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Wednesday, 28 December 2011

Stopping smoking - why and how?

@HealthMed UK No Smoking day is 14th March 2012: some helpful Q & As.

But no need to wait until then to stop ...

Why bother?
Apart from the obvious: cost, smell on clothes and breathe, and taste impairment and eventual loss of taste? Smoking is the single most preventable cause of disease and death.
For primary prevention, smokers and their advisers need to be well informed of the personally relevant risks of smoking and benefits of stopping. For younger smokers, risks include premature ageing of the skin, increased risk of impotence, risk to the developing baby in the womb, and increased risk in offspring of serious chest disorders. For older smokers, the more pressing risks are increased risk of cancer of the lung, mouth, throat, bladder and many other types of cancer; premature ageing of arteries, leading to heart attacks, strokes and other serious disorders of the heart, brain and circulation; and serious lung disorders including chronic obstructive lung disease and emphysema. And in the long-term, it is estimated that around half the smokers who do not give up smoking will die from one or more of these and other smoking-related diseases.
For non-smokers and confirmed ex-smokers the question has to be - why bother? Give up now to improve your medical and financial health.
For current smokers, the challenges are to beat the psychological, physical (nicotine), and social addiction, including resisting peer pressure. Useful ammunition to help smokers to stop smoking includes being aware that giving up tobacco can help you live longer, and that the risk of getting cancer is less with each year you stay smoke-free.

Help from friends and family
Now is a good time for smokers to be ready to think about stopping, to think about stopping and to prepare to stop. That might mean telling friends and family you are serious about stopping, and to seek whatever help may work - e.g. from pharmacist, family doctor or nurse, or other health professional, and smoking cessation support groups. The US National Institutes of Health recommend:
- 'Try not to view past attempts to quit as failures. See them as learning experiences'.
- 'Make a plan about what you will do instead of smoking at those times when you are most likely to smoke'.
- 'Satisfy your oral habits in other ways'. 
Their website provides excellent advice on other ways to help to smoking including how to plan stopping, setting a stop date, and having alternative strategies for times you associate with smoking. 

Stop smoking apps
There are now several free or low cost 'apps' which may be helpful. For example, the UK NHS mobile 'Quit smoking' app provides links for UK smokers to the NHS Stop Smoking helpline and other UK NHS Stop Smoking Servces. 'My Last Cigarette' - MLC provides a dashboard with daily changing reminders of dangers of smoking, and updating estimates of effects of stopping smoking on risk of heart disease, lung disease and other serious medical problems, money saved since stopping, life expectancy gained, and number of smoking-related deaths since the time a smoker has stopped.

Benefits of training health professionals and funding nicotine replacement treament
A controlled study in Germany reported benefits from extra training for family doctors, and further benefit when costs of anti-smoking treatment are subsidized. However, for these over 10/day cigarette smokers, although very helpful for those who succeed in stopping, outcomes were very modest: by
12 months after intervention, 1 in 30 had stopped with usual support, 1 in 10 when their family doctor had received training and been paid a €130 incentive for each patient who stopped, and 1 in 7 where patients also had costs of treatments subsidized.

Unexpectedly rapid benefits from banning smoking in public places
More recent encouragement for anti-smoking campaigns has come from evidence of the rapid time to benefit from stopping: around 1 in 5 fewer heart attacks within 1 year of stopping in countries which have moved to ban smoking in public places. That provides clear evidence to smokers that their cardiovascular risk reduces very rapidly after stopping smoking.

Avoiding temptation to smoke
A recent review of a large number of trials of ways to help people to stop smoking concluded that the evidence for success was 'strongest for interventions focusing on identifying and resolving tempting situations'.

If you are a smoker you quit, what worked for you? Please add a comment ...

© DRJ Singer

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