E- ciggs v. NRT patches

[Eye_]

nhs.uk/news/2013/09Septembe...

This helpful link from NHS Choices sets out the findings from a research study in New Zealand which you may have seen cited in the media. As always, the headline doesn't always reflect the full picture.

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Personally I feel it would take years to research the value of e-cigs as an aid to stopping smoking. No one seems to be able to say whether they have any more of a detrimental effect on health than NRT. The success rate of NRT is pretty abysmal really in the long term and what really annoys me most about any research done by anyone is their failure to come back in 12 months, 2 years, 3 years down the line and see if the people who stopped are still stopped. The NHS seems to have this magic number of 4 weeks quit and you're all done and dusted......if only stopping smoking was that simple.

[jillygirl Administrator LONG TERM WINNER]

Sinfree, Like they say in parliament here here. or hear hear,

I agree sometimes you can tell its people who have never smoked that think it so easy to quit.

[antons]

I started to use e-cigs as a means to quitting cigarettes altogether back in late January this year and after two weeks I started to get pains along my side (rib area) and also found it difficult to breathe and to cut a long story short I was diagnosed with PNEUMONIA which apparantly is not uncommon with the steam you inhale fro these.

There was no other reason why I caught this as especially a couple of years ago I had the pneumonia jab so you can imagine my view on e-cigs.

Still hell bent on giving up 3 months ago to the day I went to my local NHS stop smoking clinic and with the help of the patches and one other product, in my case the inhallator I have have gone 3 months and hopefully this will continue although as the saying goes never say never.

[jillygirl Administrator LONG TERM WINNER]

Hi anton. well done on staying quit. very interesting info about the pneumonia and e cigs. keep being positive.

[Eye_]

Ok, so there is quite a lot in those posts for me to answer so here goes…..

There is lots of research going on about the impact of smoking and how we can best support smokers to quit. Unfortunately the majority of that is translated into attention seeking headlines which don’t always give a true reflection of what the evidence actually tells us.

There are a number of universities who undertake research in what is known professionally as ‘Tobacco Control’, Stirling and Bath are amongst those who are most active. If you Google any of the work undertaken by Professors Linda Bauld; Gerard Hastings; Anna Gilmore or Robert West and you will see first rate research outcomes.

The link below is to Smoking in England and gives the most up to date information on outcomes.

smokinginengland.info/

This link is to the National Centre for Smoking Cessation Training (NCSCT) and this is recognised as the standard setting body for those of us who practice as stop smoking advisors. There is a wealth of outcome information on here.

ncsct.co.uk/

Research now shows that the best results for using NRT are from using combination therapy. A transdermal patch delivers constant nicotine and then that is enhanced by using an oral product such as gum or inhalator which is used as required to manage cravings. The results with Champix are more or less equal to combination therapy.

With NRT being available over the counter many people who obtain it that way are using it without any guidance or support, with the result that it is not used the way it should be. When a stop smoking advisor first meets the smoker, it is important that they assess how dependant on nicotine the smoker is. This is done by asking a series of questions to the smoker. (I’ll pop up a link here once EmJay has finished writing the post up about it.) Once completed, this enables the correct therapy to be chosen for that person.

It is important to recognise that although the pharmacological products are a great help they work best when combined with behavioural support. So much of smoking is related to behavioural cues and these are different for each individual. This might be socialising with friends, whilst having a pint or that first cigarette of the morning with a coffee. As you all know, that takes careful thought and planning to come up with alternatives which don’t lead to a cigarette.

To address the 4 week quit comments, this is indeed a tricky one. As stop smoking advisors at Roy Castle Lung Cancer Foundation we continue to track our clients for 52 weeks. The most vulnerable time for those who have been quit 4 weeks seems to be between 12 -16 weeks. That is probably because people relax into being a non-smoker and probably are less focussed on being on the lookout for cues and triggers and wham….someone offers them a cigarette and so it starts again. As Emjay has told you all, relapse is very common but it gives the chance to learn and not make the same mistakes next time around.

At a population level the measure which people look at is prevalence, that is, what proportion of the population smoke at any given time. Prevalence has fallen from 24% in 2007 to 19.4% in 2013, so that shows the impact of not only smoking cessation but also HMRC work in preventing counterfeit tobacco being smuggled; Trading Standards in tackling illegal tobacco and legal frameworks such as laws on display of tobacco and smoking in enclosed spaces.

I hope that answers the questions you pose and reassures you that there is a great deal of research and examination going on within the Tobacco Control aspect of public health. Any other questions, then let us know and we will do our best to answer them.

Eye

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Lots of interesting points there Eye, I will have a look at some of the links. It's good to know that there is research being carried out into stopping smoking and that its recognised as being a long term thing. This is my third attempt at stopping smoking and the longest time I have ever stopped. I honestly think that the biggest reason I have managed to stay stopped this time is because I suffered quite badly with PMT for most of my adult life. On my two previous quit attempts I got to 3 months, hit the PMT time and just snapped. I couldn't take the stress of it all any more and started smoking again. This time I don't have that problem getting in the way. It's still been extremely hard and I think the other thing that has kept me going too is age related. I think once you get to a certain age you realise life doesn't last for ever and that it really is time to take stock and make a serious attempt at preserving your health. I know that if I was to start smoking again, that would be it, there is no way I could ever put myself through all this misery and anguish ever again.

I strongly suspect that the support I received through the NHS is contracted out to an organisation that is paid out once a patient has been stopped for 4 weeks. I think they probably then get paid and have no further incentive to carry on helping. I stopped smoking on 26th January and had got to the point of just telephone counselling with my quit support worker. Then there was a family incident and I started smoking again. I only had 18 cigarettes and I phoned her asking if I could go and see her as I really didn't want to go back to smoking but felt Champix just wasn't working for me. She just said she didn't think I was ready to quit and maybe I should try again when the time was right - end of conversation. That was back in April, I really feel like phoning her and saying hey I'm still stopped smoking, if I'd listened to you I'd be a smoker again. Sorry to chat on, but also you made a point of saying that counselling helps a lot too. That was the other thing with the support worker I had, I could never get a word in edgeways, she used to talk at me and never stopped talking so that I could put my own views forward, I used to find that really frustrating and didn't see the point of the counselling sometimes.

It's really good that the Roy Castle quit support goes on for 12 months. My husband who stopped smoking 10 years ago always tells me it takes about 12 months to be really rid of the urge to smoke. Anyways thanks for all the info Eye, I'm going to read some of the links now.