OPINION: Smokers need support to quit

 IT’S that time of year when smokers steel themselves to kick that habit.

Some will succeed, but we know many find the challenge too great.

We also know tobacco is the No.1 cause of death and illness in Australia.

In addition, it is related to substantial social and financial disadvantage. Quitting smoking benefits every smoker, no matter how long they have been smoking, regardless of their age or health.

Most smokers say they want to quit and many have tried, repeatedly.

 Studies have shown that it takes many attempts to  succeed long term.

About half of quit attempts fail in the first week. 

There are a number of reasons for the high failure rate. Firstly, nicotine is highly addictive. Nicotine withdrawal symptoms, like anxiety, depression, irritability and insomnia, on top of the cigarette cravings, make quitting a physical challenge. 

Secondly, people who smoke tend to have social networks of smokers – family and friends    – who smoke.

If a smoker is surrounded by other smokers, they are less likely to receive the social support to quit.

Thirdly, low confidence or self-belief that they can quit will limit success, as will mental illness, other addictions, and heavy nicotine dependence as a result of smoking for many years.

Finally,  only about a third of people trying to quit seek out some type of help.

There is ample research evidence showing which types of support improve the chances of quitting long term. The two main types of effective support  are behavioural support and counselling as well as medicines, such as nicotine replacement therapy. 

The best bet is to use both.

Behavioural therapies aim to improve motivation, provide social support, and educate smokers on ways to deal with cravings or situations which may trigger a return to smoking. 

Setting a quit date is advised and both a complete stop or a gradual reduction in the number of cigarettes smoked have been found to be effective.

Medicines to support quit attempts, known as pharmacotherapies, work by reducing cravings. 

The most well known of these, nicotine replacement therapy, comes in gum, patch, lozenge, inhaler or nasal spray form. 

In Australia, use of patches is subsidised for some  when prescribed by their doctor, making it more affordable. Other medicines that can be obtained from a doctor that greatly improve quitting success include bupropion and varenicline.

Behavioural support can be delivered in person by the smoker’s GP or other health care professional, or via  the Quitline (137848 for the cost of a local call from anywhere in Australia).

Both the Cancer Council NSW (cancercouncil.com.au/get-support/) and the Cancer Institute NSW (icanquit.com.au) have websites devoted to helping smokers quit. 

The main message for people wanting  to stop smoking are: seek professional help, find a friend or relative who will support you, try the medicines, and don’t be discouraged if you fail on your first, second or third attempt. 

Billie Bonevski is an Associate Professor at the School of Medicine and Public Health, University of Newcastle, and a research fellow with the Cancer Institute NSW

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