Stop smoking services: why accessing support is a real drag

It’s generally the case that if you want someone to do anything even remotely tricky, it’s a good idea to remove all barriers to action.

Few things in life are more challenging than trying to quit smoking. So, it certainly makes sense to part the waves and create a smooth path to cessation support. Those who avail themselves of stop smoking services are four times more likely to quit their habit.

The government has set ambitious targets for reducing smoking rates in the UK. It published Towards a Smokefree Generation: A Tobacco Control Plan for England in 2017. This lengthy document laid out the government’s strategy for encouraging more people to quit. The need for free smoking cessation support was highlighted.

Unfortunately, the responsibility for organising and offering the services was devolved to local authorities in England. The city and county councils were encouraged to engage in a little joined up thinking but, predictably, they didn’t quite manage to do that.

“Comprehensive and effective local tobacco control strategies require joined up working and integrated commissioning between local government and the NHS. It is through these dedicated joint partnerships that local areas can demonstrate real strategic leadership and champion the importance of a collaborative ‘whole system approach’ in working towards a common goal.”

Local authorities may have had a common goal. However, they didn’t try anything as obvious as working together and the result is an unholy mess commonly known as a postcode lottery. If you want help to stop smoking, it matters where you live – a lot.

Localised stop smoking services

Following the publication of the government’s strategy, every local authority considered the need to provide smoking cessation service and how to deliver them. The services they have established vary from comprehensive to non-existent.

Depending on where a smoker lives, they may have access to a 12 week support programme including face to face meetings and nicotine replacement therapy. On the other hand, they could be provided with nothing more than a link to the appropriate page on the NHS website.

Smokers in Kent benefit from impressive cessation support and detailed information about the available services is easy to find.

Heaven help any smoker in Shropshire who would like to quit as their county council hasn’t bothered to provide any service at all.

To make matters infinitely worse, in some areas it isn’t entirely clear which service smokers should attempt to access. This ridiculous situation has arisen because city councils act independently of county councils. So, smokers in Hampshire should contact the service offered by the county council. Unless, that is, they happen to live in Southampton, as residents of the city need to refer themselves to an entirely different service. It would have been nice if a list of postcodes had been published to clarify who should apply for which service. But no such list exists, unless it is so well-hidden that smokers would need to call in a detective to find it.

Confusion reigns supreme

Smokers seeking to quit might find that they qualify for support in the area in which they work, as well as in the region where they live. Others will be confined to home turf and some will discover that they have to be pregnant, disabled or chronically ill to qualify for assistance. Age limits for the various services vary and some county councils merely direct smokers to local pharmacies. The pharmacies concerned may or not feature a trained advisor.

Nicotine replacement therapy and medications are available free or on prescriptions to smokers in some regions but not others. Many cessation services embrace vaping, but others do not. The information provided via the local authority websites and those of the service providers is often vague. Stop smoking websites can be difficult to navigate and leave smokers wandering exactly what they are signing up for.

Covid-19 has caused an even greater state of chaos to emerge with face to face services being suspended in most regions but not in all. Where such services have been suspended, there is usually no indication given as to when and if they may recommence.

At the time of writing, roughly 130 people per day are dying in England because they have contracted coronavirus. Around 190 people per day are dying of smoking related illnesses.

What should have happened?

Local authorities were permitted to plough their own furrows in establishing stop smoking services. Or, as it turns out in certain regions, in not establishing them. They didn’t manage to confine themselves to the same farm let alone the same field when ploughing those furrows. Was it too much to ask that city councils at least set up the same services as the local authorities of the counties in which they are located?

Surely, the government should have decided what constituted an effective smoking cessation service and then ensured that this was made available to everyone across the country.

Smoking is an incredibly important issue. The habit continues to kill a disturbing number of people every single day. It costs the nation £billions each year when healthcare, lost productivity, social care, fire damage and harm to the environment are factored in.

Research suggests that smokers are far more likely to quit if they take advantage of a stop smoking service.

A case of Ashes to ashes

How many smokers are falling through the net because they don’t know that help is available or how to access it? How likely are they to quit if there is no support offered in their area? Smokers will continue to die when they could have been saved by receiving the right level of support.