By Louise Ross
Stoptober 2019 may long be over but there are still many smokers all over the UK who need to quit and who may have missed this opportunity. This winter, they will be turning up at your community pharmacies, presenting prescriptions for antibiotics for chest infections, buying cough medicine, possibly getting medications for their children who are likely to be more at risk from second-hand smoke if the parents still smoke indoors.
You may already run a stop smoking service, in which case you will be familiar with the business of making your patients aware of the in-house offer. All counter staff should be ready to undertake brief opportunistic interventions with customers.
Your local authority may have recently decommissioned the stop smoking service. Sadly, this is a reality of life now as council budget cuts bite hard. This gives community pharmacists a fresh opportunity to not only make a public health impact but also to increase sales directly with patients, without waiting for invoices and claims to be paid.
Being ready with a good stop smoking display at point of sale is the first step. There are downloadable posters to use, and you could add an in-house sign (‘20 patients have quit smoking with our stop smoking advisor this month!’) to attract attention and offer the promise of success.
Displaying a range of stop smoking products that you sell will create an interest. Just standing on the shelf, patches, mouth spray and gum may get overlooked. They have to be right there where smoking patients will see them; a nudge like a poster saying ‘Even if you’re not ready to stop smoking yet, why not try a product to get you through the times when you can’t smoke?’ will provoke a train of ideas that may well turn into action.
Browsing in a pharmacy isn’t like in other outlets and smokers generally don’t proactively hunt down solutions to their problem. Many don’t even see it as a problem, which is why brief advice at any given opportunity can be a turning point, especially when the harms of smoking are linked to the patient’s health condition.
Ask: ‘And can I ask, do you still smoke? (adding the ‘still’ subtly reminds the patient that there are fewer and fewer smokers nowadays)
Advise: ‘Do you know that the best thing you can do for your (insert health condition here) is to stop smoking?
Act: ‘We can help you here at the pharmacy, with tailored support and products that make it so much easier to quit. Would you like to see some of the products we have?’
An essential part of the display will be a carbon monoxide monitor. Cheap to buy (or provided by your local Stop Smoking team if you are contracted to provide this service), it adds value by increasing interest.
People love to see their own results and it gives would-be quitters something to look forward to the following week. ‘Let’s see if we can get that reading down to a non-smoker’s level by next Monday!’
Vaping as option
Some smokers will have tried everything from the medicinal licensed route but be intrigued by the possibility of vaping to stop smoking. Martin Dockrell, head of the tobacco control programme at Public Health England, writes that vaping has become the most popular and the most effective way of stopping smoking. There is now a range of high-quality UK-made e-liquids which, along with vaping devices, have been launched in 2019 specifically for community pharmacy outlets.
There has been much hostile press about vaping, however, stop smoking practitioners, who inform themselves appropriately and who confidently recommend this method to patients who thought they’d tried everything, get very good results – better in fact than with licensed products.
This is partly due to the variety of flavours a newly switched ex-smoker can enjoy, but also due to the fact that with vaping, individuals can titrate the dose to meet their needs at the time, and that it’s convenient and pleasant to use.
For pharmacists who want to extend their knowledge and skills, an excellent source of training materials is available from the National Centre for Smoking Cessation and Training (ncsct.co.uk), including how to give brief advice, the standard treatment programme for stopping smoking, a full analysis of medications, courses on pregnancy, mental health and vaping.
It’s free to use and well worth the time for any community pharmacist or their staff who wants to make a difference for patients who smoke.
Louise Ross is a clinical consultant at National Centre for Smoking Cessation and Training
This article also appears in the December/January issue of Pharmacy Business.