Pharmacy-led counselling in a dermatology centre cuts smoking rates
Results of a Singapore study have shown the effectiveness of a structure pharmacist-led cessation counselling in reducing smoking rates. Smoking cessation can thus be made a part of the holistic management of dermatological conditions.
“Given the adverse effects of smoking on the skin and the importance of stressing on physical appearance for behavioural modification, dermatological clinics represent a unique opportunity and effective platform for clinicians to engage patients in the cessation or reduction of cigarette smoking,” researchers said.
This single-centre, retrospective study identified 74 current smokers who received counselling at a structured smoking cessation clinic. Researchers collected information on baseline demographic characteristics and detailed past medical history, including smoking history, and conducted follow-up at 2 weeks and 3 months.
Of the 57 patients who were assessed at 2 weeks, nine (15.8 percent) had stopped smoking and 26 (45.6 percent) reduced the number of cigarettes they smoked per day (mean reduction, 4.1 cigarettes per day). [Singapore Med J 2019;60:31-33]
On the other hand, there were also a few patients who did not change habits or even increased the number of cigarette sticks smoked per day following counselling.
“Our results showed that smoking cessation intervention at a dermatology clinic was effective,” researchers said.
A local study at a restructured government hospital reported quit rates of 27.3 percent and 23.1 percent at 3 months of participation in the inpatient and outpatient smoking cessation programmes, respectively. In a recent Cochrane review, results showed a quit rate of 18–21 percent, depending on whether behavioural support was administered with pharmacotherapy. [Ann Acad Med Singapore 2012;41:230-232; Cochrane Database Syst Rev 2015;10:CD009670]
“Comparatively, in our study, 33.3 percent of participants ceased smoking and 22.2 percent had a reduction of cigarettes smoked at 3 months,” researchers said.
A previous study by Thompson and colleagues found the following factors to be associated with lower attrition rates: older participant age, being followed up by telephone call, smoking relapse or failure to reduce smoking levels. [Trials 2016;17:524]
Thompson suggested that to reduce dropout rates in future studies, “strategies to engage younger participants should be followed and reassurances given to participants that smoking behaviour should not influence ongoing participation in the study.” In addition, when following up participants through phone calls, researchers should work flexible hours, so that those who are employed can be contacted during regular working hours. [Trials 2016;17:524]
In the present study, fees for follow-up appointment were reduced to ease the financial load. Participants were also counselled that attending at least one follow-up was mandatory.
“Increasingly, more pharmacists are being trained to run the programme and doctors will receive prompts on the computer during consultation with participants, so that they can play a more constructive and hands-on role in motivational interviewing as well as encouraging compliance with treatment and follow-up,” researchers said.
“Cigarette smoking is a leading cause of morbidity and mortality and has a deleterious effect on dermatological conditions, such as skin cancers, hidradenitis suppurativa and psoriasis,” they noted.