Southampton: Embedding stop smoking expertise across services

Residents in Southampton who want to quit smoking and need help can access national NHS materials and an eight-week package of help via many pharmacies or their GP practice if they need it.

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Southampton City Council takes a targeted approach to tobacco dependency treatment. Alongside a basic universal offer, specialist stop smoking support and expertise is being embedded in services such as hostels for people who are homeless, drug and alcohol support, maternity care and mental health services.  

Why a universal offer is not enough  

Residents in Southampton who want to quit smoking and need help can access national NHS materials and an eight-week package of help via many pharmacies or their GP practice if they need it. In line with national guidance, these locally-commissioned services provide specialist support and nicotine replacement therapy. 

But the public health team recognise that will not reach some important groups. Public Health Consultant Charlotte Matthews said: “Smoking is highly addictive – we refer to it as tobacco dependence. Your likelihood of smoking is influenced by other factors too – starting young, stresses in your life or early childhood experiences – and we take a trauma-informed approach.  

“There are lots of people you probably won’t reach if you focus on a universal offer, particularly people who are often socially-excluded, have higher rates of smoking and sadly a much shorter life expectancy. We need our help to be where people already are, as a seamless part of their care, delivered or supported by people they already know.” 

Equipping frontline staff with the skills  

To address this, the public health team commissioned Solutions 4 Health to manage and run Southampton Smokefree Solutions (SSS). SSS has a training, development and quality assurance role, building capacity across the health and care system. The service is also commissioned with a focus on strengthening tobacco dependency treatment in existing frontline services for people who are homeless, in drug and alcohol treatment services and/or who have severe mental illness. 

Over the last three years SSS has done this in a variety of ways. Like many areas, SSS has run very brief advice training for frontline staff to help them engage the people they work with about their smoking. More than 150 people have completed this training.  

But alongside this, the service has also delivered stop smoking support in these settings and trained staff to become stop smoking specialists, so they can provide the treatment longer term.  

One project has involved working with the Salvation Army, which runs a homeless hostel service in the city. The SSS team attend breakfast clubs to engage with clients and deliver tobacco dependency treatment.  

Southampton Smokefree Solution Service Manager Chris McMahon said: “You have to build a relationship first, before you can engage people in treatment. That is why working with a service they trust and already use is essential alongside making it as easy as possible for them to access support.”  

The work with the drug and alcohol service has been slightly different. Southampton City Council commission Change Grow Live (CGL) to deliver drug and alcohol treatment services. The SSS team began by delivering treatment within the service and collaborating with CGL such that the provider is now deliver tobacco dependency treatment themselves.  

Similar arrangements have been introduced with the local mental health trust as well as with primary care staff. Through working with the six local primary care networks, SSS has helped train a variety of staff from social prescribers, practice nurses and in-house pharmacists to becomes stop smoking specialists.  

Practitioners access the National Centre for Smoking Cessation and Training free online programme and receive additional bespoke training from SSS. “We have worked very closely with new tobacco dependency treatment practitioners,” said Ms McMahon. “They shadow us for a while and then we are always there to support them if they have questions or complex cases and we also provide CPD.”  

‘Smoking is everybody’s business’ 

To support the frontline staff who have become stop smoking specialists, SSS run a monthly practitioner network to share best practice, provide updates and facilitate peer support. Some 140 practitioners are part of the network and have been trained or supported by SSS, including pharmacists, occupational health advisors and midwives. Many of the practitioners are part of services which have received funding from public health.    

Senior Public Health Practitioner Helen Dougan said: “What we have aimed to do is make smoking truly everybody’s business. That is why having a network like this is really important to share information and provide quality assurance. We talk about a range of different issues from how to support complex cases to what the latest evidence is. It is very much two-way support.” 

The whole approach certainly seems to be working. NHS Digital figures for 2022-23 show more than 6,000 smokers per 100,000 set a quit date in Southampton through stop smoking services – more than double the national rate, while the self-reported quit rate in Southampton was more than 50 per cent higher than England’s too.  

“We are delighted with how it is going,” said Ms Dougan. “The targeted work seems to be paying off – and we have also had the added bonus of engaging some of the frontline staff who smoke and are now keen to stop smoking themselves”. 

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Information about services in Southampton: Stopping smoking (