Smoking Targets

April 16th, 2012 at 1:00 pm by David Farrar

Labour’s Iain Lees-Galloway has said:

The Government is deliberately ignoring data that doesn’t tell the story it wants the public to hear, Labour’s Associate spokesperson says.

“Statistics collected by the Ministry of Health reveal that every district health board (DHB) except one is failing to get close to acceptable rates for early cessation intervention.

“The Government wants us to believe it has made smoking cessation a priority. These figures highlight the reality – it hasn’t, “Iain Lees-Galloway.

“The Ministry of Health expects 90 per cent of smokers who see a GP to be provided with advice and help to quit, yet only one DHB is reaching that target.

“No other DHB is even close. In fact, on average they are underperforming by 57%.

“Tony Ryall, of course, is allergic to bad news, so these figures never get reported.

 “Interestingly he talks up statistics around smokers who end up in hospital* and the advice they get there.

“But only reporting smoking cessation activities in hospitals is ludicrous. Far more people see their GP than go to hospital.

This is an interesting issue. Lees-Galloway is taking about two seperate things – the proportion of smokers who see their GP who get advice and help to quit, and the proportion of smokers in a hospital who get advice and help to quit.

The hospital figure is the official national health target. It was 90% and has just gone up to 95%. The DHB average was 95% in the first quarter of 2011/12 and slipped back to 89% in the second quarter. Six DHBS made 95% and 12 made 90%, while eight did not.

Now hospitals are actually run by DHBs. DHBs control hospitals. A DHB has the ability to put in place policies around offering quit smoking services to patients. Also be aware that the average person spends hours or days in hospital, so it is easier to do something additional to the reason they are in hospital.

GPs are not employed by DHBs. They are private entities, that only get a portion of their income from the Government. The ability of a Government to get GPs to do something is very limited, and frankly it is silly of Lees-Galloway to think they can.

Now from what I can tell, the DHBs only started funding GPs to even code their patients as to whom are smokers and non-smokers. Sure it is recorded in notes in long-hand, but it is a big job to go through every file and mark them in the database as a smoker.

The new target for GPs only started this year, and they noted:

Unlike the other health targets, this measure started from scratch as provision of advice and help to smokers was not recorded previously nor even offered routinely.

So imagine what is involved to get every GP in NZ recording the status, and then also recording if they offered quit smoking assistance. I’ve worked in a medical centre. The average visit is around 15 minutes, and covering anything apart from the immediate problem slows things down a lot. Now this is not to say it is not a good idea – it is. But expecting 90% achievement in the first year is silly.

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8 Responses to “Smoking Targets”

  1. jims_whare (399 comments) says:

    Hmm I wonder what percentage of smokers will decide to stop because their doc gives them a pamphlet.

    My Mother in law is a long time smoker (50 years +)and she’s been told by us, her doc, nurses and other family members to quit.

    She still hasn’t, never mind the incessant coughing, breathlessness, and many other health problems.

    People won’t quit until they decide to (never mind the cutting down nonsense) and there aint nothing that any one else can do about it.

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  2. Andrei (2,529 comments) says:

    More Government busybodyism – no wonder this country is broke, taxpayers money wasted on telling people to live according to the mores of the parasitic urban elites.

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  3. Colville (2,150 comments) says:

    Galloway should think a little closer to home and try and get rid of the dozen or so smokers (hospital staff) that are always sitting on the fence of Palmerston North hospital on Ruahine St having a puff.

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  4. Joel Rowan (99 comments) says:

    You’re right, Colville, every time I go past there I see people smoking outside. It smacks of blatant disregard for their own health, to be smoking outside a hospital. It saddens me.

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  5. V (686 comments) says:

    Anyone else just completely switch off when you read the words “Lees-Galloway” in relation to any subject ?

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  6. Steve (4,517 comments) says:

    Starting/stopping smoking will always be a personal choice. Since when did anyone listen to their Doctor until it was too late?
    I stopped after 44 years because I had spinal bone graft surgery twice (nicotine affects the graft healing) I had no problem stopping, it was my choice.
    Now has Lees Galloway thought of where the taxes will come from if everyone stops smoking? Yes the tax take more than covers the medical cost. I say keep smoking, because if you stop I will have to pay more Tax.
    Bloody Socialists, always telling people what to do

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  7. wat dabney (3,714 comments) says:

    Labour preaching intolerance to justify still more state interference. What a surprise.

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  8. annie (540 comments) says:

    “The Ministry of Health expects 90 per cent of smokers who see a GP to be provided with advice and help to quit, yet only one DHB is reaching that target.

    Ok then, let the Health Dept fund a special visit for all patients to come in to get screening, advice and help, then send out the cops to force them to come.

    People typically come to a 15min GP consult with a couple of medical issues they want to address, and are paying the have addressed. To safely and effectively deal with these complaints, the consultation will be lucky to be finished within the 15min timeframe, leaving no time for extra detailed interventions such as the Department wants.

    In any case, very brief interventions have been shown to be more useful than a prolonged haranguing. Saying ‘Are you still smoking? When you want to stop, let us know and we may be able to help” ‘ serves as a reminder without getting the patient’s back up. Most GPs will do this.

    Government imposition of various random requirements is a major reason why general practice is increasingly unattractive to doctors.

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