Marketing the NSD stop smoking challenge to ‘Hard to Reach’ groups Part 1

Smoking is the main reason why inequalities in health are widening between the general population and disadvantaged groups. Only one in 4 of the adult UKpopulation smokes. But smoking rates are as high as 8 out of 10 amongst the certain groups including the poorest, Asian men, prisoners, mental health service users, homeless people, drug and alcohol addicted and the gay community. These groups are often described as ‘Hard to Reach’ but the tobacco industry seems to be able to get to them!

So it is a ‘Great Challenge’ for No Smoking Day Challenge local organisers whose job it is to reach those groups where smoking is at its highest levels and offer help to smokers to stop smoking.

Here are some suggestions for reaching disadvantaged groups with the Great No Smoking Day Challenge including some good practice case studies. :

Types of activities for promoting the Great No Smoking Day Challenge to hard-to-reach groups

There are many ways of reaching smokers with the Great No Smoking Day Challenge but these are the most popular.

o Stalls are the most popular activity for No Smoking Day and there is a guide to running a NSD stall on the NSD website.

o Services to help smokers to stop - one to one, drop in, groups, telephone and text support, self-help groups.

Reaching disadvantaged groups and increasing their access to stop smoking help

People in disadvantaged groups often don’t want to have to visit their GP or go through lots of bureaucratic hoops to get help to stop smoking. Here are some tips to increase the number of disadvantaged groups to take up the Challenge.

o Set up services and activities in the target community and make it easy to access.

o Have written information in plain English and have resources for those with only basic literacy.

o Make your event or services friendly and welcoming and make sure you make this a feature in your publicity.

o If necessary get testimonials from local people confirming that the stop smoking advice is helpful and friendly.

o Find out what time of day is best for your target group – after dropping off children, during lunchtime, evenings or weekends.

o It helps if smokers can identify with the advisors. Train successful quitters as group leaders particularly in your target groups and target areas.

o Train community tobacco control activists to publicise and promote No Smoking Day and all stop smoking support available and to campaign on other tobacco issues such as smuggled tobacco and youth access.

CASE STUDY

GPs in training

Many smokers are embarrassed or resistant to visiting their own GP to ask about stopping smoking. However many smokers are more influenced by a doctor’s advice that other people. Various projects have used GPs in training to attend No Smoking Day events.

- One used 5 public health trainees to answer the special phone lines set up at a radio station to talk to callers.

- Another ran a Give it Up Give it a Go event in a community centre. Four GPs from other parts of town volunteered take part and see smokers. The queue went out into the street! People wanted a doctor’s advice but ‘anonymously’. They were told that if any signs of illness were spotted they would have to inform the person’s own GP and 4 people with undiagnosed COPD were identified and their GPs informed.

- A third project was an Asian Heart Health project which invited Asian GPs in training to come to the weekly stop smoking drop in. The attendance of the doctors was advertised on the Asian radio programme and numbers went up from 3 visitors a week to 23!

The more people who try to quit will result in more people eventually quitting. Do everything possible to encourage smokers who want to quit to give it a go! With any of the groups where smoking is at high levels, it is harder to get even small numbers to quit. But there are many smokers wanting to quit in all these groups. Research shows that people try to quit but have less success in staying stopped. The challenge is to find ways of encouraging more smokers who want to quit to try to stop and finding ways to support them to stay stopped. It is also about setting lower expectations of success. Rejoice in the smaller numbers of successes and use these for encouraging others.

o Counter the myth that you need buckets of willpower to quit. Willpower grows with every day that you stay off cigarettes!

o Challenge the view that having tried and failed is the end of the road. The average number of quit attempts is 14!

o Encourage people to expect relapse as part of the process and use it as a learning. experience.

o Make sure people know they can come back to the service and that there is not a limit to the number of attempts.

o Make sure people who have tried before are welcomed and given the same help as anyone else.

o Offer incentives and support to stop. Give awards to everyone who stops for the one week of the challenge.

o Quit & Win and similar challenges offer smokers a sense of belonging to a group and an incentive.

o On stalls in disadvantaged areas make sure that anyone wanting to quit is recruited and given a time and place to meet with an advisor.

o Have incentives and encouragement for smokers who have quit to recruit other smokers in their group or community.

o Invite smokers to ring a helpline and send them a quit pack and follow up support by text or phone.

o Invite back 4 week quitters who have not quit and give them extra support and encouragement to try again.

o Use 4 week, 6 month or 12 months follow up to invite back to service if relapsed.

o Encourage ex-smokers to call the helplines in between one to ones or groups. Include Pregnancy and Asian language helplines if relevant.

o Maintain support for as long as people need it. If you have a fixed 6 weeks this may not give enough support for some people.

You need to be set up wherever you can reach your target audience to sign up to take the Great NSD Challenge. In any setting you will need to obtain permission to set up a stall from the person in charge. Write down a list of all the potential places where you could reach your target group or groups. Here are some suggestions: