Regional Officer – Smoking Prevention Ann O’Farrell, Research Officer, Department of Public Health Dr. Nazih Eldin, Regional Manager – Health Promotion

2. Objectives To provide all smokers in the north east with support for quitting; (North-eastern region includes 4 counties & population of 345,000). To monitor this service on an ongoing basis; To develop an annual multi-media campaign promoting smoking cessation and prevention.

3. Cessation Service The service commenced in December 2000, and is based in 5 acute hospitals. Referrals come from hospital or community based staff, self-referrals & National Smokers Quitline; Counsellors available for between 24-39 hours per week in each hospital.

4. Support is free, and is either on a 1-1 basis or group support ; Group support consists of 6 week Stop Smoking courses which are run in the evening time. Each hospital runs 2-3 of these courses every year.

5. Advertising the cessation service. Box advertisements in all 8 regional papers; Slots (minimum 3 each day) on both regional radio stations; Flyers to all General Practitioners, pharmacists and Public Health Nurses; Key dates used for press releases (Jan 1st, Ash Wednesday, World No Tobacco Day); Notices sent to health care staff via e-mail and the intranet;

6. Health care staff can avail of free nicotine replacement therapy for up to 4 weeks. All clients who set a quit date are followed-up at 2 weeks, 3 months and 12 months; UK guidelines adopted for the monitoring system: 3 attempts are made to contact the client; 2 weeks either side of the follow up date at 3 & 12 months can be used during which to follow up a client.

7. Methods Client monitoring data collated on Excel - Client code number Date seen Category of client Type of support Demographics Stage of Change in relation to smoking behaviour (Prochaska & DiClemente) Quit date (if applicable) Smoking status 2 weeks, 3 months & 12 months after quit date.

8. Results Quantitative analysis completed by the Dept of Public Health in August 2004. n = 7,253 (incl. clients supported from Dec. 2000 - July 2004). Age range : 14 - 90 years, with median of 47 years.

9. No. of smokers availing of support

10. Gender

11. Type of support

12. C ategory of client

13. Q uit rate results (2002-2004)

14. Results Being quit at 3 months was sig. related to: Being older (49 years vs. 45 years) Attending group support Being a staff member. No relationship was found between gender and being smoke free at 3 months.

15. Impact of Smoking ban on cessation service (March 29 th 2004) 25.7% increase

16. Cost-effectiveness 1. UK cessation services: Stapelton J. (2001) calculated cost per life year saved at: £601 for those aged 35-44 £766 for those aged 45-54 (Based on a cost per patient treated of £209) Compared to: Median cost of £17,000 per life year saved for a range of 310 medical interventions (Tengs et al, 1995).

17. 2. North-Eastern region cessation service: In 2004, the service costs were approx. €212,000; 2,851 clients were provided with support that year. Hence, cost per client treated = €74. Very good value for money!

18. Conclusions This is an effective service which has helped over 8,500 smokers in their efforts to quit. Although hospital based, the service is reaching out - % of clients coming from the local community (public) increased from 10% in 2002 to 18% in 2004. Demands on this service increase each year and crucially, the 12 month quit rate has increased significantly from 9% in 2002 to 12.2 % in 2004.

19. The Good News……… Smoking in Adults (SLAN Surveys)

20. Smoking in 12-18 year olds in the north-east