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Pharmacy Training

Stop Smoking

By October 22, 2019 October 28th, 2019 No Comments

MediaPharm’s OTC Stop Smoking Training Course

MediaPharm provides training for Stop Smoking advice service. Our training course is designed to get you and your team up to speed and advising patients as quickly as possible.

Access the OTC Stop Smoking Training Course now or read on for more information about this important service.


Overall aim of course

This course is for pharmacy support staff who want to help customers stop smoking. It will help you to give customers appropriate advice and make confident recommendations and prepare you for the national awareness campaigns so you can promote your service.

Learning outcomes

By the end of this course you will be able to:

  • Use national awareness campaigns to promote the pharmacy’s involvement in stop smoking services
  • Communicate the risks associated with smoking to customers
  • Advise customers on how to go about stopping smoking
  • Recommend appropriate products to people that want to quit
  • Support customers on their quit journey

Duration 

This course will take approximately 20 minutes to complete.

Why is this module important? 

Quit smoking campaigns and services are having a positive effect. Not smoking has become the norm, but millions are still smoking.

The annual Stoptober campaign is one example of a stop smoking initiative, and this year it has become mandatory for pharmacies to get involved in. Pharmacy is now a firm place for smokers to come for quit smoking advice and products.

What’s new in 2019/20

This year Stoptober is one of the six national health promotion campaigns that all pharmacies have to take part in as part of the pharmacy contract. Taking part in Stoptober also means your pharmacy is demonstrating that it is meeting its Healthy Living Pharmacy requirements. 

Stop smoking also touches on other parts of the pharmacy’s services. The pharmacy contract announced in July has included asthma consultations as part of the Pharmacy Quality Scheme (PQS) which means there may be additional opportunities to help smokers quit. In addition, the new Community Pharmacist Consultation Service (CPCS) will see NHS 111 advisors referring patients to the pharmacy for minor illness. These are also new opportunities of making every contact count and raising the subject of quitting where appropriate.

Latest figures

The latest figures for 2018 show that across the UK there were 7.2 million adult smokers.* 

Smoking rates are dropping at the fastest rate in over a decade, according to Public Health England (PHE), with around 200 fewer smokers every hour.

Not smoking is now the norm but there are still millions who smoke (14.4% of the adult population in England) and there were an estimated 77,800 deaths attributed to smoking in 2017. 

Who to target

PHE has recognised some key people where levels of smoking are high (2018 figures): 

  • 25 to 34-year-olds – 1.4 million smoke, equivalent to one in five in the population.
  • People in manual jobs – 1 in 4 people smoke compared to 1 in 10 in managerial and professional jobs. They are also more than twice as likely to smoke than people in other jobs.
  • Unemployed –  almost twice as likely to smoke as those in work.

PHE has also recognised that people using E-cigarettes are another good group to target because they are often further down the quit journey. Figures for 2018 show there are now just under 2.5 million vapers (people using E-cigarettes) and just over half of them have stopped smoking altogether. With the rest (who are still vaping and smoking), half (600,000) are vaping as a means to quit and this is the group the pharmacy can reach out to and support. The total number of vapers in Great Britain in 2018 was 3.7 million.*

How to reach smokers

There is still more the pharmacy can do and everyone in the team can contribute.

Some smokers are already coming into the pharmacy for other services and can be targeted where appropriate with stop smoking messages. For example:

  • Many longer-term smokers will already be in poor health and be in regular contact with the pharmacy for prescriptions.      
  • Many people with mental health problems and pregnant women also access the pharmacy regularly.
  • The pharmacy’s other services can also be used as a way of identifying smokers and broaching the subject of quitting. These include weight management, NHS Health Check, diabetes checks, medicines use reviews (MUR) and the new medicines service (NMS). 

Data for your local area

You can find out what the smoking rates are in your area and how it compares with the rest of your region. Visit the Local Tobacco Profiles for England website where all the latest data is available.

Your pharmacy’s Health Champion may have already looked this up and can share it with the team.

* Office for National Statistics July 2019 

Why it’s hard to quit

Even people who really want to quit can find it hard. Nicotine is very addictive and withdrawal symptoms and cravings are the reasons why most smokers do not try to quit.

Common withdrawal symptoms include:

  • Urge to smoke
  • Weight gain
  • Headaches
  • Insomnia
  • Concentration problems
  • Fatigue
  • Restlessness
  • Irritability

Advice to help with quitting

Here is some information to help you advise your customers:

  • Pick a date to quit
  • Keep positive – make a list of reasons that you are quitting
  • Get some support e.g. quit with a friend or join a smoking cessation clinic
  • Get rid of all cigarettes and ashtrays
  • View every day without a cigarette as a success
  • Keep busy at times when you would normally have a cigarette e.g. wash up straight after dinner
  • Save the money you would have spent on smoking in a ‘cash, not ash’ jar
  • Don’t replace cigarettes with food, and include exercise into your day (even a 5-minute walk can cut cravings)

Stop smoking products and services

Recent research in the British Medical Journal has shown that when behavioural support and/or nicotine replacement therapy (NRT) were delivered through community pharmacies, people were more than twice as likely to stop smoking as those who relied on brief advice from a GP. This means pharmacy has a great opportunity to help people that want to quit.

