How Community Pharmacies Can Help Patients Quit Smoking
By Missy Ervin |
Despite intensive public health campaigns over the past several decades, cigarette smoking continues to be a serious public health issue in the United States. According to the Centers for Disease Control, approximately 15 percent of U.S. adults were still cigarette smokers in 2015. The CDC named cigarette smoking the leading cause of preventable disease and death in the country, accounting for more than 480,000 deaths per year.1
Pharmacists understand that cigarette smoking impacts the health of their patients. The CDC notes that smoking causes cancer, heart disease, stroke, lung diseases, diabetes and chronic obstructive pulmonary disease (COPD). Cigarette smokers also are at greater risk of tuberculosis, certain eye diseases and rheumatoid arthritis. And smokers who smoke in their homes or vehicles may expose loved ones to secondhand smoke, which has been linked to stroke, lung cancer and coronary heart disease.2
But community pharmacists have something else to worry about when caring for patients who smoke cigarettes. Cigarette smoking has been shown to affect drug therapy by both pharmacokinetic and pharmacodynamic mechanisms.3
A smoking cessation pilot shows encouraging results
While independent pharmacists can encourage their patients to quit smoking to improve their health, does a pharmacist’s advice, counseling and encouragement really make a difference in a patient’s decision to quit?
The results of programs such as the West Virginia Smoking Cessation Project, sponsored by Good Neighbor Pharmacy, suggest that a pharmacist-led intervention can have significant and lasting results in helping patients kick their cigarette habit.
Partnering with the CDC, five West Virginia independent pharmacies and the West Virginia Division of Tobacco Prevention, Good Neighbor Pharmacy targeted five rural areas in West Virginia with the highest prevalence of smoking in the country. This partnership used a mix of mass communications and hyperlocal, geo-targeted social media advertising to enroll 50 cigarette smokers who wanted to stop smoking. Targeting parameters included age (18 to 65+) and online interests, such as nicotine gum or being tobacco free.
To help patients quit, the pilot program combined OTC nicotine replacement therapy (NRT) products with counseling services (both in-person counseling administered by the community pharmacists and phone counseling over a toll-free telephone quit line).
In addition, Good Neighbor Pharmacy provided anti-smoking marketing material, including bag stuffers, posters and social media graphics, to supplement each participating community pharmacy’s anti-smoking arsenal.
Community pharmacists participating in the pilot also had the option of directing patients to a mini-site, http://www.mygnp.com/smoking-minisite, containing multimedia information on the hazards of smoking, the benefits of quitting and resources to do so.
At the end of the 10-week pilot program, 40 percent of the enrolled patients had successfully quit smoking. Over 33 percent of enrollees were still successfully abstaining from cigarettes after 24 weeks. These impressive figures show the efficacy of a comprehensive pharmacist-led anti-smoking program that includes counseling, OTC NRT products and supporting marketing material.
“[The West Virginia Smoking Cessation Project] has utilized our accessibility as pharmacists to build a vital relationship with patients as they begin their journey towards smoking cessation,” said Beth Kelli Louthan of Goodykoontz Drug Store, a participating community pharmacy.
“It also allowed the pharmacist and technician to work as a team to make a lasting impact on the lives of the patients enrolled.”
Four ways to help patients stop smoking
The takeaway from this anti-smoking pilot program is that a comprehensive, multifaceted program that combines pharmaceuticals, counseling and information can have good results. Here are four ways for independent pharmacists to incorporate the lessons learned from the pilot program to aid smoking cessation among their own patients and in their own communities:
- Provide patients with access to educational anti-tobacco materials
An independent pharmacy dedicated to smoking cessation should provide literature to educate patients both on the dangers of prolonged tobacco use and the options available to quit.
These educational materials can come in the form of brochures, flyers and small booklets. Independent pharmacies should also display educational materials in the form of posters that advertise smoking cessation and apps patients can download to assist in their journey to smoking cessation.
