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Country/JA: Ireland flag Ireland
Action type: Program

Problem: Tobacco use is the leading cause of preventable death in Ireland, with nearly 6,000 people dying from tobacco related illnesses each year. Smoking prevalence is declining nationally, however areas of disadvantage are disproportionately impacted, experiencing higher prevalence rates than that of more affluent areas.

Objective: The ‘We Can Quit’ (WCQ) program was developed in 2013 to tackle some of these health inequalities, with a particular focus on the growing rate of lung cancer among women living in these communities.

Implementation status: Implementation is complete and programme is ongoing

Key Contextual Factors

  • The Health Service Executive’s (HSE) Tobacco Free Ireland Programme manages WCQ, which was initially developed by the Irish Cancer Society (ICS).
  • WCQ is delivered in the community by community partners who manage the delivery aspect through funding provided by the HSE. Partners include, Local Area Partnerships, County Councils, Family Resource Centres and other community organisations.
  • Due to the COVID-19 pandemic, the WCQ programmes are being delivered online. This has created additional challenges, including the implications of digital poverty and prolonged isolation. WCQ takes a holistic approach to health and by its nature, tackles many of the other health and societal issues related to smoking.

Key Components/Steps

Pilot delivered by ICS in 2014 across 5 communities in partnership with the HSE, National Women’s Council of Ireland, the institute of Public Health and community partners in North County Dublin.  This was followed by continuous progress each year and periodic evaluations:

  • 2014 – 2 partners, delivered 5 courses, with 39 women registrations
  • 2015 – 2 partners delivered 7 courses, with 92 registrations
  • 2015 – evaluation: “Findings from the Action Research Study”, 2015, University of Stirling
  • 2016 – 7 partners (3 partners in Cork and 4 in Dublin) delivered 14 courses with 145 registrations
  • 2017 – 7 partners delivered 19 courses, with 232 registrations
  • 2017 – evaluation: “Findings of WCQ Programme” February 2015 to October 2016, Trinity College Dublin
  • 2018 – 7 partners delivered 23 courses, with 247 registrations
  • 2019 – 8 partners (3 partners in Cork and 5 in Dublin) delivered 28 courses, with 335 registrations
  • 2020 – 7 partners (2 partners in Cork and 6 in Dublin) delivered 21 courses, with 192 registrations (COVID impacted)
  • 2020 (July) – ICS withdrew resourcing and coordination of WCQ and HSE took over this responsibility
  • 2021 – 7 of the existing partners are planning to deliver 26 courses targeting a minimum of 208 registrations. This number is down on previous years due to the COVID-19 pandemic and limited capacity to deliver courses online. In addition to this, there will be 3 men’s pilot programmes

Key components of the program include:

  • Women only group (men only programme in the development stage)
  • Community partnerships, local knowledge and expertise
  • Uses lay health stop smoking facilitators from within the community trained to the same standard as professional stop smoking advisors within the health service
  • 12 weeks of group support
  • Flexible one to one support provided by the Community Facilitator, outside of the group setting
  • 12 weeks supply of free stop smoking medication
  • Community Pharmacist dispenses medications and offers additional support and advice.
  • Celebration of achievements

Main Impacts

  • Individuals quit smoking: average 50% quit rate at end of the course (postively compared to other smoking cessation services)
  • Improvements in other areas of health and wellbeing: physical activity, nutrition, dealing with stress, isolation, mental health, gender specific issues, etc.
  • Ripple effect on family members, friends and colleagues
  • Host venues creating smoke free campuses or sites

Lessons Learned

  • Accessible support to quit smoking is important: course and medication is free, and is delivered in the community
  • Important to consult with female smokers, stop smoking advisors and community workers in the design of the programme and the development of the materials
  • Important to collaborate with academic institutions to conduct formal evaluations of impact and effectiveness
  • Whole community approach and engagement added value to the course and increased buy in from the wider society
  • We drew on widespread expertise on smoking cessation, community development, social integration, gender issues, and other health professionals (pharmacists, general practitioners, nurses, social workers)
  • 2020 and COVID-19 pandemic impacted delivery and recruitment/retention of participants, so courses were moved online and recruitment targets were decreased to accommodate this (not viable to deliver online to a group of more than 10 people)

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