Smokers paid to quit in Perth, Scotland, in spite of dismal success rates in Dundee

More chaos in the world of smoking cessation as Perth becomes the next place where smokers will be paid to stop smoking.

To its credit, the Courier points out that a very low proportion of Dundee smokers have succeeded in quitting in spite of an investment of £530,000. It claims that 'fewer than one in ten are known to have quit for good' - the only surprising thing about this is seeing it in mainstream news media.

Chemist & Druggist have a view here, acknowledging that the success of cessation schemes is low but suggesting that paying pregnant smokers to quit may get better results. This was (of course) covered in a session at the 2010 UK National Smoking Cessation conference, by Linda Bauld of the UK Centre for Tobacco Control Studies, a body with publicly declared conflicts of interest. It is quite phenomenal that a drug that is known to work in a very low number of cases is supported not only with publicly paid prescription charges but also with funds to encourage people to make use of it. Academics whose careers depend on promoting smoking cessation medication, and those who profit directly from the sale of such treatments, seem able to do both without arousing public ire.

Last word to Johann Hari, who comments in an unrelated piece:

The Cranfield School of Management studied 170 companies who had used management consultants, and it discovered just 36 percent of them were happy with the outcome - while two thirds judged them to be useless or harmful. A medicine with that failure-rate would be taken off the shelves. [my emphasis!]

I wonder if he has ever studied the issue of smoking cessation medication?

Surrey Primary Care Trust axes pharmacy-based smoking cessation services

Sad to learn that the funding for pharmacy-run smoking cessation services will be axed in the autumn! Surrey Primary Care Trust has announced that it will no longer fund pharmacies to offer smoking cessation after October. GP services will not be affected.

This (I understand) doesn't mean that you won't be able to buy Niquitin from the chemist. It means that pharmacies won't get incentive payments for enrolling patients on to smoking cessation services. See Appendix 2, para h in this Warwickshire PCT report from 2008/2009 that describes payments for every patient who names a quit date, successfully quits at this date, or, incredibly, fails to quit at this date.

Chemist & Druggist is aggrieved and to some extent I can sympathise with the argument that the services offered by pharmacists are being sacrificed so as to avoid antagonising the GPs and the BMA, and that the pharmacy has much more regular and convenient access to the public than the average GP. However it's difficult to get worked up about who gets the lion's share of the smoking cessation market. Even ASH UK acknowledges the treatment is a patch-up job (see 'Habit, not nicotine prompts cigarette cravings').

That's what we are talking about here: who gets the market share of a product that promotes official anti-smoking agendas, and who gets the sweeties for delivering the marketing service. There is surely a wider tale to tell of rivalries between pharmacies and medically trained personnel in delivering health care ...