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The Pharmacists' Challenges in the Provision of Smoking Cessation
Counseling Service Survey
Prof. T. H. Lam, Chair Professor and Head, Department of Community Medicine
School of Public Health,The University of Hong Kong
Dr. Sophia S. C. Chan, Head, Department of Nursing Studies, The University of Hong Kong
May 10, 2007
2
Survey OverviewObjective To understand the pharmacists' challenges in the provision of
smoking cessation counseling services
Date April 17 – May 4, 2007
Methodology Questionnaires
Target Community pharmacists in Hong Kong (includes two chain pharmacies and other pharmacies)
Institute Department of Nursing Studies and Department of Community Medicine, School of Public Health, The University of Hong Kong
No. of Sample 2 chain pharmacies: 105 copies Other pharmacies: 350 copies
Successful Sample
2 chain pharmacies: 77 copies (73%)Other pharmacies: 50 copies (14%)The response rate of other pharmacies is comparatively low, so the analysis will only be focused on 2 chain pharmacies.
1. HK people’s needs of smoking cessation counseling services
4
All respondents' workplace provides smoking cessation products
Q: Does your workplace offer any smoking cessation products ？
Successful sample ： 77
Yes100%
5
About 90% respondents' workplace offers NRT-gum, NRT-spray and NRT-
patch
87%
88%
95%
82% 84% 86% 88% 90% 92% 94% 96%
NRT-patch
NRT-spray
NRT-gum
Q: What kind of smoking cessation products does your workplace offer?
Successful sample ： 77 (multiple answers)
6
In the recent week, on average 4 customers asked respondents about smoking cessation
16%9%
75%
0%
10%
20%
30%
40%
50%
60%
70%
80%
None 1 to 5 people 6 to 10 people
Successful sample ： 77
Q: In the recent week, on average, how many customers asked you about smoking cessation ？
Mean: 4 customers asked
7
In the recent week, on average, 3 customers purchased smoking cessation
products from the respondents
9%14%
75%
1%0%
10%
20%
30%
40%
50%
60%
70%
80%
None 1 to 5 people 6 to 10 people 11 to 20 people
Successful sample ： 77
Q: In the recent week, on average, how many customers purchased smoking cessation products from you ？
Mean: 3 customers purchased
8
In the recent week, 2 out of every ten customers who purchased smoking cessation products
asked respondents about smoking cessation counseling services
34%
1%
4%
49%
3%
9%
0% 10% 20% 30% 40% 50% 60%
No comment
None has asked
None
1-3 person
4-6 people
7-9 people
Successful sample ： 72
Q: In the recent week, how many out of every ten customers who purchased smoking cessation products asked you about smoking cessation counseling services?
Mean: 2 customers purchased smoking cessation products asked about smoking cessation counseling services
9
No3%
Yes85%
No customers purchased any
smkoing ;cessation product
thus did not ask12%
In the recent week, 86% of respondents asked their customers about their smoking habit
Successful sample ： 76
Q: In the recent week, have you ever asked your customers about their smoking habit?
10
In the recent week, on average, respondents have asked 3 customers about their smoking habit
92%
8%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
6-10 people
1-5 people
Successful sample ： 67
Q: (Only for those who asked their customers on their smoking habit) How many customers have you asked in the recent week?
Mean: on average, community pharmacists asked 3 customers about their smoking habit
11
88% respondents’ customers asked about the instruction of using smoking cessation products
80%
88%
23%
10%
11%
30%
77%
61%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Others
Changes in lifestyle
Customized advice
Physical discomfort
Side effects
Product info (such as ingredients)
Product effectiveness
Product usage
Successful sample ： 74 (multiple answers)
Q: What kind of questions did your customers ask about smoking cessation?
12
38% of respondents are often proactive in providingcounseling services to customers who purchased smoking
cessation products
9%
38%
51%
1%0%
10%
20%
30%
40%
50%
60%
Often Sometimes Seldom No comments
Successful sample ： 76
Q: Are you proactive in providing counseling services to those who purchased smoking cessation products?
13
18% of respondents can identify quitters and are often proactive in providing counseling
services
Successful sample ： 76
Q: Are you able to identify the potential quitters and proactive in providing counseling services?
30%
18%
46%
5%0%5%
10%
15%20%25%30%35%
40%45%50%
Often Sometimes Seldom No comment
14
In recent week, on average, 2 out of every ten respondents’ customers refused to accept counseling services
61%
6%
7%
26%
0% 10% 20% 30% 40% 50% 60% 70%
7 – 9 people
4 – 6 people
1 – 3 people
None
Successful sample ： 54
Q: In the recent week, on average, how many out of ten customers refuse your counseling services?
Mean: on average, 2 out of every ten respondents’ customers refused to accept counseling services (Inactive in providing service and
no comment is not included)
15
When customers refused listening to their advice, 78% respondents would provide leaflet or additional info
78%
31%
4%
6%
13%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Others
Suggest the customer to visitother smoking cessation
clinics or to call the hotline
Stop doing anything
Provide leaflet of other clinicand make referrals
Provide leaflet or additionalinfo
Successful sample ： 72 (multiple answers)
Q: What would you do when your customers refused listening to your advice?
