Pacific Nurse Leader and Smoking Cessation

FonoKate Magner, Ministry of

Health

The Issue

• 31% of Pacific peoples in New Zealand identify as smokers

• Higher smoking rates among younger Pacific peoples

• 25% of pregnant Pacific women smoke during their pregnancy

• Smoking rates vary by Pacific ethnicity, with Taokelauan (39%) and Cook Island Maori (35%) having the highest rates

Tuatua Tika Pacific Tobacco Control Report 2010

Second Hand Smoke

• 1 in 10 Pacific non-smokers are exposed to second hand smoke in their home, and 1 in 8 in their car, each week

• 1 in 3 Pacific non smokers are exposed to second hand smoke at work

Tuatua Tika Pacific Tobacco Control Report 2010

Harms of Smoking

• Nicotine is HIGHLY addictive• Tobacco use is leading cause of death

and disease in New Zealand• Cancer• Cardiovascular disease• Respiratory disease• Reproductive effects• And others

Do People Want to Stop?• 4 in 5 smokers said that

they would not smoke if they had their life over again

• 3 in 5 had tried to quit in the last 5 years

• 1 in 4 had quit for at least a week in the last 12 months

• Pacific, Maori and young smokers are as likely to have tried to quit NZ Tobacco Use Survey 2009

Cumulative chances of quitting over time when making one quit attempt per year with and without

cessation treatment

Aveyard and West. Managing Smoking Cessation. BMJ 2007;335:37-41

Nurses are Important!

• The key to a successful quitting is making a quit attempt in the first place!

• 1 in 40 smokers will quit just from receiving brief advice to quit from their health care provider

• A small effect, but important when delivered across the population

ABC reminds you what to do

• A - ask whether a person smokes

• B - give brief advice to quit to all people who smoke and

• C – make and offer of and refer to cessation treatment

The Health Target

• 95% of hospitalised smokers will be provided with advice and help to quit by July 2012.

• 90% of enrolled patients who smoke and are seen in General Practice, will be provided with advice and help to quit by July 2012.

Health Target results over 2 years

0%

20%

40%

60%

80%

100%

120%

Q12009/10

Q22009/10

Q32009/10

Q42009/10

Q12010/11

Q22010/11

Q32010/11

Q42010/11

2 years by Quarters

Results achieved by %

Shorter stays in emergency departments

Improved access to elective surgery

Shorter waits for cancer treatment

Increased Immunisation

Better help for smokers to quitBetter diabetes and cardiovascular services

Target range

Supporting smokers to quit

• Cessation focus – more smokers making more quit attempts (supported with evidence based treatments) more often

• Reliable and routine assessment of smoking status, advice to quit and prescription of NRT or referral to cessation services

• Investment in national cessation services and in access to NRT and other pharmacotherapies

Resources and Tools

• You Tube – How to use NRT correctly – Dr Hayden McRobbie

• Smoking Cessation ABC e- Learning tool – www.smokingcessationabc.org.nz

• The hiirc website – www.hiirc.org.nz

• STEPS training – Train the trainer

• Pacific ABC training programme

Conclusions

• Smoking is a considerable source of health inequalities for Pacific people

• More quit attempts more often, linked up with more support and treatments

• Do the ABCs - a 2 minute conversation could change someone’s life

Thank You