Pharmacists can also point patients to the quit smoking mini-site used in the pilot or to CDC resources such as https://www.cdc.gov/tobacco/quit_smoking/index.htm.
- Carry a full range of products to help patients quit
Community pharmacies should be sure to stock a range of NRT delivery methods. Some patients may prefer to use NRT chewing gum or lozenges, while others will want to try a skin patch, nasal spray or inhaler. Pharmacists should be prepared to counsel patients on the pros and cons of each delivery system.
Naturally, independent pharmacies should carry the most-often prescribed anti-smoking medications. But, carrying such anti-smoking remedies will only go so far; community pharmacies must also have conversations with patients and form relationships with local physicians when they think this could be a viable solution for nicotine-dependent patients. Supplying the drug is only the first step, getting the word out and educating both patients and physicians on this option is the best way to see it in the hands of those who need it most.
- Host support groups and hold events to educate and inspire customers to kick their cigarette habit
Quitting smoking can be a real challenge. As smokers try to quit, it can be helpful for them to meet people who have succeeded in kicking the habit or who are on the same journey. Community pharmacies can facilitate this type of support by hosting support groups and holding educational events.
Some independent pharmacies have established a dedicated room to hold group discussions and education sessions. Other pharmacists prefer to host these events at churches, libraries or community centers. Pharmacists can lead these events themselves or bring in guest speakers — such as a patient who succeeding at quitting smoking 10 years ago and has seen dramatic health improvements in the years since then.
In designing the West Virginia anti-smoking pilot, Good Neighbor Pharmacy partnered with Strand, formerly Creative Pharmacist, a solutions provider that teaches pharmacists the best ways to educate patients. For pharmacists who may not feel comfortable leading a group anti-smoking session, Creative Pharmacist can provide guidance on maximizing the effectiveness of one-on-one counseling sessions between the pharmacist and patient.
- Find ways to incorporate technology into your anti-smoking efforts
There are a number of platforms geared toward “behavior change” in the healthcare space. These often present a “360 approach,” combining an app, alerts, predictive analysis, education, caregiver and peer support, as well as gamification.
Fortunately, with smartphones universally carried and apps commonly used by patients, community pharmacies can suggest that patients utilize these tools. One such app, Kwit, utilizes game techniques, which includes 84 achievements users can unlock and a ranking system, to encourage patients to quit smoking. The LIVESTRONG Dare to Quit Smoking, which has over 1,000 reviews and a user rating of over four stars, gives users a personalized plan to rid themselves of their nicotine dependency. Whether quitting cold turkey or opting for a gradual process, this app allows patients to keep tabs on their progress and receive goal-based achievements.
Another app, QuitNow!, boasts more than two million quitters who have successfully used the app and offers real-time stats, including the time since a patient’s last cigarette and money saved. And, much like the LIVESTRONG app, the platform is social, which serves as another key motivator to keep patients on track.
Independent pharmacists are well positioned to provide valued, trusted advice to patients. By helping patients quit smoking, community pharmacists can help patients — and those who might be impacted by patients’ secondhand smoke — to live longer, healthier lives.
And for independent pharmacies that join the Good Neighbor Pharmacy network, they can access the same full suite of resources — which includes educational materials such as bag stuffers, posters and social media graphics — that were available to the participants in the West Virginia Smoking Cessation Project. Such materials can help kick-start your community pharmacy’s program to help patients end their smoking habit.
1. Centers for Disease Control and Prevention. (December 1, 2016). “Current Cigarette Smoking Among Adults in the United States,” https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm. Accessed December 11, 2017.
2. Centers for Disease Control and Prevention. (February 9, 2017). “Smoking & Tobacco Use,” https://www.cdc.gov/tobacco/basic_information/health_effects/index.htm. Accessed December 11, 2017.
3. Zevin, S.; Benowitz, NL. Clinical Pharmacokinetics, “Drug interactions with tobacco smoking. An update,” 1999 Jun; 36 (6): 425-38, https://www.ncbi.nlm.nih.gov/pubmed/10427467, accessed December 11, 2017.