The NHS Stop Smoking Service is a national network of advisers who are trained to offer customers stop smoking support. They are free for customers to access in person (e.g. at a GP surgery, or within a pharmacy), on the phone or online and can increase the chance of stopping for good. 

Advisers offer support, motivational tools (e.g. carbon monoxide testing) as well as NRT, bupropion (Zyban) or varenicline (Champix). These can also be prescribed by a GP, where the usual prescription charges apply. Advice is also being given on E-cigarettes.

The pharmacy is often the first place customers go to for advice on stopping smoking and pharmacy staff are able to train to become an NHS stop smoking adviser via their local clinical commissioning group (CCG).

Nicotine replacement therapy

NRT products are available on prescription from an NHS adviser and over the counter (OTC).

  • NRT works by delivering the nicotine the smoker is addicted to but not the other toxic chemicals found in cigarettes
  • It can be recommended to smokers quitting outright (stopping cigarettes completely)
  • It can also be recommended to people who want to cut down before quitting completely
  • When used correctly NRT can double a person’s success in quitting smoking
  • It can cause side effects such as nausea, dizziness, indigestion, insomnia, headaches, vivid dreams, hiccups, skin irritation (when using patches), irritation of nose, throat or eyes (when using a nasal spray).

What are the different types of NRT?

NRT comes in different forms including patches, chewing gum, inhalator, nasal spray, mouth spray, tablets and lozenges.

The main NRT brands are Nicorette, Nicotinell and NiQuitin.  Deciding which formulation is right for a person depends on how much and when they smoke and their personal preferences. Make sure people are following the dose reduction schedule.

Some customers may benefit from combining more than one form of NRT e.g. patch plus chewing gum.

To help you learn more, handle each of the products you sell, look at the packaging and get familiar with how to use them.

NRT formats

Patch

  • Easy to use and gives continuous nicotine so good for people who want to quit without cutting down first
  • There are 2 types of patches, those worn for 24 hours and those worn for 16 hours (which is removed while the customer sleeps). 
  • The 24-hour patch can disturb sleep in some people
  • Patches can cause skin irritation in some people, but this can be reduced by alternating where the patches are placed

Oral

  • Includes gum, lozenge and microtab
  • Releases the nicotine immediately, but some may dislike the taste
  • Can help people wanting to cut down before quitting or are suffering from intermittent cravings
  • The gum should be chewed until the taste becomes strong, then the gum is ‘parked’ between the gumline and the cheek until the taste fades, then repeat the chew and park cycle

Inhaled

  • Includes inhalator and nasal spray
  • Releases the nicotine immediately and can help people wanting to cut down before quitting
  • Inhalator may help those who wish to replace the hand and mouth action of smoking
  • The sprays release nicotine in a rapid manner and are best for highly dependent smokers who experience strong cravings

Pre-quit products

  • These allow customers to smoke as needed for the first 2-4 weeks prior to their quit date
  • They are available as patches and lozenges 

Prescription Products

Be aware that some customers may have been given medicines on prescription or via an NHS adviser to help them quit. They are classified as Prescription Only Medicines (POMs) and help reduce the cravings for cigarettes.

Bupropion (Zyban)

It is started 1 or 2 weeks before the customer’s quit date and then continued for around 2 months to help with withdrawal cravings.

Varenicline (Champix)

It is started 1 or 2 weeks before the quit date and treatment normally lasts for 12 weeks.

Where do E-cigarettes fit in?

The first electronic cigarettes (E-cigarettes) was licensed in December 2015 by the Medicines and Healthcare products Regulatory Agency (MHRA), the Government body that licenses medicines and devices. 

These products are getting regulated and are now being regarded as good options to recommend to some would-be quitters.  Some customers may ask you about E-cigarettes so it is important to know more about these so you can offer up to date advice.

This includes the following:

  • Public Health England (PHE) has concluded that the E-cigarette devices are significantly less harmful than smoking.
  • They also found no evidence that E-cigarettes act as a route into smoking for children or non-smokers. E-cigarettes have been included in the Stoptober campaign.
  • Examples of brands available through pharmacy include Strive, 10 Motives and Vype.
  • E-cigarettes are regulated in the UK under the Tobacco and Related Products Regulations 2016, designed to ensure that E-cigarettes are safe and that people have the information they need to make informed choices. Manufacturers of E-cigarettes have to conform to new safety standards, including specifying the ingredients used in their product and limiting the size of tanks and refills.
  • It is illegal for retailers in England and Wales to sell E-cigarette products to anyone under the age of 18.

Ask your pharmacist for brands stocked and store-specific guidance on E-cigarettes.


Access OTC Stop Smoking Training Course from MediaPharm

This 20-minute training course has everything you and your team need to consult with confidence.

Access the OTC Stop Smoking training course now