L. Currie1; S. Keogan1; P. Campbell2; M. Gunning3 Z. Kabir1 ; V. Clarke1 and L. Clancy1

1Research Institute for a Tobacco Free Society, 2Health Service Executive, Dublin North East, 3Health Service Executive, Irish Health Promoting Hospitals Network

Introduction Tobacco related mortality accounts for 7000 deaths per annum in Ireland, 1500 of which

are due to lung cancer. While measures have been implemented in Ireland to discourage people from starting to smoke, attention must also be paid to smoking cessation in order to achieve an appreciable reduction in smoking related mortality. Ireland is currently ranked second in Europe for treatment of smokers on the Tobacco Control Scale; however, much more could be done to support smoking cessation among Ireland’s smokers.

Objective:To assess the range and availability of smoking cessation services in Ireland with

emphasis on the type and intensity of intervention and service distribution relative to need.

Methods Database of smoking cessation services throughout Ireland developed 93 Smoking cessation service (SCS) providers identified Questionnaire tool developed covering the following areas:

Background, training of staff providing the service Range, intensity and frequency of services offered Service setting, location and resources

Questionnaire piloted among 6(6.4%) of the sample and modified 77 SCS providers were deemed valid for inclusion in the study Descriptive analysis using SPSS performed

ResultsSample Response rate was 81.8% (63/77) Non-responders (n=14) were from:

HSE West (3/25; response rate 88.0%) HSE South (4/16; response rate 75.0%) HSE Dublin Mid-Leinster (4/22; response rate 81.8%) Psychiatric (5), General Hospital (1), Community (2) and Health Promotion (6)

service settings.

Service Provider Profile 53(84.1%) of providers have more than 2 years experience Providers come from various backgrounds:

Nursing (46; 73.0%) Health Promotion (10; 15.9%) Other: pharmacy, addictions counselling, medicine, physiotherapy, environmental

health (5; 8.0%) All had some specific smoking cessation training

Service ProfileMost common form of support provided is individual counselling with initial sessions

averaging 40 minutes in length and weekly follow up sessions 20 minutes in length.

Table 1: Percentage of providers offering each support format to client groups

Results

Follow up 36(57.1%) providers attempt to follow up all clients24(38.1%) providers attempt to follow up only those who set quit dates

Distribution of services relative to the distribution of smokers by Health Service Executive Area

ConclusionsThis is the first study to have attempted a comprehensive review of smoking cessation service provision in Ireland. While smoking cessation services are available in all of the four Health Service Executive regions, there appears to be regional differences in resource allocation with HSE South and HSE Dublin Mid Leinster relatively underserved. In addition, there is little uniformity or consistency countrywide in the delivery of these services. Evidence would also suggest that there is no systematic follow up, and current review and evaluation is dependant on local resources.

At present there is no national structure in place to assist in this process and consequently no collation of local findings that could assist with an adequate review on the value and effectiveness of current smoking cessation services. This information is crucial if Irish health service planners are to ensure the integration of cessation services into an improved quality healthcare service, one that can adequately respond to the challenge of reducing tobacco use which is the most important public policy action that will bring about significant health gains.

AcknowledgementsAuthors acknowledge project partners who include:Institute of Public Health in IrelandIrish Health Promoting Hospitals NetworkHealth Service Executive

This work was funded through a partnership grant from the HRB and the DOHC / OTC.

For additional information, please contact:Laura CurrieResearcherResearch Institute for a Tobacco Free Societylcurrie@tri.ie+353 1 489 3624

The range and availability of smoking cessation services in Ireland



Eligible client groups:

Support Format

Individual(%)

Telephone(%)

Group(%)

Patients 62.0 57.0 33.0

Community Members

68.0 73.0 35.0

Facility Staff 60.0 64.0 38.0

All of these groups

37.0 37.0 24.0

Total providers using support format

98.5 90.5 61.9

Follow up period Number(%) of providers attempting to follow up at this period

Two weeks 34(54.0%)

One month 30(47.6%)

Three months 47(74.6%)

Six months 28(44.4%)

One year 43(68.3%)

HSE Area Proportion of total smokers (%)

Number of smokers

Hours/week of service per 100,000 smokers

Service providers (FTE)

Proportion of total SCS (%)

Dublin North East

22.9 181,000 185.9 9.6 33.3

Dublin Mid Leinster

28.0 221,904 96.9 6.1 21.3

West 23.5 186,221 170.8 9.1 31.5

South 25.6 202,830 84.2 3.9 13.6