11 March 2020
Dr Zaid Hirmiz is a GP practising at Spire Portsmouth Hospital. Dr Hirmiz provides Spire Portsmouth Hospital with support, advice and lectures on GP clinical education. Today he answers our questions on the benefits of giving up smoking and the help available.
"I want to stop smoking, but what changes do I need to make to help me resist the temptation to light up?"
- Think positive: You might have tried to quit smoking before and not managed it, but don't let that put you off. Look back at the things your experience has taught you and think about how you're really going to do it this time.
- Make a plan to quit smoking: Make a promise, set a date and stick to it. Sticking to the "not a drag" rule can really help.
- Consider your diet: Is your after dinner cigarette your favourite? A US study revealed that some foods, including meat, make cigarettes more satisfying. Others, including cheese, fruit and vegetables, make cigarettes taste terrible. So swap your usual steak or burger for a veggie pizza instead.
- Change your drink: The same US study as above also looked at drinks. Fizzy drinks, alcohol, cola, tea and coffee all make cigarettes taste better.
- Identify when you crave cigarettes: A craving can last 5 minutes. Before you give up, make a list of 5 minute strategies.
- Get some stop smoking support: If friends or family members want to give up, too, suggest to them that you give up together. There's also support available from your local stop smoking service. Did you know that you're up to 4 times more likely to quit successfully with their expert help and advice?
- Get moving: A review of scientific studies has proved exercise, even a 5-minute walk or stretch, cuts cravings and may help your brain produce anti-craving chemicals.
- Keep your hands and mouth busy: Nicotine replacement therapy (NRT) can double your chances of success. As well as patches, there are tablets, lozenges, gum and a nasal spray. And if you like holding a cigarette, there are handheld products like the inhalator or e-cigarettes.
"If I feel I need extra help to quit, what options are there out there?"
The best treatment for you will depend on your personal preference, your age, whether you're pregnant or breastfeeding and any medical conditions you have. Speak to your GP or an NHS stop smoking adviser for advice.
Nicotine replacement therapy (NRT)
NRT can be bought from pharmacies and some shops. It's also available on prescription from a doctor or NHS stop smoking service.
It's available as:
- chewing gum
- inhalators (which look like plastic cigarettes)
- nasal and mouth spray
- skin patches
- tablets, oral strips and lozenges
Treatment with NRT usually lasts 8-12 weeks, before you gradually reduce the dose and eventually stop.
Sometimes it may be advisable to get medical advice first, for example if you have kidney or liver problems, or you've recently had a heart attack or stroke.
Varenicline is a medicine that works in 2 ways. It reduces cravings for nicotine like NRT, but it also blocks the rewarding and reinforcing effects of smoking. Evidence suggests it's the most effective medicine for helping people stop smoking. Varenicline is only available on prescription, so you'll usually need to see your GP or contact an NHS stop smoking service to get it.
It's taken as 1 to 2 tablets a day. You should start taking it a week or 2 before you try to quit. A course of treatment usually lasts around 12 weeks, but it can be continued for longer if necessary.
Bupropion is a medicine originally used to treat depression, but it has since been found to help people quit smoking. It's not clear exactly how it works, but it's thought to have an effect on the parts of the brain involved in addictive behaviour. Bupropion is only available on prescription, so you'll usually need to see your GP or contact an NHS stop smoking service to get it.
It's taken as 1 to 2 tablets a day. You should start taking it a week or 2 before you try to quit. A course of treatment usually lasts around 7 to 9 weeks.
An e-cigarette is an electronic device that delivers nicotine in a vapour. This allows you to inhale nicotine without most of the harmful effects of smoking, as the vapour contains no tar or carbon monoxide.
Research has found that e-cigarettes can help you give up smoking, so you may want to try them rather than the medications listed above. As with other approaches, they're most effective if used with support from an NHS stop smoking service.
There are no e-cigarettes currently available on prescription. For now, if you want to use an e-cigarette to help you quit, you'll have to buy one. Costs of e-cigarettes can vary, but generally they're much cheaper than cigarettes.
Dr Hirmiz is part of our private GP service which is available for quick and easy access to a GP appointment when you need it, a 30 minute appointment is £110.
The content in this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other healthcare professional.