Abstract

Context:
Helping younger smokers to quit is one of the most impactful preventative health interventions possible, reducing smoking-related morbidity and mortality. However, younger smokers may not develop respiratory conditions that strongly motivate quit attempts until later in life when permanent harm has already occurred. This small-scale primary care pilot aimed to create “teachable moments” and move smokers from pre-contemplation towards contemplation by targeting smokers aged 45 and under with non-respiratory conditions who may not recognise smoking as contributing to their health issues. The project assessed whether tailored, low-burden interventions could increase engagement with Smoking Cessation Services (SCS) across two GP practices in West Cheshire.

Strategy for Change:
The project was designed to integrate into routine practice workflows with minimal operational burden. Interventions included online Very Brief Advice (VBA) training for practice staff, targeted condition-specific SMS messaging linked to smoking cessation information pages hosted on practice websites, and promotional materials displayed within practices. Messaging focused on smokers aged 45 and under with conditions including depression, diabetes, and hypertension, highlighting the impact of smoking on their condition, benefits of quitting, and signposting to local SCS support. Evaluation included assessment of staff training uptake, SMS reach, website engagement, referral activity, and post-referral engagement.

Effects of Change:
Across both practices, 53 staff completed VBA training, representing a 77% completion rate. Targeted SMS messaging reached 703 eligible patients, with website engagement varying across condition cohorts. Referrals to SCS increased compared to baseline activity, with healthcare professional-led referrals becoming the most common referral route. Of 39 patients referred, 49% attended a first appointment and set a quit date, with 63% achieving a four-week quit. Practices also reported increased patient awareness and engagement around smoking cessation discussions during the project period.

Lessons Learned and Key Messages:
Low-resource, digitally embedded smoking cessation interventions can be integrated into routine primary care workflows with minimal operational burden whilst strengthening collaboration between practices and local SCS providers. Although this was a small-scale pilot and it was difficult to determine which intervention components were most effective, the approach demonstrated potential for wider implementation and further evaluation.