|In this section:|
|Smokers want to quit|
|Barriers to quitting|
|The physician's role|
|Need for affordable medications|
Read complete report: Making Quit Happen: Canada’s Challenges to Smoking Cessation
Based on the results of its new report entitled Making Quit Happen: Canada’s Challenges to Smoking Cessation, The Lung Association is calling for universally accessible smoking cessation supports for all smokers living in Canada. (Read the news release issued May 28, 2008).
British Columbia has some of the strongest tobacco control legislation in Canada and the lowest smoking rate (16.4 percent) of any other province or territory.
A ban on smoking in public vehicles such as buses and trains has been in place for a long time. Not only are indoor workplaces including work vehicles, 100 percent smoke-free, but business owners are encouraged to make the entire business property smoke-free.
In addition, smoking within three meters of a building’s air intake was restricted in March 2008 with some communities further strengthening this restriction to a six-meter distance.
B.C.’s Ministry of Health has committed to smoking cessation as part of its overall tobacco control strategy by funding QuitNow – its toll-free telephone helpline services and web-based services provided in partnership with the BC Lung Association.
The province also serves special populations with specific programs targeted to cardiac patients, college students, workplaces and patients with mental health issues, women and in-patient programs in a hospital setting. In a few cases, nicotine replacement therapies are also provided free of charge to program registrants. Cessation services are provided by nurses, psychologists, pharmacists and specially trained smoking cessation facilitators.
Although smoking rates in B.C. remain lower than any other province or territory, the rate of decline has slowed in the past few years. In 2006, the rate of decline was 16.4 percent compared to 15.0 percent in 2005. Currently more than 550,000 people continue to smoke.
|(Table 1) The Top Three Reasons for Attempting to Quit Smoking|
|Future health concerns||70%|
|Cost of cigarettes||49%|
|Present health concerns||27%|
|Base: B.C. smokers (n=236)|
Smokers in B.C. believe that habit and physical addiction are the main barriers to quitting. Physicians surveyed in B.C. also see habit and addiction as significant barriers for their patients (see Table 2).
|(Table 2) The Top Two Barriers to Quitting||Smokers||Physicans|
|Craving/ physical addiction||53%||83%|
|Habit/ part of daily routine||50%||70%|
|Bases: B.C. smokers who have tried to quit in the past (n=195) B.C. physicians (n=23). CAUTION: Small base size.|
Despite clear benefits, many smokers do not speak to their doctor about quitting.
Making Quit Happen: Canada’s Challenges to Smoking Cessation reveals that most family physicians and allied health professionals feel they have a role to play in their patients’ smoking cessation.
In contrast, however, less than 20 per cent of family physicians (18 per cent) and allied health professionals (16 per cent) are trained in smoking cessation counselling. In addition, while 92 per cent of physicians reported speaking to their patients about the need to stop smoking, only 46 per cent of patients agree that the topic has been raised by their family doctor. This disconnect is even more pronounced in remote and rural areas where people do not have full access to cessation supports - online, telephone helpline, group and individual counseling.
Only 38 percent of B.C. smokers have spoken to their family physician/general practitioner about quitting in the last two years, and only 17 percent discussed the topic with a health professional other than their family physician. Yet for those who did, 77 percent state that their doctor / allied health professional suggested ways to quit. Further, as many as 52 percent of the ex-smokers who consulted their family physician or allied health professional about quitting say the advice they received actually helped them quit.
Both the physicians and the smokers surveyed in B.C. view the physician’s role in cessation as multi-faceted, from simply initiating the conversation and suggesting ways to quit, to prescribing cessation medications, providing cessation counselling, and scheduling on-going consultations for follow-up. Of the B.C. smokers surveyed, 84 percent believe that physicians should help patients make a plan to quit. Few physicians and few allied health professionals in B.C. (4percent and 11% respectively) have had any formal training in smoking cessation counselling. Unlike physicians in Ontario and even Quebec, relatively few B.C. physicians (only 9 percent) note they are currently being reimbursed for cessation counselling.
|(Table 3) The Top Five Methods Tried|
|Abrupt cessation by means of willpower only ('cold turkey')||71%|
|The nicotine patch||36%|
|A reduction in number of cigarettes smoked by means of willpower only until complete cessation||33%|
|Chewing nicotine gum or a lozenge||30%|
|A prescription therapy for smoking cessation||17%|
|Base: B.C. smokers who have tried to quit in the past (n=195)|
Improve and expand surveillance
Improve and expand surveillance to include rate of former smokers who remain smoke-free each year, and for those continuing to smoke, the number of quit attempts, the length of relapse and the length of time between relapses.
Expand access to programs and trained counsellors
Expand access to programs and trained counsellors. Ensure trained smoking cessation counsellors are available to all those who want to quit. Provide support and encouragement to quitters over the long-term.
Disseminate training to all health professionals
Disseminate training to all health professionals by including standard screening and intervention strategies in the curriculum for all physicians and allied health professionals and more extensive intervention training where required or requested.
Improve access to medications
Improve access to medications by including all medications on provincial formularies and drug coverage plans.
Provide more culturally relevant cessation support for Aboriginal Peoples
Provide more culturally relevant cessation support for Aboriginal Peoples that recognizes the realities of the First Nations, Métis and Inuit cultures, traditions, and language as well as their remote and/or dispersed locations.
May 25, 2009
The Lung Association Celebrates Quitters
February 12, 2009
Cupid’s Arrow Bypasses Smokers
January 21, 2009
Vancouver Sun ‘Weedless Wednesday’ Information Supplement
January 19, 2009
Thousands Join QuitNow Contest to Stop Smoking
February 12, 2008
BC Joins Nova Scotia in Protecting Kids from Second-Hand Smoke in Cars