The health risks of tobacco are well documented, but employer-sponsored drug plans in Canada often remain hesitant to provide a smoking cessation benefit.
Objective:
The aim was to describe and assess the effectiveness of a smoking cessation program using community pharmacists to provide behavioural support to smokers motivated to quit.
Methods:
This was a descriptive study using administrative prescription claims data for an employer-sponsored smoking cessation program that ran between November 4, 2006, and December 17, 2006. Selected pharmacies provided assessments and behavioural support to 81 participants wishing to quit smoking. Pharmacies were reimbursed for their assessment and follow-up time. Self-reported, 6-month quit rates were the main outcome measure.
Results:
The smoking cessation program resulted in a self-reported, 6-month quit rate of 37.5%. Quit rates were higher for males than females (46.8% vs 24.2%) and higher for employees than for their spouses and dependents (47.2% vs 18.5%).
Conclusions:
These results suggest that Canadian employers can successfully sponsor smoking cessation programs that target smokers who are highly motivated to quit by providing community pharmacy—based behavioural support to achieve quit rates similar to or higher than those reported elsewhere in the literature. Additional research is required to confirm these results.
Get full access to this article
View all access options for this article.
References
1.
BaliunasDPatraJRehmJ. Smoking-attributable mortality and expected years of life lost in Canada 2002: conclusions for prevention and policy. Chronic Dis Can2007;27(4):154–62.
FioreMCBaileyWCCohenSJ. Clinical Practice Guideline: treating tobacco use and dependence. Rockville, MD: US Department of Health and Human Services; June 2000. Available: www.surgeongeneral.gov/tobacco/treating_tobacco_use.pdf (accessed April 29, 2008).
4.
The Tobacco Use and Dependence Clinical Practice Guideline Panel. A clinical practice guideline for treating tobacco use and dependence — a US Public Health service report. JAMA2000;283(24):3244–54.
5.
CurrySJGrothausLCMcAfeeTPabiniakC. Use and cost effectiveness of smoking cessation services under four insurance plans in a health maintenance organization. N Engl J Med1998;339(10):673–9.
6.
BoyleRGSolbergLIMagnanS. Does insurance coverage for drug therapy affect smoking cessation?Health Aff (Millwood)2002;21(6):162–8.
7.
KaperJWagenaEJWillemsenMCvan SchayckC P. Reimbursement for smoking cessation treatment may double the abstinence rate: results of a randomized trial. Addiction2005;100(7):1012–20.
8.
National Association of Pharmacy Regulatory Authorities (NAPRA). Summary of the Scientific Rationale for Unscheduled Status of Nicotine Replacement Therapy (Chewing Gum and Transdermal Patches), July 2001. Available: www.napra.org/docs/0/92/307/336.asp (accessed May 16, 2008).
9.
National Association of Pharmacy Regulatory Authorities (NAPRA). Outline of the Schedules. Available: www.napra.ca/docs/0/92/112/154/139.asp#schI (accessed April 29, 2008).
HalapyHMacCallumL. A pharmacist-run smoking cessation program. Can J Diabetes2006;30(4):406–10.
12.
TranMTHolfordDAKennedyDTSmallRE. Modeling the cost-effectiveness of a smoking cessation program in a community pharmacy practice. Pharmacotherapy2002;22(12):1623–31.
13.
SinclairHKBondCMLennoxAS. Training pharmacists and pharmacy assistants in the state-of-change model of smoking cessation: a randomized controlled trial in Scotland. Tob Control1998;7:253–61.
14.
TaylorJSemchukWNeubauerSKuzG. Patient satisfaction with a smoking cessation program in community pharmacies. Can Pharm J2003;126(5):30–3.
15.
DentLAHarrisKJNoonanCW. Tobacco interventions delivered by pharmacists: a summary and systematic review. Pharmacotherapy2007;27(7):1040–51.
16.
WilliamsDMNewsomJFBrockTP. An evaluation of smoking cessation-related activities by pharmacists. J Am Pharm Assoc (Wash)2000;40(3):366–70.
17.
HotzSB. Understanding and using the Transtheoretical Stages of Change Model. Available: www.ptcc-cfc.on.ca/pubs/RDS_0056.pdf (accessed April 29, 2008).
18.
Representative Board of Saskatchewan Pharmacists Professional Practice Committee. “PACT” — Partnership for Assisting in the Cessation of Tobacco Use. Saskatoon, SK: Representative Board of Saskatchewan Pharmacists; 2005.
19.
PierceJPGilpinEA. Impact of over-the-counter sales on effectiveness of pharmaceutical aids for smoking cessation. JAMA2002;288(10):1260–4.
20.
General Motors Canada Limited, Durham Region Health Department, CAW. Quit Smoking Challenge. Motoring to Wellness. Fall 2006.
21.
Canadian Pharmacists Association. QUIT: Quit Using and Inhaling Tobacco. Ottawa, ON: Canadian Pharmacists Association; 2006.
PreacherKJBriggsNE. Calculation for Fisher's exact test: an interactive calculation tool for fisher's exact probability test for 2 times 2 tables [computer software]. May 2001. Available: www.people.ku.edu/∼preacher/fisher/fisher.htm (accessed April 29, 2008).
25.
SidorovJChristiansonMGirolaniSWydraC. A successful tobacco cessation program led by primary care nurses in a managed care setting. Am J Man Care1997;3(2):207–14.
26.
KennedyDTGilesJTChangZG. Results of a smoking cessation clinic in community pharmacy practice. J Am Pharm Assoc2002;42(1):51–6.
27.
ZillichAJRyanMAdamsA. Effectiveness of a pharmacist-based smoking cessation program and its impact on quality of life. Pharmacotherapy2002;22(6):759–65.
28.
WeinbergerMMurrayMDMarreroDG. Issues in conducting randomized controlled trials of health services research interventions in nonacademic practice settings: the case of retail pharmacies. Health Serv Res2002;37(4):1067–77.
29.
CharroisTLNewmanSCSenthilselvanATsuyukiRT. Improving asthma control in the rural setting: the BREATHE (Better Respiratory Education and Asthma Treatment in Hinton and Edson) study. Can Pharm J2006;139(4):44–50.
30.
TomsonTBjörnströmCGilljamHHelgasonA. Are non-responders in a quitline evaluation more likely to be smokers?BMC Public Health2005;5(1):52.
31.
MotheralBBrooksJClarkMA. A checklist for retrospective database studies — report of the ISPOR Task Force on Retrospective Databases. Value Health2003;6:90–7.
32.
GradenSESchafermeyerKW. Performance reporting for managed care prescription programs. J Managed Care Pharm1998;4(2):160–6.
33.
LawMTangJL. An analysis of the effectiveness of interventions intended to help people stop smoking. Arch Intern Med1995;155(18):1933–41.
34.
OkuyemiKSNollenNLAhluwaliaJS. Interventions to facilitate smoking cessation. Am Fam Physician2006;74(2):262–71.
35.
HeyKPereraR. Quit and Win contests for smoking cessation. Cochrane Database Syst Rev2005;(2):CD004986.
