Biomedical subjects

Ann McNeill

Publications and source records attributed to Ann McNeill.

4 recordsLinked to original sources

PubMed2005

Lessons from the English smoking treatment services.

This paper summarizes and discusses the key findings of the evaluation of the English smoking treatment services, which were established in 1999 as part of the English National Health Service. Within 4 years these services existed throughout the country and were working at full capacity, a total of pound 76 million having been spent on them over this period, excluding medication costs. In the fourth year almost 235,000 people attended treatment and set a quit date, and the total budget, including medications, was approximately pound 50 million. At the end of the fourth year the government allocated pound 138 million for the services for the period April 2003-March 2006. The CO-validated 4-week abstinence rate was 53%, the validated 52-week abstinence rate was 15%, and the relapse rate from 4 to 52 weeks was 75%. There was no sex difference in cessation rates at long-term follow-up. The cessation results and relapse rate from weeks 4 to 52 are consistent with results from published studies, including clinical trials. The estimated cost per life-year saved was pound 684 and the figure is even lower if the potential future health care cost savings are taken into account at pound 438 per life-year saved. This compares with the benchmark of pound 20,000 per life-year saved, which the National Institute for Clinical Excellence (NICE) is using to recommend new health care interventions in the National Health Service. The services were also succeeding in reaching disadvantaged smokers. However, there have been problems, and other health care systems considering an initiative of this kind should: set national training standards and increase training capacity before launching the services; standardize the provision of pharmaceutical treatments and make them as accessible as possible before launching the services; and give the services at least 5 years of central funding to allow them to become well established. Monitoring is extremely important but should not be so much of a burden that it detracts from developing a quality service and although cessation targets can be helpful, care needs to be taken that they are reasonable and do not promote throughput at the expense of quality.

Cost-Benefit Analysis↗

PubMed2004

Harm reduction.

Explore the source record for details and available documents.

Humans↗

PubMed2004

Prospective study of the effect of exposure to other smokers in high school tutor groups on the risk of incident smoking in adolescence.

Adolescent smokers tend to have peers who smoke, but it is unclear whether this arises from self-selection of smoking peers or whether this is a causal effect on the uptake of smoking (incident smoking). The authors used school tutor group current smoking prevalence, an unbiased measure of peer smoking in high schools in the United Kingdom, to estimate the independent effect of peer smoking on incident smoking among high school students. In a prospective cohort study of children aged 13-15 years (grades 9 and 10) in 10 high schools in Nottinghamshire, United Kingdom, smoking behavior was surveyed in 2,881 students in 2000, and the survey was repeated in 2,109 students (73%) in 2001. There were 267 incident smokers (15%) among the 1,766 nonsmokers in 2000. The adjusted odds of incident smoking were significantly higher in girls, in students with parents or siblings who smoke, and in relation to school tutor group current smoking prevalence in 2000 (relative odds for highest relative to the lowest quartile of prevalence = 1.78, 95% confidence interval: 1.20, 2.64). This tutor group effect was independent of having a best friend who smoked in the 2001 study. Incident smoking is therefore increased among students exposed to other students who smoke, and preventing smoking at school may reduce adolescent smoking.

Adolescent↗

PubMed2004

'You can't go without a fag...you need it for your hash'--a qualitative exploration of smoking, cannabis and young people.

AIMS: To examine the relationship between smoking tobacco and cannabis use among smokers in their mid-to-late teens. DESIGN AND PARTICIPANTS: Two qualitative studies in Scotland. One study used semistructured paired interviews involving 99 16-19-year-old smokers, the other comprised eight focus groups involving 46 15-16-year-old smokers. MEASUREMENT: The interviews and focus groups explored the role and meaning of smoking in the participants' lives, smoking histories and future cessation intentions and how these related to other aspects of their lives, particularly cannabis use. FINDINGS: Cannabis use was regarded as an important and enjoyable aspect of many of the participants' lives. Importantly, cannabis use and cigarette smoking were linked inextricably. Several reported how smoking joints had been a 'gateway' to smoking cigarettes. While most wanted to quit smoking cigarettes, cannabis use reinforced their cigarette smoking and few wanted to stop using cannabis. CONCLUSION: National studies need to be conducted to examine how widespread the problem identified is and tobacco control initiatives and smoking cessation treatment services need to consider urgently how to overcome the barrier that a desire on the part of young people to continue cannabis smoking poses to achieving a reduction in tobacco use.

Adolescent↗