Are stop smoking services successful?: an evaluation of smoking cessation clinics in Malta

Abstract

Introduction. Smoking cessation clinics in Malta have been organised by the Health Promotion Department in government primary health care centres on a regular basis since 1991. Aim. A research project was set up to evaluate the clinics' process, outcome and consequent cost-benefit. Methods. The qualitative procedure involved questionnaire completion and interpretation by a total of 40 clients who attended the last session of all clinics held during one year from October 1999. The quantitative method entailed measurement and analysis of participants' smoking status at the quit session, final session and following a six-month period. Results. The thirty participants (75% response rate) who completed the questionnaire spoke quite favourably of the clinic process. Of the 101 clients attending quit sessions, there were 27 quitters by the final session (giving an immediate success rate of 27%), and only ten were still not smoking at the six-month follow-up (long-term success rate of 10%). Discussion. The consequent savings to lung cancer treatment were conservatively estimated at Lm 3245 during the first year of diagnosed disease, more than five times the clinics' running costs over one year. Recommendations for service improvement include: · The integral use of pharmacotherapy and carbon monoxide monitoring; · The organisation of clinics on a more frequent basis, with follow-up support meetings; · The setting-up of state-of-the-art training for facilitators; · The introduction of an on-going quantitative and qualitative evaluation system; · The classification of nicotine addiction as a Schedule 5 disease to enable pharmacotherapy to be available free on prescription; and · Full support and funding of smoking cessation and other tobacco control services.