Optimising standard care smoking cessation advice from Health Care Assistants, Practice Nurses and GPs in the Management of Smoking in Primary Care (MaSC) trial

Background

Despite the clear harms associated with smoking tobacco, some people are unwilling or unable to stop. Health care professionals (HCPs) find conversations with smokers who are unwell about quitting challenging as they expect resistance. Yet HCPs are mandated to give stop smoking advice and offer treatment during routine appointments to reduce harm. Our ongoing study is examining whether offering smokers with long-term medical conditions who decline standard treatments during annual reviews a free electronic cigarette (e-cigarette) plus support might be more effective than standard care alone. Our proposed project is based on information already collected on how the standard stop smoking advice and treatment offers were given to patients during the study. We will use this resource to try and understand and overcome the challenges faced by HCPs when offering standard care.

Methods/design

Our study patients are smokers with smoking-related disease or serious mental illness. We have already asked our HCPs and patients to audio record their conversations about stopping smoking tobacco and about trying e-cigarettes during the trial. The proposed project will allow us time to closely examine the sections where HCPs are giving standard care stop smoking advice and offering treatment to patients. We will use a well-established method called ‘Conversation Analysis’ to identify the different ways by which HCPs approach giving advice and offering treatment to stop smoking, and any patterns in how patients respond, for example the ways they resist advice or help and reasons given.

Anticipated impact

This will be the first large investigation of HCPs unsuccessfully delivering advice and offering standard treatment to patients with smoking-related diseases or serious mental illness who smoke. With input from patients, we will use our findings to enhance exisiting training for HCPs that can be widely shared to optimise future standard care and help reduce smoking-related harm.