Why smoking is still a hot topic
It's that time of year again - spring has sprung, the sun has come out (and possibly gone in again, but at least the weather was good over the weekend!) and No Smoking Day is here again. I try to make my blogs topical and varied, but there are certain subjects that come up time and time again - alcohol and smoking among them. I've covered the practicalities and challenges of quitting successfully, the psychology behind becoming a 'non-smoker' rather than an 'ex-smoker' and the rapidly growing popularity of e-cigarettes. So why do I think it's worth highlighting the dangers of smoking yet again?
First let's touch on the benefits of not smoking. If I have a patient in front of me with high blood pressure, high cholesterol, obesity and type 2 diabetes it can be hard to know where to start to make the biggest difference to their health. But if they smoke as well, there's no contest - stopping smoking, for most people, is the single most important thing they can do for their health.
Secondly, smoking is highly addictive and smokers need all the help they can get. We've made a lot of progress - in 1948 smoking was very much the norm, with 82% of men smoking in the UK. Women used to be much less likely to smoke than men - half as many women as men smoked in 1948, and levels peaked at about 45% in the mid 1960s. Between 1974 and 1994 there was a steep drop in smoking numbers, and levels were down to about 21% by 2007. (1) Unfortunately, levels have stayed pretty stable since then - and given that half of continuing smokers will die from a smoking-related disease, there are smokers stopping because they die as well as because they quit. That means young people are still starting, despite all we know about the risks.
Lots of my patients tell me that they use smoking to relieve their stress levels. I'm regularly told that it's the only pleasure they have left in life, and that smoking is the only thing that stops them sinking into depression. Interestingly, a new study shows that even though patients believe smoking relieves their stress, quitting successfully leads to lower stress levels as well as a lower risk of anxiety and depression. (2) Quality, as well as quantity, of life is improved, and the benefits seem to be just as marked if you have mental health problems or not.
In an ideal world, I'd like to see my patients stopping cigarettes and any replacement products entirely. But many of my patients do seem to be switching to e-cigarettes and staying on them. Is this better than continuing to smoke in terms of your health? Of course it is. If it works for them when other attempts have failed, I'm all in favour of it.
So how do you maximise your chances of getting off the evil weed? It's not rocket science, but a new campaign called 'feel the FOURce' offers four useful tips:
- Seek help. You're up to four times more likely to quit successfully with help from a smoking cessation advisor than with willpower alone
- Plan. Your healthcare professional can work with you to set a quit date and do your best to avoid triggers that might sabotage your efforts
- Remember. Write down your reasons for quitting (the most effective are the ones which matter to you, not just because your partner is nagging you!) and keep looking at your list to remind yourself why you want to do this
- Reward. Whether it's stopping to sniff and smelling how much fresher your home smells or adding up how much you've saved on cigarettes, reward yourself for doing a really good thing for yourself.
Of course there are other benefits - but whatever your reasons, make this No Smoking Day the day you stop making excuses.
2) BMJ 2014;348:g1151 found at http://www.bmj.com/content/348/bmj.g1151