Telephone-based Stop Smoking Service support: experiences, accessibility and health equity implications

Background This evaluation explored the changing provision of Stop Smoking Services (SSS) from face-to-face (F2F) to telephone support (TS) across three Local Authorities in England (Central Bedfordshire, Bedford Borough and Milton Keynes) with a focus on specialist groups (those with a physical or mental health condition or pregnant) and those from the most deprived areas. Methods An evaluation, conducted between December 2022 and November 2023, comprised three components. First, analysis of existing i) quarterly return data and ii) individual level data from 8668 episodes, to explore effectiveness and cost-effectiveness. Second, surveys of 311 service-users and 23 providers to explore preferences, acceptability and experiences of TS (vs F2F). Third, qualitative interviews with 18 service-users (sampled from specialist groups and lower quintiles of deprivation) and 7 service providers. Results People from specialist groups, or more deprived areas, were less likely to quit smoking and cost more to achieve a successful quit than people not in these situations. We did not find any advantage of F2F support for quit success, and among specialist groups and those living in more deprived areas, no preference for it. Although convenience was seen as a clear advantage of TS, qualitative data highlighted the importance of choice, flexibility, and advisors’ attributes, skills and approaches as more important than mode of delivery. Conclusions Our findings suggest that: i) efforts to provide equitable support for specialist groups and those from more deprived areas are warranted; ii) SSS do not need to routinely offer F2F support for these groups; iii) choice and flexibility of delivery method is preferable to service-users and could remove some access barriers experienced by marginalised groups; iv) the skills, attributes and approaches of advisors can enhance satisfaction with SSS and improve chances of quit success. Clinical trial number: not applicable