Smoking cessation at the pharmacy: feasibility and benefits based on a French observational study with six-month follow-up

Abstract

Background

In comparison to other European countries, the number of smokers remains high in France. Approximately five million smokers wish to quit within the year and need support that is local, easily accessible, and efficient. As public health actors, pharmacists could provide this service. The Sevrage Tabagique à l’Officine: Smoking Cessation Program at the Pharmacy (STOP) study was carried out to explore the feasibility of a smoking cessation program provided at pharmacies.

Materials and methods

Pharmacists participating in the study were trained to provide a smoking cessation program to smokers recruited at the pharmacy, which included five pharmaceutical interviews in six months, along with counseling and support, in addition to nicotine replacement therapy. This observational, longitudinal, prospective study assessed the feasibility of the program by measuring the percentage of participants remaining at the six-month visit, the proportion of invited pharmacies that actually participated in the program, and the benefits to the participants.

Results

Ninety pharmacies were invited to participate, 79 (88%) pharmacies entered the study, and 49 (54%) included study participants and treated 227 subjects with a mean age of 45.4 years. At six months, 23.3% of participants attended their follow-up visit, among which 75% had been abstinent since their last visit and more than half for 90 days. From the second follow-up visit, their Short Form 12 physical and mental health composite scores were improved in comparison with baseline. Participants and pharmacists all reported being highly satisfied with the program; however, the attrition rate was substantial, possibly due to some study limitations.

Conclusion

The provision of support for smoking cessation by pharmacies is feasible despite some barriers such as lack of awareness and difficulty to change habits for the smokers or lack of time and training for the pharmacists. The conditions necessary for this program to be implemented on a large scale include training of pharmacists, access to a private space in the pharmacy, remuneration for the pharmaceutical interviews, collaboration with other health care professionals, and an effective communications program regarding the service, both inside and outside of pharmacies. The relatively low number of participants at the end of the study could be improved by increasing awareness of the program, involving health authorities, and enlarging the number of pharmacies engaged in the program.

Keywords:

• counseling
• nicotine replacement therapy
• prevention
• training

Acknowledgments

This work was supported by Pierre Fabre Health Care, Castres, France. The authors are grateful to Dr Anne Laurence Le Faou, ambulatory center of addiction medicine, European Georges Pompidou Hospital, Paris, for her contribution to this work. She supervised the university memoir presenting the intermediate results of the study (Place du pharmacien d’officine dans la prise en charge du sevrage tabagique: résultats intermédiaires de l’étude observationnelle STOP/Place of the pharmacist in the management of smoking cessation: intermediate results of the STOP observational study). She provided improvements in the methods and reporting, and participated to the discussion in the light of the specific context of the French health system. The authors express their gratitude to all the pharmacists who took part in the study: Cristel Albert, Castres; Edouard Amalric, Montastruc la Conseillere; Xavier Ardillon, St Etienne; Martine Azemar, Clermont l’Herault; Stephanie Blanc, Ramonville St Agne; Eliane Blanc, Montrabe; Remi Boudou, Albi; Vincent Bousquet, Foix; Christelle Boyaud, St Chamond; Henri Caillot, Villefranche de Lauragais; Sebastien Cayotte, Castres; Bernard Champanet, Albi; Jean Marc Chavoix, Muret; Sofia Cherif, Elne; Marie France Chraibi, Firminy; Isabelle Clouscard, St Jory; Gladys Combettes, Narbonne; Gaelle Corallo, Cahors; Guillaume Dautezac, Castres; Isabelle Escouboue, Lagarrigue; Dominique Fabre, Lavaur; Florence Farrugia, Figeac; Jean Paul Ferrer, Grenade; Daniele Fourniols, Castelnau Montratier; Benoit Galibert, Limoux; Florence Gasquet, Montpellier; Isabelle Gschwind, Toulouse; Jacques Guichard, St Gilles; Christophe Huther, Nancy; Christine Laborde, St Orens de Gameville; Genevieve Lafond, Roanne; Anne Laures, Toulouse; Marie Lebastard, Payrin Augmontel; Elisabeth Marchal, Barentin; Mireille Martignac, Cordes sur Ciel; Bettina Mastrangelo, Lattes; Maud Mingeau, Pouilly sur Loire; Thierry Muller, Sarreguemines; Martine Oldak, Blagnac; Lionel Raynal, Bressols; Isabelle Remy, Thiaucourt; Valerie Rocchi, Allauch; Brigitte Roqueta, Lattes; Patricia Salama, Castelginest; Maxime Segala, Cazouls les Beziers; Agnes Tarodo de la Fuente, St Amans Soult; Laurie Tournut, Lorp Sentaraille; Jean Charles Vautrin, Sete; Luc Vetillart, Sete.

Disclosure

All the authors declare having received honoraria from Pierre Fabre Health Care for their participation in the study. They report no other conflicts of interest in this work.