Manurewa clinic leading the way in a national push to help patients get serious about giving up.

If you go for a check-up at the Greenstone Family Clinic you will almost certainly be asked, "Do you smoke?"

No matter whether you've got the flu or a sore foot, 99 per cent of the time a doctor or a nurse will ask and record your smoking status, well above the target of 90 per cent.

And it works, says Dr Bruce Arroll, a GP at the clinic in Manurewa, South Auckland.

He said the rate of Greenstone patients quitting or cutting down smoking was about 20 per cent higher than at a comparison clinic where only 50 per cent of patients were asked.


"If you've got a smoker in the room, it's what you should be talking about. You've got the patient's agenda, but the doctor's agenda should absolutely be smoking.

"I ask patients, 'Do you think I'm nagging?' and they say, 'No'. It's my job."

The Health Ministry says in its newly-released Health Targets report for the July-September quarter that 40 per cent of smoking patients who were seen by a health worker in primary care were urged to quit and offered help to do so. The target is 90 per cent.

Those targets don't cover the rate of primary care patients whose smoking status was recorded. However, a report last December put that rate at 75 per cent. It also stated 34 per cent of smokers had been urged to quit smoking or offered help, which indicates a 6 percentage point increase has occurred subsequently.

The ministry's tobacco control manager, Karen Evison, said the percentages of smoking patients in primary care having their smoking status recorded and being encouraged or helped to quit were increasing rapidly. "It takes [time] to get the momentum up and the routines in place."

The smoking targets were introduced to primary care last year and achieving a certain level was required before incentive funding could be accessed to provide the "brief advice and support" to encourage quitting.

The idea is to ask all patients if they smoke and record this; advise them to quit, regardless of whether they want to; and offer quit-smoking treatment. Surveys indicate most smokers want to quit and that it typically takes a number of attempts to quit long-term.

In public hospitals, 94 per cent of patients who smoked were urged to quit and offered quitting support in the September quarter, 1 percentage point below the target. But it took hospitals two years before the national rate hit 85 per cent.

Persistence from all corners pushes mum to stub out

Joanna Walker credits the persistence of her GP - and her son - for getting her off tobacco.

The 43-year-old shop worker from Takanini smoked from the age of 18, until two years ago. Before she quit, she was smoking at least 20 cigarettes a day.

Her GP, Dr Tana Fishman, of the Greenstone Family Clinic in Manurewa, talked to her about quitting smoking at every opportunity.

"She kept going, 'Have you stopped smoking'. Some people go 'Yeah, yeah, yeah', but after a while it gets to you, that maybe it would be good for me.

"I joined the gym. I was finding it really hard to do some of the exercises with still smoking and my son [Kaine, now 10] was asking me like, when am I going to stop, when am I going to stop."

Eventually Ms Walker yielded to the pressure.

"I went to the doctor and got Zyban, was on that for two weeks and I just stopped, no cravings. I found it really easy. Once you get it in your head that you want to stop and that's it, it makes it a lot easier."

When asked what was her main motivation to quit smoking, Ms Walker said she wanted to make sure she was around in future for her son and for any grandchildren.