A prospective investigation of the predictors of intervention effects of the NHS smoking cessation programme.

Background: The government has invested NHS Stop Smoking Services to help
smokers quit. However, less than 5% of smokers use these services and approximately
half of these fail to successfully complete the programme and over 75% of
quitters relapse within six months. The factors relating to this short-term failure are
unclear. It is important to determine the factors related to smoking status from the
NHS Stop Smoking programme as this would help cessation advisors identify
“at-risk” smokers at the start of the intervention, which would aid in the more
appropriate use and allocation of resources and help identify factors by which
interventions can be tailored. The aim of the study was to assess the extent to
which the Transtheoretical model could provide a framework for understanding
smoking behaviour in the context of the NHS stop smoking programme.
Methods: Smokers were recruited at the point of entry to stop smoking services
based at GP surgeries across Avon and the West Midlands. In order to determine
the factors important in smoking cessation and to identify those “at risk” at the start
of the programme, smokers completed questionnaires on entry to the programme
and four weeks later, at the end of the programme.
Results: Participants were on average 39 years old, were smoking 21 cigarettes
a day for approximately 21 years. Of the 183 smokers recruited, 49.7% quit at the
end of the programme. Female participants were 2.3 times more likely to drop-out
than males, OR=2.34(1.11, 4.93) and those living with other smokers were 2.4
times more likely to drop out of the programme, OR=2.37(1.08, 5.21). Only three
variables predicted smoking status; weight, p=0.001; sessions attended, p<0.001;
maladaptive cognitions, p=0.008. The addition of the TTM variables did not significantly
improve the model.
Conclusion: The results highlighted important characteristics of those enrolling
on the NHS Stop Smoking programme and provided an insight into those “at risk”
of dropping out of the programme. However the predictive ability of the TTM variables
was not demonstrated and thus these variables may not be useful for
participants enrolling on these programmes.
Higher Education Funding Council for England.