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London borough ceases smoking cessation service

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The third largest London borough will discontinue its NHS-provided stop smoking service to save money.

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Ealing LBC will stop its smoking cessation service at the end of March, saving £395,000 over the next two years, as the council grapples with £1.3m cuts over 2018-19 and 2019-20, Health Service Journal reports.

West London Trust – formerly West London Mental Health Trust – started the service through primary care and pharmacies in 2013, when more than a fifth of Ealing residents were smokers. This rate dropped to 15 per cent by 2017-18, when the service achieved a 47% quit rate.

The council assured the trust at the end of last year that “the decision had been taken due to financial pressures on the part of the local authority and was not by any means a reflection of the performance or quality of the service”, according to a December trust board paper.

Tobacco control and stop smoking services have succeeded in reducing the number of smokers nationwide over the past eight years. A landmark study in The Lancet last year found “two-thirds of the improvements to date in premature mortality in the UK can be attributed to population-wide decreases in smoking, cholesterol, and blood pressure”.

However, smoking remains the leading cause of preventable death in England and the “single biggest cause of inequality in death rates between rich and poor in the UK”. There are also substantial ethnic disparities – in Ealing, nearly 30 per cent of black Caribbean men are estimated to be smokers.

It comes amid an intense debate about public health funding. The NHS long-term plan, published this month, indicated the NHS could take a greater role in commissioning some public health services.

The plan also set out three ways the NHS would help reduce the smoking rate, including supporting people to quit when they interact with NHS services and providing a universal smoking cessation offer as part of its mental health services.

However, it said: “Action by the NHS is a complement to, but cannot be a substitute for, the important role for local government.”

Help to quit will still be available through pharmacists and GPs in Ealing, the council said. However, responses to the council’s formal consultation on ending the service showed local NHS bodies and charities were worried primary care and pharmacies will not be equipped to deal with increased demand.

Ealing Clinical Commissioning Group said it was worried cutting the service would increase demand for prescribed interventions from GPs but without providing the “specialist training, support and remuneration provided to practices by the [cessation service] for this activity”.

The council said it had “no option” but to find savings where it could. It decided to end “all tobacco control activities” because of budget constriction and “the national trend of a drop in smokers using local stop smoking services to quit”.

It cited the increase in online tools providing support as a reason to withdraw its face-to-face service. It will continue to offer “mandatory services such as health checks for those over 40, sexual health and drug and alcohol activity”.

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