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Setting the scene
Gay Sutherland
Abstract
This is an exciting time for smoking cessation within
the UK as services continue to become fully integrated
within the NHS. It is perhaps worth reflecting on some
of the major achievements within the smoking cessation
field over the past few years, and some of the challenges
which it has had to face. In fact it is worth reminding
ourselves that up until 1999 there were no NHS service
and that we still remain the only country in the world
to have a comprehensive national smoking cessation service.
The publication of Smoking Kills in 1998 signalled the
government's intention to take the issue of smoking seriously
and to make real efforts to reduce health inequalities.
The White Paper set targets for reducing smoking rates
and the measures described included provision of NHS smoking
cessation services. Also in 1988, Thorax published evidence-based
guidelines on smoking cessation activities for health
professionals and these guidelines were endorsed by many
professional bodies. The first smoking cessation treatment
services were established in Health Action Zones in 1999
and a year later NHS smoking cessation treatment services
were established nationally.
In 1999 smokers on low incomes were eligible for one
week's free supply of NRT and nicotine gum became available
for general sale. In April 2000 a national voucher system
for NRT was a popular introduction; while the setting
of targets for services was less well received. Later
in 2000 the voucher system was extended to allow up to
4 to 6 weeks supply of NRT and bupropion became available
on NHS prescription.
In December 2000 updated national smoking cessation guidelines
were published in Thorax. NRT joined Zyban on NHS prescription
in April 2001 but funding for these medications now had
to come from the NHS drugs budget; in May further NRT
products became available on general sale. At the same
time the distinction between specialist and intermediate
services was abandoned and new minimum standards for smoking
cessation services were introduced. April 2002 saw one
extra year of central funding provided and a year later
this was reduced to a suggested, but not obligatory, minimum
funding level. Primary Care Trusts became responsible
for commissioning and funding services in 2003 and the
HDA Training Standard for smoking cessation was published.
Of course the most significant development is in the
number of people who have received treatment from NHS
smoking cessation services and who have been helped to
stop smoking by them. Since the service came in to operation
in 1999 up to 2003 over 600,000 smokers had set a quit
date with the services and over half of these, 314,000,
were not smoking four weeks after their quit date. The
treatment NHS smoking cessation services provide is a
life saving one, and its staff are its greatest resource.
This conference aims to assist the professional development
of the smoking cessation field and to provide a forum
for practitioners to share their best practice, wealth
of experience and innovative ideas. I am delighted to
open the 1st UK National Smoking Cessation Conference
and am confident that it will be an enjoyable and stimulating
two days.
Biography
Currently a Research Psychologist at the Tobacco Research
Unit, Institute of Psychiatry, King's College London University
and Hon. Consultant Clinical Psychologist at the South
London and Maudsley NHS Trust Smoking Cessation Clinic.
Gay has been involved in treating and researching tobacco
dependence for 18 years.
Research interests include trials of the nicotine nasal
spray, patch, inhaler and the sublingual tablet, and investigations
of the potential of naltrexone, mecamylamine and combined
nicotine replacement therapy for smokers. She has examined
the potential of reducing the harm for smokers unable
or unwilling to quit, through studies of new cigarettes
prototypes, such as Premier and Eclipse. Recent research
interests have included collaborative studies trying to
identify genes related to smoking and investigations of
the roles of smoking and quitting on oral health and immune
function. She is a Trustee of the charity QUIT, and President-Elect
of The Society for Research on Nicotine and Tobacco -
Europe.
Gay Sutherland
Maudsley Hospital Smoking Cessation Clinic
g.sutherland@iop.kcl.ac.uk
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