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Researchers from the Discipline of Public Health and Primary Care, School of Medicine at Trinity College Dublin, undertook a pilot programme in response to the need to find more effective ways to engage socio-economic disadvantaged (SED) women smokers in smoking cessation services and to improve health equity.

Their findings were published in the journal Nicotine and Tobacco Research recently and the respondents highlighted the role of the community pharmacist in their efforts to quit. Lung cancer is now the most common cause of cancer death for women in Ireland, having surpassed breast cancer rates.

The health consequences of smoking tobacco impact women more in low socio-economic status groups, where they are more likely to smoke to cope with negative emotions and stressful situations. SED contributes to higher tobacco use among adult women, which affects subsequent generations through role-modelling or by exposure to second-hand smoke.

The World Health Organisation Framework Convention on Tobacco Control has recommended the need for gender-based approaches to tobacco control policies in the light of increasing lung cancer rates, especially in SED women. We Can Quit (WCQ) is a community- based stop smoking programme specifically designed for women living in socio-economic disadvantaged communities in Ireland. It was developed initially by the Irish Cancer Society (ICS) in collaboration with the National Women’s Council of Ireland, the Institute of Public Health and the Health Service Executive (HSE). Uniquely, the programme is delivered by trained local lay women (Community Facilitators). The key components of the WCQ programme were: Group-based support once a week for 12 weeks, delivered by Community Facilitators (CFs): Lay trained women living/working in target areas. Access to nicotine replacement therapy (NRT).

Individual one-to-one text support between sessions. It was possible though challenging to recruit SED women to a smoking cessation pilot trial delivered in their local community setting through the combined effort of community, voluntary and statutory stakeholders, the organisers said. The key findings showed: Approximately half of the recruited women provided follow- up data at 12 weeks and/or six months. Low literacy was identified as a key barrier to retention at follow-up. Women recalled positive reinforcement, peer learning (from others and from the facilitators) and the motivation derived from group support as really helpful strategies.

They highlighted the support from the community pharmacist for their quit attempt. Removing cost as a barrier for using NRT was welcome. Dr Catherine Hayes, Associate Professor in Public Health/Specialist in Public Health Medicine, Trinity, and senior author on the study, said: “We Can Quit is an effective way to engage heavily-dependent women smokers who experience multiple stresses through disadvantage, by delivery of an outreach programme in their own communities in a way that is meaningful for them and that directly addresses their needs. “Having a community-based structure in place will facilitate future assessment of cost-effectiveness in terms of smoking cessation and expansion and integration of the programme into the HSE, which is currently in progress.

Removing cost as a barrier to using NRT for those who attend smoking cessation programmes is an important issue for Government policy.” The research paper: ‘Peer- Delivery of a Gender-Specific Smoking Cessation Intervention for Women Living in Disadvantaged Communities in Ireland We Can Quit2 (WCQ2)—A Pilot Cluster Randomised Controlled Trial’, is available at: https://doi. org/10.1093/ntr/ntab242