Smoking cessation and the general practice pharmacist
Deeks, LS and Kosari, S and Develin, A and Peterson, GM and Naunton, M, Smoking cessation and the general practice pharmacist, Journal of Smoking Cessation pp. 1-4. ISSN 1834-2612 (2019) [Refereed Article]
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.