NHS smoking services under fire

Last updated at 13:35 18 March 2005

NHS services to help smokers quit are insufficient to hit national targets to reduce smoking rates.

The stop smoking service has also come under fire for failing to tackle the inequalities in the nation's poorest communities.

NHS Stop Smoking Services offer support and nicotine replacement therapy to people trying to kick the habit, and form part of Government efforts to cut the proportion of smokers to 21 per cent or less by 2010 in England.

But Dr Eugene Milne says the services were unlikely to be enough to help meet this target.

Dr Milne examined the effectiveness of NHS smoking services in Northumberland and Tyne and Wear - an area with a lot of manual workers and some of the worst health and deprivation in the country.

Of a population of around 1.135 million, 333,000 were estimated to be smokers - 33 per cent of men and 26 per cent of women.

In 2003-04, more than 20,000 people in the region used stop smoking services - of whom 9,910 had still quit after four weeks.

Of these, Dr Milne, deputy medical director at Northumberland Tyne and Wear Strategic Health Authority, estimated that 35 per cent to 40 per cent would still have quit after a year - a long-term figure of 3,500-4,000.

Marginal increase

He said that services in the region helped reduce smoking rates by just 0.1 to 0.3 per cent.

If this trend continued, the study predicted that Stop Smoking Services may deliver less than one per cent of the 2010 target of a five per cent fall in smoking prevalence.

Dr Milne also criticised the failure of the target to address the need to reduce inequalities in the most deprived areas, with high rates of cancer and heart disease as well as passive smoking.

He said it was 'disturbing' that the smoking prevalence targets did not propose a narrowing of the inequalities gap, meaning it could widen still.

"To narrow health gaps in England it is not sufficient simply to be better at delivering smoking cessation," Dr Milne said.

"Bupropion (anti-smoking drug) and nicotine replacement are among the most cost-effective of all healthcare interventions, but comprehensive restriction of smoking in all workplaces works better.

"Both are needed and deprived areas need more of both."

'Comprehensive ban'

Last year the Government's Public Health White Paper said smoking would be banned in the majority of workplaces over the coming years.

But it stopped short of a total ban, with exceptions for pubs and bars which did not prepare and serve food.

A spokeswoman for campaign group Action on Smoking and Health (ASH) said: "The stop smoking services are producing promising results and have undoubtedly helped thousands of people in England to quit.

"But the Government cannot rely on the services alone to bring down smoking rates or to reduce health inequalities.

"We need a comprehensive ban on smoking in all workplaces to reduce health inequalities and not the half-hearted policy that is currently being proposed."

A Department of Health spokeswoman said they were making good progress on reducing the number of smokers in the country.

"There are now over one million fewer smokers in England since the Smoking Kills White Paper in 1998 and we are on track to meet the target of 21 per cent prevalence in 2010," she said.

"The NHS Stop Smoking Services are making a difference - in the past year they helped 205,000 people to give up.

"Evidence shows that smokers using the one-to-one or group therapy alongside nicotine replacement therapies are up to four times more likely to give up for good than those who act on willpower


"Our 2010 targets to reduce smoking prevalence will mean that the gap between the most deprived areas and the rest of the country will be reduced by two per cent."

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