The Pharmacist September/October 2018 - Page 30

MASTERCLASS KEY LEARNING POINTS • People who have least disposable income are 2.44 times as likely to smoke than those who are better off • Speaking to a stop-smoking adviser in the pharmacy will increase a smoker’s chance of quitting • Offering heavy smokers regular carbon monoxide readings is a good way to show benefits after quitting smoke and, shockingly, deaths where smoking was a factor included child smokers, with one patient as young as 10 years old. Pharmacy teams may spot early warning signs in patients who have COPD, many patients will visit the local community pharmacy and self-medicate on cough mixtures. In the two to 10 years prior to diagnosis, people are likely to have consulted primary care on multiple occasions for lower respiratory complaints and respiratory tract infections and to have received multiple prescriptions for oral steroids or antibiotics. This suggests there is scope for earlier assessment and diagnosis. Raising the subject of smoking – very brief advice (VBA): • The National Centre for Smoking Cessation and Training (NCSCT) offers great modules to help educate pharmacy team members. All staff are recommended to do the VBA module. VBA (Ask, Advise, Act) is a public health intervention delivered in a one-to-one health setting. Each VBA delivered correctly can trigger a quit attempt. The frequency of exposure to this trigger is crucial — repetition matters. VBA training takes only 20 minutes and the intervention can take as little as 30 seconds to complete in a real consultation. 6 • Ask patients if they smoke and if they have thought about stopping. You can do this when patients are identified as smokers from medicines use review (MUR) or new medicine service (NMS) interventions. You can also ask a patient about passive smoking; for example, if someone is buying over-the- counter (OTC) treatments (eg cough mixture, sore throat remedies or cold sore treatments) or if a prescription for an inhaler is being dispensed, ask if they live with a smoker. Mention that pa