Making every contact count: a first-hand experience from a COVID vaccinator
Volunteer COVID vaccinator and smoking cessation expert, Peter Mackereth, shares his experience in encouraging smokers to quit.
When it comes to helping smokers think about making a quit attempt, every contact counts – and there are more opportunities to strike up a conversation than you might think.
It’s something smoking cessation expert Peter Mackereth has decades of experience in, after managing a team of stop smoking advisors at The Christie cancer treatment centre in Manchester since the early 2000s.
From the start of the COVID-19 vaccination roll out, Peter, who had recently retired, took up the role of a vaccination nurse at the Etihad Vaccination Centre. He is putting the techniques he has driven forward over the years to excellent use during his time supporting the vaccination programme.
He said: “As a former Tobacco Control Lead at The Christie, health advisor and nurse, I just can’t ignore someone who mentions symptoms such as a ‘smokers cough’ or asks if it’s ok to smoke straight after the vaccine.
“If a person discloses their smoking status, I believe there’s always time to ask: ‘have you thought about going smoke free?’ Just leaving that question in the air can trigger a dialogue now, or in the future, with their local pharmacist, practice nurse or GP, about how to take the next step to quitting.
“Supporting the COVID vaccine roll out means that I’m on hand to answer questions from members of the public and address concerns, such the benefits and possible side-effects of taking a vaccine. I explain that becoming critically ill with COVID-19 is a bigger risk for those who are currently smoking – so it’s good that they have come forward for their vaccine. People respond best to people and striking up a conversation on their level is so important. I chat to them – ask how they are, how they’re feeling, get them to tell me a bit about their cough, if they have one – and often this plants the seed about going smokefree.
“It’s not about preaching to people; it’s about taking a moment out of your day to do something positive, being friendly, relatable and empathetic – and although it’s a serious subject, keeping it light-hearted and recognising the pressures people are facing.
“It really helps. Just one example in my past role, a woman told me that she decided to stop smoking while her husband was going through cancer treatment, and that our brief conversation the previous day (she had been smoking close the hospital entrance) helped her make the decision to quit.”
In his current role at the vaccination centre, Peter often sees the links between smoking and anxiety – for example, people having a cigarette before going in for their vaccine in an effort to calm their nerves.
“If I see people smoking, I explain that it raises their carbon monoxide levels which can make them feel more anxious and breathless, but there are alternatives, such as switching to vaping, which is far less harmful than burning tobacco or considering nicotine replacement therapy to help with cravings”
Peter is keen to see a roll out of more banners, posters and signage around vaccination centres, making it easier for staff to signpost people to the next step in going smokefree. It has helped significantly at the Etihad.
He continued: “Lots of people ask about the banners. They can spark a conversation. If we can say to people ‘the banners have a great app – why not take a picture or scan the QR code?’ – and then show them where to find them, it gives people something tangible to do next. As well as members of the public, colleagues have disclosed their smoking status, and another mentioned she wanted to engage her partner in stopping again since he had restarted in lockdown. Having details about the free stop smoking support displayed across the site are particularly helpful.
“Pharmacist also work at the vaccination centres, they too contribute to the conversations around going smokefree, suggesting ways to quit, such as using nicotine replacement therapy.”
With his many years of experience, Peter is well aware of the barriers to delivering what’s known as ‘very brief advice’ (VBA) but it is something he is a passionate advocate for and keen to encourage other members of staff to give it a go.
“My advice to colleagues delivering very brief advice to smokers is to keep it light, smile, use positive language, for example – ‘have you thought of taking the opportunity to give quitting a go?’ and ‘How are you feeling right now?’
“COVID-19 has made many people think about their health, so it’s an ideal time to stop and reduce the risk of more severe effects if they do catch the virus.
“Other tips. Be curious, ask questions. Engage and use humour when it feels appropriate. It can be a little nerve-wracking at first, but it’s about finding a way in.
“I once heard someone say that they were off to have a cigarette after the vaccine and a member of support staff tell them it was ‘well-deserved’. What was interesting is that another nurse colleague immediately said ‘…Oh, I don’t think we should say that’ and this sparked a conversation in the team about the harms of smoking and our role’
“The way I look at it, is every time someone delivers VBA, it has a cumulative effect – your conversation might just be the one that helps someone quit for good. What an amazing achievement that is.
“I’ve seen many brilliant examples of staff making a difference. A security guard gently reminding a smoker that the site is smokefree; nurses, doctors, pharmacists, taking the opportunity to strike up a conversation. Sometimes you can plant the seed by saying something like: ‘it’s so expensive to smoke these days’ and get people thinking about all the money they could save. On one occasion at the centre, a member of the public, who lost a leg through smoking, opened up about his experiences – which was so brave and thought-provoking for those listening, including myself.
“It doesn’t take long to do VBA and there is training and support for people who want to learn more, for example e-learning that takes just 30 minutes to complete. In my opinion, helping smokers get the motivation and support they need to quit is crucial to the role of every healthcare professional and can greatly improve patient outcomes.”
Learn how to give Very Brief Advice, just like Peter
Learn how to have short and supportive conversations about smoking, known as ‘VBA’, by taking this e-learning module. It takes less than 30 minutes and could help you make a big difference in your local community. Upon completion you’ll receive a certificate.
For best results we recommend that you use a desktop or laptop computer to access this course.
Free support to quit smoking in Greater Manchester
For help to quit smoking, speak to your Local Stop Smoking Service, GP or pharmacist, or call the NHS Stop Smoking helpline free on 0300 123 1044. Greater Manchester residents can also get six months’ free access to the Smoke Free app – usually worth £60 – by signing up online at www.smokefreeapp.com/GM (T&Cs apply).