Juggling many hats to advance tobacco dependence treatment

15-EmmaEmma Croghan
Division of PH and LS
15-flag United Kingdom
29 Jul 2014

Please tell us about your work with tobacco control/tobacco dependence treatment:

I’m a Registered General (RGN), Sick Children’s (RSCN) and Specialist Community Public Health Nurse (SCPHN). I started out working in paediatric haematology and oncology with very unwell children and young people who needed bone marrow transplants and other life-affecting treatments. One day, at a child’s funeral, I cried with the family (rather than in my car afterwards). It was a turning point for me – I either needed to toughen up or get out of the field.

I thought about how I could work at the other end of the scale and help people avoid getting cancer in the first place. As a result, I enrolled in a programme to get a community public health nursing degree. After that, I discovered a programme in Denver, Colorado, that had won an award from WHO for its smoking prevention work (one of only two at the time in the developed world). I went to see the programme in action. Afterwards, I presented a proposal to the Trust Board which then gave me the time off work to learn more about the programme.

There was a Professor of Public Health on the board who approached and asked if I would like to do some research! I said yes, and won a fellowship to look at smoking and young people. I was worried, though, about the fellowship not being clinical. A very part time position to set up one of the first smoking cessation services in England became available near my home. This position and the fellowship complemented each other, and that’s how I became involved in smoking cessation in 1999.

After that, I worked to maximise the potential of the services in policy at a national level (I was the tobacco control delivery lead for England with the smoking cessation services in my remit for a few years). I’m now the Global Bridges Co-Director for the European network; as well as manager of several smoking cessation services in England. I also assist with research activities with several senior colleagues in academia.

What is the main focus of your work? 

It depends on the day! Most days, I focus heavily on the quality principles being applied in our services, supporting colleagues in their work, and working strategically to assure the services and to make/maintain relationships with other health care providers so that they make every contact count and refer their patients.

What are some of the challenges you face in your work?

Some health care providers see smoking cessation as a competing priority, or something which is not a clinical issue. I also have to make sure that the services are cost effective and that all staff are trained and supported to give every smoker the best chance of quitting. Personally, I find it a challenge to do all the things I want to do each day — 24 hours is too short!

What are some success stories as a result of your work?

We recently became one of only three services in England to be awarded the “Approved Provider” status — something I am very proud of after only one year of delivering the services as an organisation. I’m always happy to hear about the smokers who use the services. One example is a gentleman named Bill who had smoked from age 13 and is now 72. He stopped smoking for 16 weeks, and is already noticing an improvement in his health, wealth and well-being. I’m delighted that our quit rates mean you are more likely to stop for good if you use our services than any other system and that we make such a difference to the lives of people and their families in our community.