The Study

A randomised controlled trial to measure the effectiveness of the intervention pad on smoking cessation activities of general practitioners

Study Method

107 GPs in 29 practices in West Dorset were randomly assigned (by practice) either to receive the smoking cessation intervention pad or to act as a control group. The intervention pad was sent to 49 individual GPs by post with an introductory letter from the Director of the Health Promotion Service.

Four weeks after distribution of the pads a survey of all GPs in West Dorset was carried out independently by St. Georges Hospital Medical School. 75 GPs responded.

The postal questionnaire asked how many times in the past week GPs had given opportunistic advice to patients to stop smoking; counselled patients about stopping smoking; prescribed or recommended Nicotine Replacement Therapy(NRT).

Results

The frequency of opportunistic advice in the intervention pad group was 4.9 compared with 3.0 in the control group - an increase of 62%.

The GPs with the intervention pads were also delivering more effective advice: the numbers reporting giving counselling were 49% greater than the control group, and there was a strong trend, which didnt quite reach statistical significance in this sample size, towards recommending and prescribing NRT.

Conclusion

The intervention pad increased smoking cessation interventions by 62%.

In the study group, this equates to 208 extra smokers being advised to stop per week - 8303 per year. Assuming a modest quit rate of 2% this would result in at least 166 permanent ex-smokers prompted to stop by the study group in a year.

2% is a conservative estimate of the effectiveness, as the GPs in the intervention group were more likely to counsel patients, advise or prescribe NRT and give out the leaflets from the intervention pad - which contain the best available advice for smokers who want to stop.

Customised pads (which were not used in the study) are likely to further improve quit rates by directly referring smokers to their local specialist smoking cessation service.

For an average health authority (such as Dorset) with 450 GPs using the pads there would be over 90,000 opportunistic smoking cessation interventions per year (an extra 34,920), leading to at least 1,800 permanent ex-smokers (698 extra).

With the cost of 5 pads each (a years supply) for 450 GPs at £6750 the cost per permanent ex-smoker is under £5