Be the Motivation Your Patients Need to Quit Smoking this New Year
10th January 2019
As 2019 begins I am sure many of us will be setting ‘New Year’s resolutions’, as will be the case for many of your patients. Quitting smoking is one of the most popular health-related resolutions, but also one of the least successful, with the Royal Society for Public Health reporting quitting smoking to be the most difficult resolution to keep (and by some margin). In the New Year of 2016, of those who resolved to quit smoking, 3 in 5 were smoking again by the end of January 2016 and just 13% had stuck to their resolution by the end of the year.
Approximately a third of the UK’s 9.4 million smokers attempt to quit their habit at least once a year, often driven by milestones such as the New Year. Yet statistics show just 4% of those who try to quit smoking unaided are successful one year later. Smokers increase their chances of successfully quitting four-fold by using stop smoking services, often combined with Nicotine Replacement Therapy (NRT). However, one of the greatest issues to overcome is how to motivate smokers to want to quit and to access the support available, rather than simple awareness of services.
Here are a few ideas regarding how we can motivate patients to want to access available support to help them quit smoking:
Persistently advise your patients to quit smoking
This may seem obvious, but studies have shown that GPs who persistently advise their patients to quit smoking at every appointment can significantly increase their patients’ chances of successfully quitting. Specifically, it is advised that smoking status be considered as one more vital sign. The AAFP Tobacco Cessation Advisory Committee recommends the delivery of a 30-second stop-smoking message such as “Smoking is harmful to you. I really would like you to quit. I’m ready to help you quit.” Delivering this message multiple times to the same patients may feel frustrating, yet it is estimated that 20% of your patients will quit, at least partially, due to this persistent messaging.
Remind patients that smoking is a legitimate addiction, not just a ‘bad habit’
Smoking ought to be viewed as a medical condition by both patients and physicians, that often requires medication and psychological support. Due to many patients perceiving smoking as ‘just a bad habit’, alongside the associated stigma, pride is often a barrier to people seeking help to quit. This is seen within a shocking 1 in 10 smokers hiding their smoking habit from their doctors. It is recommended that GPs remind their patients that quitting is a challenge, but with support, the chances of successfully quitting massively increase; so, there is no need to ‘go it alone’.
Remind patients of the serious health consequences of smoking
Smoking remains the number one cause of preventable death in the UK. Shock tactics often work. A devastating 85% of new lung cancer cases are caused by smoking, while smokers are also 30-40% more likely to develop type 2 diabetes than non-smokers. From the alternative perspective it may be encouraging to remind patients that quitting smoking significantly reduces the risk of developing lung and other cancers, heart disease, COPD and other serious diseases.
Provide practical tips
Smokers often do not attempt to quit due to their awareness of some of the challenges they will face from nicotine withdrawal. Suggesting the ‘4Ds’ to cope with the potential challenges may make these individuals feel empowered to attempt to quit:
- Drink plenty of water – 6-8 glasses a day
- Delay smoking a cigarette for 5-7 minutes and the urge should subside
- Do something else with your hands e.g. play games on your phone, or something relaxing (e.g. have a bath)
- Deep breathing releases endorphins and may mimic the sensation of smoking a cigarette.
Ask your patient why they do not want to quit smoking
Let’s not forget the most basic approach; ask your patient if they want to quit smoking. If they do, signpost to available support. If they do not, ask why. It is important to customise treatment and support to your patients, where possible. For example, some patients may feel they do not have the willpower to abruptly quit or some may have relapsed while previously attempting to quit, or others may need hand-to-mouth sensation. Your patients may not be aware of the varied support available which would adapt to each of these fears; Reduce to Quit, Combination NRT and Inhaler use respectively.
New Year’s resolutions can be a fantastic way to ‘draw a line in the sand’, get motivated and stay motivated. Those who try to quit smoking at New Year are more than 3 times as likely to succeed than the national average. GPs have a vital role in supporting individuals in quitting smoking. Yet this role is more than simply signposting patients to available support services, often plastered over GP waiting room walls. This role expands to motivating individuals to seek help and care about wanting to quit smoking. Hopefully these tips will come in handy when fulfilling this role this New Year!