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Smoking cessation and the general practice pharmacist

Published online by Cambridge University Press:  05 April 2019

Louise S Deeks ,
Sam Kosari ,
Anne Develin ,
Gregory M. Peterson  and
Mark Naunton
Louise S Deeks
Affiliation:
Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, Canberra, ACT 2601, Australia
Sam Kosari*
Affiliation:
Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, Canberra, ACT 2601, Australia
Anne Develin
Affiliation:
Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, Canberra, ACT 2601, Australia
Gregory M. Peterson
Affiliation:
Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, Canberra, ACT 2601, Australia Faculty of Health, University of Tasmania, Hobart, TAS 7001, Australia
Mark Naunton
Affiliation:
Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, Canberra, ACT 2601, Australia
*
Author for correspondence: Sam Kosari, E-mail: sam.kosari@canberra.edu.au
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Abstract

Introduction

Roles for pharmacists in general practice are developing in Australia. It is known that pharmacists can provide effective smoking cessation services in other settings but evidence in general practice is lacking.

Aim

To determine whether a pharmacist can provide effective smoking cessation services within general practice.

Method

Data from smoking cessation consultations were obtained for 66 consecutive patients seen by one practice pharmacist. The pharmacist tailored interventions to the individual. Medication was offered in collaboration with community pharmacists and general practitioners. Quit coaching, based on motivational interviewing, was conducted. Smoking status was ascertained at least 6 months after the intended quit date and verified by a carbon monoxide breath test where possible.

Results

The patients’ median age was 43 years (range 19–74 years); 42 were females (64%). At baseline, the median (i) number of pack years smoked was 20 (range: 1–75); (ii) Fagerstrom Test of dependence score was 6 (1–10); and (iii) number of previous quit attempts was 3 (0–10). Follow-up after at least 6 months determined a self-reported point prevalence abstinence rate of 30% (20/66). Of all patients who reported to be abstinent, 65% (13/20) were tested for carbon monoxide breath levels and were all below 7 ppm. The biochemically verified smoking abstinence rate was therefore 20% overall (13/66). Successful quit attempts were associated with varenicline recommendation (69% v 25%), increased median number of practice pharmacist consultations (4 v 2 per patient) and mental health diagnosis (85% v 51%).

Conclusion

Our observed abstinence rate was comparable or better than those obtained by practice nurses, community pharmacists and outpatient pharmacists, indicating the general practice pharmacist provided an effective smoking cessation intervention. A larger randomised trial is warranted.

Keywords

General practicepharmacistprimary caresmokingsmoking cessation
Type
Brief Report
Information
Journal of Smoking Cessation , Volume 14 , Issue 3 , September 2019 , pp. 186 - 189
Copyright
Copyright © The Author(s) 2019 

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