The change from face-to-face to telephone specialist smoking cessation service and its effects on underserved communities in Bedford, Central Bedfordshire and Milton Keynes

Evaluation completed February 2024

What does the research mean for Local Authorities?

The aim is to generate policy and service recommendations for councils across England through a robust, mixed-methods evaluation of a Stop Smoking Service that has shifted to telephone delivery. Learning from this evaluation will be used locally to inform decisions about the Stop Smoking Service and have wider implications for councils in other areas. It will inform key policy and service recommendations about whether Stop Smoking Service should be delivered via the telephone or face-to-face and how to engage underserved communities.

What does the evaluation research mean for the Public?

This evaluation will mean that the development of the Stop Smoking Service locally will be better able to take into account the needs of the service users. It will also be able to ensure the specific needs of vulnerable groups or under-served communities are met so that the shift to telephone delivery doesn’t exacerbate inequalities.

How are the public involved in the evaluation?

We ran three co-production workshops with partners from Bedford, Central Bedfordshire and Milton Keynes and a user of the Stop Smoking Service attended each of these workshops providing input into the development of the research design. We have now recruited three more service users to form a public advisory panel. The panel will guide the evaluation and provide input into the delivery of the evaluation including the development of the ethics application, data collection tools, accessing participants, and strategies for sharing findings.

Lay summary of research

What is this evaluation about?

Stop Smoking Services (SSS) in England have helped millions of smokers quit but are currently changing because less people are using them. The covid-19 pandemic saw a big change from face-to-face contact to telephone support. This has potential positives and negatives. The use of telephones could create benefit because it could make it easier for people to talk to and use SSS. Because people who smoke are sometimes from underserved communities, the use of telephones could therefore help reduce health inequalities caused by smoking. However, if people find it difficult to use telephones or they do not like talking about smoking over the telephone, then SSS may no longer work. The aim of this evaluation is to find out what happens when SSS change to telephone support and how to engage underserved communities. 

What do we already know?

We know that SSS in England have helped millions of people to stop smoking and reduce health inequalities. We also know that some people from underserved communities continue to smoke, can find it harder to stop, and that they are difficult to reach. However, research suggests that it is possible to engage underserved communities if SSS are flexible in how they approach them. We also know that telephone counselling can help smokers quit. 

What don’t we know?

There is a lack of research on telephone SSS in England. We don’t know how face-to-face contact and telephone support compare or how underserved communities respond to the change. Also, while it is known that SSS can engage underserved communities by reaching out to them, how to do this for different people in different settings is not known. For example, a different approach may be needed for manual workers in the workplace than for people who smoke in disadvantaged neighbourhoods. 

Why is an evaluation necessary?

Our evaluation will help us understand the positives and negatives of telephone delivery. This is important because SSS are changing across England. The evaluation findings will help councils in other areas make decisions. For example, it will help them decide whether to use telephones only or to use face-to-face for some people. It will also tell them how to engage underserved communities so health inequalities caused by smoking may be reduced. 

How will it be carried out?

We will use a mix of methods to explore telephone delivery across three councils: Central Bedfordshire, Bedfordshire Borough and Milton Keynes. We will look at existing data to compare quit rates between face-to-face and telephone support. Economic methods will add up the costs of the change from face-to-face to telephones. Surveys, interviews and focus groups will explore how people using the service think and feel about the change. We will also talk to the professionals who deliver the service. Finally, we will work with local SSS partners to understand how they are engaging underserved communities. We will observe their attempts to engage them and speak to people from underserved communities about their smoking and how they may be reached. 

What will we do with the results?

The findings will find out what happens when SSS change to telephone delivery. They will help councils in other areas make decisions about their SSS. The findings will be shared with Central Bedfordshire, Bedfordshire Borough and Milton Keynes councils and people who have participated in the project. They will also be circulated in academic and briefing papers for the public health sector. 

Local Authority/Partner(s)

Bedford Borough Council
Central Bedfordshire Council
Milton Keynes City Council

PHIRST South Bank Research Team

Prof Lynne Dawkins; Prof Daniel Frings; Dr Elisa Lewis; Dr Thomas Mills