Pharmacy smoking cessation services have long been popular with pharmacists and patients alike – so why is the number of those using them declining?  Emma Rosser investigates.

Some 4,500 fewer smokers set a quit date with community pharmacies in the last nine months of 2017 compared to the previous year amid public health funding cuts.

Community pharmacists helped over 36,200 people through NHS stop smoking services between April and December, with 15,900 successfully quitting within four weeks, according to recently released NHS statistics.

This is a drop from over 40,600 people seeking pharmacy services the previous year, with around 17,600 quitting in 2016.

Hover over the graphic below to find pharmacy smoking cessation statistics in your area.

 

The NHS stop smoking services annual report analyses the number of people accessing services in England between April 1 and December 31.

In 2017, 195,800 people accessed NHS stop smoking services during this period, compared to 215,600 over the same period last year and 462,700 ten years ago. Some 97,600 had quit after four weeks, down from 107,400 in 2016.

 

Local cuts

Royal Pharmaceutical Society (RPS) English Pharmacy Board member and Southampton contractor Sid Dajani said the drop of people accessing services is due to a combination local authority funding cuts and the fact that remaining smokers are often less inclined to quit and the hardest to help.

He said: ‘The health authorities are using the cuts as an excuse to proudly to turn their backs on the most vulnerable people that we can help.

‘It just seems perverse that whilst we’ve now got the hardest to tackle, that they decide to pull the plug.’

 

Services forced to close

Mr Dajani said his pharmacy was forced to close its free stop smoking service to the public, despite helping over 400 people to successfully quit and winning multiple awards. He said: ‘Our service was dropped because there’s just no money, and it literally happened overnight.’

He explained that pharmacies like his that can no longer offer these services are forced to direct patients to nearby clinics, over-capacity GP surgeries, or run private services at a fee.

He added: ‘A lot of people aren’t accessing those services because they can’t get to them, some of them are on the poverty line.

 

‘It defies logic that they are now getting surgeries to start smoking cessation services when they are trying to get people out of surgeries and more into self-management in the community.

‘There’s a lack of joint strategy thinking here, there’s a lack of multidisciplinary process and clearly there is money somewhere but it’s being diverted away from the frontline and that’s not in the interest of patients.’

 

Reduction in public health funding

Councillor Izzi Seccombe, chairman of the Local Government Association (LGA) community wellbeing board, said: ‘Councils remain committed to helping smokers quit, however this is made all the more difficult by a £600 million reduction to the public health budget - which councils use to fund stop smoking services – by central government between 2016/17 and 2020/21.

‘We have long argued that this is a short term approach which will only compound acute pressures for NHS services further down the line.’

A Department of Health and Social Care (DHSC) spokesperson said: 'Thanks to our tough action, smoking rates in England are at an all-time low. But we know smoking still kills hundreds of people every day – which is why we recently refreshed our tobacco control plan to target local action and prevention.

 'Local areas are best placed to understand local needs – and we have given councils £16 billion over the course of this Parliament to fund public health services in their area.'

‘Something is going wrong’

Ms Seccombe stressed that ‘council-led schemes have had a major impact on helping people to quit smoking’. She added that ‘although investment in stop smoking services has fallen, councils still spend almost £100 million each year on these services and wider tobacco control.’ She highlighted specialised stop smoking programmes targeting groups such as pregnant women and people with mental illness and combined lifestyle services.

Ministry of Housing, Communities and Local Government (MHCLG) statistics provided by the LGA confirm that in 2017/18 the local authority spend on smoking and tobacco services sat at £100,000. This figure has steadily declined in recent years, down from £148,500 in 2013/14.

See below for a breakdown of MHCLG spend on smoking and tobacco services.

A recent survey from the charity Action on Smoking and Health (ASH) found that half of local authorities cut stop smoking service budgets in 2017.

ASH’s director of policy Hazel Cheeseman told The Pharmacist that the decline of people accessing services is part of a continuing decline over the last decade. She said public health funding cuts alongside national media campaigning cuts, drops in GP referrals, and the reorganisation of services that has created a ‘perfect storm’ for stop smoking services.

Ms Cheeseman said: ‘It’s a collection of circumstances which mean that smokers are not being encouraged, driven and informed and being told that these services give them the best chance of success.’

She acknowledged that ‘cash-strapped’ local authorities experiencing funding cuts mean that non-mandatory stop smoking services are more likely to be axed.

But she stressed that smoking is the leading cause of preventable death and said ‘it does warrant a proportion of that budget, and so something is going wrong’.