How to stop smoking

Helen Cowan

Quitting smoking is difficult because of the addictive nature of nicotine; it triggers feelings of pleasure in the brain. Withdrawal causes difficulty with concentration, memory, anxiety, irritability and insomnia. It’s no wonder so many people relapse, but how do you stop for good?

“Giving up smoking is the easiest thing in the world. I know because I’ve done it thousands of times,” said Mark Twain. Are you one of the millions of smokers who have tried to quit and relapsed one or more times? Helen Cowan has interviewed smoking expert Dr Graham Cope, Honorary Senior Research Fellow at the University of Birmingham and author of Smoking—what all healthcare professionals need to know and reports back.

 

What helps?

There has been a lot of work to find out the best way to quit smoking and the most successful is nicotine replacement therapy. This comes in the form of patches for long term help with withdrawal, while gum, lozenges and sprays can be used in the short term when the urge to smoke becomes too strong.

 

A systematic review of 136 studies by the Cochrane Library in 2018 concluded that nicotine replacement therapy increases the chance of stopping smoking by 50 to 60 per cent in those who are motivated to quit, and who smoke more than ten to 15 cigarettes each day.

Nicotine therapy might work better in some people if it’s combined with cognitive behavioural therapy provided by smoking cessation counsellors. This helps to “retrain” the brain, undoing negative thoughts such as, I’ll never be able to quit and helping identify alternative strategies for stress relief.

 

Do e-cigarettes help people to quit?

A lot of people are turning to electronic cigarettes as a means of quitting, seeking the nicotine in a more acceptable and pleasurable way than patches or gum, so there has been a big reduction in nicotine patch prescriptions and the use of counsellors.  

Public Health England estimate that e-cigarettes are 95 per cent less harmful than regular cigarettes since they do not contain harmful tobacco tar and carbon monoxide. Do they help people quit? Dr Cope is not sure. They help some people but not all. What’s more, many people find e-cigarettes less satisfying and so use normal cigarettes as well. Meanwhile, some non-smokers start using e-cigarettes, and then begin smoking too.

 

Health hazards associated with e-cigarettes

Whilst safer than regular cigarettes, their nicotine content is a concern—especially if they don’t help you to quit.
 “In adolescents, early exposure to nicotine can reduce brain activity and negatively affect concentration and memory,” says Patricia Folan, director of the Center for Tobacco Control in New York; nicotine inhaled during pregnancy, meanwhile, can affect foetal brain development.

The immune system is also sensitive to nicotine, with smoking increasing the risk of respiratory diseases like influenza and reducing the body’s ability to heal wounds and mend bones. Using e-cigarettes after operations may increase the risk of post-operative complications so it’s advisable to refrain from e-cigarettes both before and after operations, especially procedures on the hips and knees, at least in the short term.  

Going smoke-free

Every year, on May 31, the World Health Organization (WHO) celebrates World No Tobacco Day, raising awareness of the harms of tobacco and discouraging its use in any form. The WHO includes nicotine replacement therapy on its list of essential medicines, citing its success in helping people stop smoking. Is it time for you to try it out, and quit for good? Speak to your GP or an NHS Stop Smoking Adviser for advice (especially if you are pregnant or breastfeeding).