16
Respondents think the reason for customer not listening to their advice was that customers think
they can manage the process themselves
54%
29%
51%
25%
15%
22%
15%
0% 10% 20% 30% 40% 50% 60%
Others
Customers feel embarrassed
Customers are not aware of the services
Customers consider smoking cessation products easy to use, therefore didnot ask
Customers do not see the value
Customers do not have the need to quit smoking
Customers think they can manage the process themselves
Successful Sample ： 69 (multiple answers)
Q: Do you know why your customers did not listen to your advice ？
2. The importance of counseling services to smoking cessation outcomes
18
Respondents consider the key driver for successful smoking cessation is:
The will power and determination of the quitter
3.65
2.84
3.53
3.73
4.74
4.32
0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5
Tthe effectiveness of othersmoking cessation products
NRT
Professional smoking cessationcounseling services
Practical smoking cessation plan
Support from family and friends
The will power and determinationof the quitter
(N=77)
Q: How important are the following factors in contributing to the success of smoking cessation? (0= completely no impact ， 5=have significant impact)
(N=77)
(N=77)
(N=75)
(N=75)
(N=75)
3. The mindset of quitters in the smoking cessation process
20
74% Respondents consider the most common perception of smoking cessation amongst quitters are
quitting smoking will lead to weight gain
74%
59%
13%
7%
26%
0% 10% 20% 30% 40% 50% 60% 70% 80%
Others
Quitting smoking will bring early death
Quitting smoking will weaken the body
Do not need to quit smoking as many smokers aged 80+ arestill alive
Quitting smoking will contribute to weight gain
Successful sample ： 76 (multiple answers)
Q: Which of the following do you think the quitters would agree with?
21
In the recent 3 months, amongst those who was contacted by respondents,
14% of them set a smoking cessation plan
21%
8%3%
52%
14%
0% 0%3%0%
10%
20%
30%
40%
50%
60%
1 – 20% 21 – 40% 41 – 60% 61 – 80% 81 – 90% 91 – 100% none (0% ) no comment
Successful sample ： 77
Q: How many of those you have contacted set a smoking cessation plan for themselves?
Mean: 14% of customers set a smoking cessation plan
22
In the recent 3 months, amongst those who have contacted by respondents,
65% considered it takes 3 months or less for quitting smoking successfully
18%
34%
10%
21%
9%3%5%
0%
5%
10%
15%
20%
25%
30%
35%
40%
1 to 2 weeks 3 to 4 weeks 2 to 3 months 4 to 6 months 7 to 12months
12 months ormore
no comment
Successful sample ： 77
Q: In the recent 3 months, amongst those you have contacted, how long do they think they will need to spend in order to quit smoking successfully?
Mean: 12 months
23
66% of respondents consider themselves capable of setting a practical plan for the quitters
Successful sample ： 77
Q: Do you think if you can help quitters to set a practical plan of smoking cessation?
no comment31%
I can't3%
I can66%
24
Respondents consider they are 38% successful in helping quitters quit smoking
Successful sample ： 74
Q: How successful do you think you are in helping quitters quit smoking?
16%14%
1%
11%
0%
5%
26%23%
4%
0%
5%
10%
15%
20%
25%
30%
100%successful
80% - 90%successful
60% - 70%successful
50%successful
40%successful
30%successful
20%successful
10%successful
100%unsuccessful
Mean: respondents are 38% successful in helping quitters quit smoking
25
84% of the respondents considerthey are more than half confident in helping
quitters quit smoking successfully
Successful sample ： 74
Q: How confident do you think you are in helping quitters quit smoking?
24%
1%4%
54%
1%
15%
0%
10%
20%
30%
40%
50%
60%
100% confidenct 80 -90% confident 60 -70% confident 50% confident 30 -40% confident 10 -20% confident
Mean: 84% of the respondents consider they are more than half confident in helping quitters quit smoking successfully
26
50% of the respondents considerthey are capable in helping quitters quit
smoking successfully
Successful sample ： 74
Q: How capable do you think you are in helping quitters quit smoking successfully ？
46%
0%4%
37%
3%
11%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
100% capable 80 -90% capable 60 -70% capable 50% capable 30 -40% capable 10 -20% capable
Mean: respondents consider they are capable in helping quitters quit smoking successfully
Conclusion
28
Low Utilization of Smoking Cessation Counseling
The survey was the first such study on pharmacists in Hong Kong. The response rate was 73%, which was good. 90 per cent of pharmacists said that various smoking cessation products such as NRT-gum, NRT-spray and NRT-patch, are being offered in the pharmacies they work. Yet smokers fail to make use of those products as they seldom seek help from pharmacists, who are more than happy to help.
29
Pharmacists Counseling on Smoking Cessation Boost Success
Since the 2 mg NRT products are freely accessible over-the-counter, smokers easily by-pass the pharmacists. As such, they miss the chance of getting the best treatment as well as developing an effective smoking cessation plan. Different smokers have different needs. Well-trained pharmacists can provide customized services that are far more effective.Smokers should seek help from pharmacists promptly.
30
NRT + Pharmacist’s Counseling Boost Success
It takes determination, usage of NRT, pharmacist assistance, and good planning in order to quit smoking successfully To be effective, quitters should use NRT products continuously for at least eight weeks. In general, the therapy takes around two to three months to complete.Smokers should be on their guard not to smoke again afterwards. As the Kong Kong Council on Smoking and Health says, “Don’t be defeated by the cigarette!”
Respondents Profile
32
Gender
Successful sample ： 74
Female62%
Male38%
33
Age
7%
77%
16%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Aged 35 or below Aged 36 to 44 Aged 45 to 54
Successful sample ： 74Mean Age: 37
34
Professional Qualifications
19%
1%
80%
0%10%20%30%40%50%60%70%80%90%
Diploma Bachelor degree Master degree orabove
Successful sample ： 74
35
Duration of Practice
5%
50%39%
5%
0%
10%
20%
30%
40%
50%
60%
1 to 5 years 6 to 10 years 11 to 20 years 21 to 30 years
Successful sample ： 74Mean Duration of Practice: 7 years
36
Smoking Habit
Successful sample ： 74
96%
1%
3%
0% 20% 40% 60% 80% 100% 120%
Somking once in a while
Smoked in the past ;yet quitted over 1year
Never smoke
