Evaluation of a programme to increase referrals to stop‐smoking services using Children's Centres and smoke‐free families schemes

Abstract

Aims To assess the feasibility and effectiveness of a new service using referral liaison advisers to increase the number of referrals of parents/carers at selected Children's Centres to National Health Service (NHS) Stop Smoking Services (SSS) and/or smoke-free families schemes (SFS). Design This mixed-methods pilot study collected numerical data on indicators of smoking behaviours and carried out face-to-face and telephone interviews. Settings Thirteen Children's Centres in Liverpool and Nottingham using local providers of smoking cessation services, from September 2010 to April 2011. Participants Parents and carers registered with, and staff working for, Children's Centres. Measures Number of smokers referred to smoking cessation services and/or smoke-free family schemes and the views of service providers and users on the new service. Findings In Liverpool, 181 referrals to NHS SSS were made from 331 identified smokers (54.7%); extrapolated to 12 months, this represents a 182% increase in referrals from baseline and a similar extrapolation indicates a 643% increase from baseline of referrals to smoke-free families schemes. There were no reliable baseline data for Nottingham; 31 referrals were made (30.7% of smokers) to SSS and 44 referrals to SFS from 52 contacts (84.6%). The interviews highlighted the need for sustained personal contact with parents/carers to discuss smoking behaviours and concerns and their willingness to be referred to SFS as part of caring for their child. Conclusions Routine recording of smoking status and appropriate follow-up by trained staff in Children's Centres can lead to significant numbers of clients attending stop-smoking services, although relatively few stop smoking.

Proactive Referral to Behavioral Smoking Cessation Programs by Healthcare Staff: A Systematic Review

“… 59–61 The majority of the ­studies were conducted in the United States ( n = 24). 26 , 29–34 , 37 , 38 , 40–46 , 48 , 49 , 52–55 , 58 , 60 Six studies were conducted in the United Kingdom, 50 , 51 , 56 , 57 , 59 , 61 two in Canada, 39 , 47 one in Australia, 36 and one in Hong Kong. 35 …”

Developing the evidence base for addressing inequalities and smoking in the United Kingdom

“…Tobacco can be seen as a stigmatized behaviour, and therefore professionals involved in the projects frequently had to find imaginative ways of raising the issue of tobacco use sensitively and in a non-judgemental manner. For example, for parents who smoked and attending the children's centres, staff found it easier to raise the issue of smoking through a more generic discussion around promoting child health rather than parental health [28]. Indeed, throughout the projects, the most successful strategies for raising the issue of tobacco use Addressing inequalities and smokingappeared to be those that embedded tobacco among other issues about wellbeing that were being discussed routinely.…”

Understanding willingness to access and experiences of NHS Stop Smoking Services: a qualitative systematic review with meta-aggregation synthesis

“…Furthermore, referral pathways may need to be reviewed. Innovation and improvements to the referral systems have demonstrated increased numbers of referrals to NHS-SSS [53]. Evidence suggests that an 'opt-out' referral system permits for a more straightforward process and is acceptable to women who are pregnant [40].…”

“…Lastly, to enhance smokers' ability to engage with NHS-SSS, the importance of having convenient services and 'credible' advisors, who are empathetic, non-judgemental and come from diverse backgrounds should be acknowledged. Interventions including outreach personalised invitations [53] and phone apps [55] have been shown to overcome some of these barriers particularly for women who are pregnant who may be more susceptible to feeling judged [40][41][42][43][44]. Attempts have been made to upskill professionals by fostering reflective practice to overcome these challenges [56].…”