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Making Quit Happen Report

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.

Smokers want to quit

• Eighty-one percent of B.C.’s smokers have tried to quit in the past, averaging seven quit attempts in total, two in the last year alone.
• When asked to rate themselves on a scale where 10 meant they definitely wanted to be smoke-free and 0 meant they definitely did not want to be smoke-free, B.C.’s smokers scored an average of 7.2.
• Seventy-seven percent are concerned about the impact their smoking will have on their long-term health, and when asked why they would quit, future health concerns topped the list (see Table 1).

(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)

• Further, the vast majority of B.C.’s smokers (89%) believe that quitting—despite being difficult—is possible.
• Most (62%) are aware of the various national, provincial, and local organizations and support services that specialize in helping smokers quit.

Barriers to quitting

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.

The physician’s role

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.

Cessation methods

• B.C.’s smokers have tried numerous methods in their effort to quit. “Cold turkey” is the most frequently used method (see Table 3).
• Seventeen percent have tried a prescription therapy, with more than half of these patients (55 percent) paying full price for it as opposed to paying through a private or provincial drug plan.

(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)

Need for affordable medications

• Sixty-eight percent of B.C.’s smokers believe that an increase in the availability of affordable cessation medications would help motivate them to quit. All the physicians surveyed in B.C. agree.
• When asked what could be done to lower the national prevalence to 12% by 2011, B.C. physicians identified “access to affordable cessation medications” the most often (39%).

Recommendations

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.

 

Smoking Cessation news and announcements

May 25, 2009
The Lung Association Celebrates Quitters

Feb 20, 2009
Smoke-Free Winners Celebrate With Prizes and Healthy Lifestyles

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

January 2, 2009
Last Call for Smokers Ready to Quit and Earn the Chance to Win $20,000 in Prize

November 24, 2008
Quit and Cruise in 2009 - Local organizations launch massive quit smoking campaign

August 21, 2008
Caution Business Owners, Lack of Proper No Smoking Signage Could Cost You

August 1, 2008
*Announcement* Vancouver Continues to Lose the Lead on Smoke-Free Legislation

May 27, 2008
The B.C. Lung Association Calls for Improved Support to Help Smokers Butt Out for Good

May 26, 2008
Rebel Smokers Out to Sea - Smokers Retreat Offshore to Avoid Rising Tide of Tobacco Bans

February 12, 2008
BC Joins Nova Scotia in Protecting Kids from Second-Hand Smoke in Cars

January 23, 2008
*Announcement* Lung Association & Heart and Stroke Foundation Mobilize Support for a Smoke-Free BC

January 23, 2008
Our Kids Deserve It: BC Lung Association Launches National Push For Smoke-Free Cars