Routes to Quit

Just over 40% of smokers will make an attempt to stop smoking each year, with over half choosing the least effective method of stopping by going unassisted, despite the fact that there are other more effective options available. The most effective option is the support offered by stop smoking services and over the last 10 years, the NHS has provided dedicated support for all smokers wanting to stop following the abrupt model of support. During this time, over 4 million smokers have been in contact with NHS Stop Smoking Services, over 2 million of whom stopped in the short-term (4 weeks) and over 500,000 in the long-term (at 12 months).

Whilst the research evidence suggests that smokers who quit abruptly are more likely to be successful in the longer term and the stop smoking service statistics are impressive, there is a growing awareness that not all smokers want or feel able to stop smoking straight away and therefore a large proportion of smokers are unlikely to engage with the current services available. As a result, the Routes to Quit Model (RtQ) has been developed, intended to develop a system that engages more smokers into evidence-based stop smoking support, based on the ‘hierarchy of evidence’ shown in Figure 1, Step 3.

Figure 1 – Routes to Quit model

Services to help people stop using tobacco – tailored quit plans (TQP)

The TQP model has been developed to enable smokers who are referred or self-refer to a stop smoking service to make an informed choice about the most effective support that they feel is appropriate for them. After an initial assessment, people are presented with the first of 5 different options (Figure 1, Step 3), to be offered to them in sequence based on the strength of the evidence for their efficacy. Once an option is chosen, the assessor locates and facilitates referral to the preferred provider and no further TQP options are offered.

Routes to Quit (RtQ) pilots

The NCSCT Community Interest Company (NCSCT CIC) has been commissioned by the Department of Health to test the RtQ model. Three pilots are being developed;

Two large scale pilots

• Somerset PCT
• NHS County Durham and NHS Darlington (including pregnant smokers and a potentially prison setting)

One small scale smoking population specific pilots

• The Bridge, class A drug clinic in Solihull

Pilot aim:

To test the feasibility of the RtQ model

Pilot objectives:

1. To test whether the RtQ model attracts more smokers to the stop smoking services and smokers who wouldn’t have previously engaged with a stop smoking service.
2. To identify the key elements required to implement the RtQ model as well as the potential barriers.
3. To test the RtQ model with specific smoking populations such as pregnant smokers and substance misusers.

All pilots are being quantitatively and qualitatively evaluated. An interim pilot report is now available here and a final report will be available in Spring 2012.

Project contact:

Melanie Chambers, Senior Delivery Manager

melanie.chambers@ncsct.co.uk