Co-creation of local smoking cessation services: an innovative public health intervention in times of austerity

Abstract

BackgroundAs seen nationally in the UK, the London boroughs of Camden and Islington have had a decline in smokers accessing stop smoking services. We aimed to develop an innovative model for local smoking cessation services based on wide user and stakeholder consultation with the objective of countering the declining trend in service use. MethodsWe carried out a consultation among local stakeholders to inform the new service model. To understand the professional perspective, we sent an online survey to 210 selected stakeholders (public and community sector organisations), which was completed by 110 (52% response rate). 19 key stakeholders were invited for in-depth interviews. To understand the service user perspective, we conducted six focus groups with different groups of smokers and ex-smokers (pregnant women, people with long-term conditions, serious mental illness, and in routine and manual occupations, minority ethnic communities, and Turkish speakers), totalling 48 people. On the basis of these findings, we brought 29 smokers and 30 stakeholders together in two workshops to explore what an effective stop smoking service would look like and how the service could be delivered. FindingsThe survey and interviews with local professionals showed that sustainable funding, integrated databases, and a flexible service that adapted to user preferences were the most important factors for a new stop smoking service. Smokers suggested developing new terminology for the service, moving away from current language (words like “quit” or “clinic”), and positioning the service as supportive and flexible. These ideas were presented in the workshops, where smokers and professionals agreed a three-tiered model (based on the Stop Smoking+ model proposed by Robert West, provided that specialist support, brief-support, and self-support would offer the desired flexibility. Adaptations of the model to the local reality were suggested, including flexibility on how support could be delivered (eg, offer digital support), and integration of different services to provide continuous support. InterpretationOn the basis of extensive consultation with local smokers and professionals, a new service model was implemented in April, 2017. The new model reflects what local smokers are looking for in a stop smoking service by providing users the flexibility they want and by moving away from traditional terminology. The hope is that this model will counter the declining trend in users of stop smoking services seen in the past 3 years. FundingNone.