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by James Thomas, Thursday, 21 July 2016 | Categories: Smoking

Is There Really an "Easy Way" to Stop Smoking?

It’s a question that thousands of smokers around the world ask themselves every day: Is there an easy way to stop smoking? Something that will prevent withdrawal symptoms and eliminate all those pesky cravings?

The short answer is no – but that doesn’t mean you should lose hope. Quitting smoking is a complex process that differs hugely from person to person, and how difficult you find it depends upon factors that include how much you smoke, and what kind of lifestyle you live.

Today, many "stop smoking" treatments are available – as well as other options, which are not treatments as such, like e-cigarettes. And unsurprisingly, all have been subject to various criticisms from both users trying to quit and the medical community trying to protect their health.

The E-Cigarette Argument

There’s been a great deal of controversy surrounding the safety of e-cigarettes. In 2014, the World Health Organization called for e-cigarettes to be banned indoors and advised that manufacturers not be allowed to market their devices as smoking cessation aids. But then last year, Public Health England declared that e-cigarettes were 95% safer than regular cigarettes, and recommended that the UK’s eight million smokers switch over to vaping.

Unsurprisingly, this was met with criticism, and earlier this year the British Medical Association echoed the advice of the WHO by recommending that vaping be banned indoors, a statement that has in turn been criticised by tobacco control experts keen to encourage smokers to quit.

Like any hot issue under debate by the medical community, the discussion around e-cigarettes is unlikely to die down for some time – and until more studies are carried out into the long-term effects of vaping on our health, we won’t have any firm answers about whether or not it’s a safe alternative.

Smoking Cessation Treatments Approved by the NHS

If you’re looking to quit smoking but you feel dubious about using e-cigarettes there are some other ways to kick-start the process.

*Nicotine Replacement Therapy*

Nicotine replacement therapy (or NRT) is available over the counter in any high street pharmacy. As most of us are aware, the addictive ingredient in cigarettes is nicotine; by substituting cigarettes with skin patches, chewing gum, inhalators, tablets or sprays that contain nicotine (but none of the other poisonous chemicals) you can start to break your smoking habit.

Taking nicotine replacement therapy regularly after you stop smoking helps to minimise cravings and withdrawal symptoms, and allows your body to adjust slowly. Normally NRT lasts eight to 12 weeks before the dose of nicotine is reduced, allowing you to wean yourself off.

Champix and Zyban

Two other stop smoking treatments are Zyban and Champix. Both these medicines come in the form of a tablet, taken daily, and work by breaking down your addiction to nicotine.

It is not completely understood how Zyban works; however, Champix is known to prevent nicotine from binding to the parts of the brain that respond to it. This helps to slowly diminish the pleasant "reward" feeling you get from smoking.

For treatment with Zyban or Champix to work, you should start taking your tablets seven to 14 days before you quit smoking. A full course of Zyban normally lasts for seven to nine weeks, and a full course of Champix normally lasts 12 weeks – however, further courses can be prescribed if you are at risk of starting smoking again.

The Online Clinic does not prescribe Zyban.

Additional Stop Smoking Tips

Other tips that can help you quit for good include:

  • Downloading a "quit smoking" app to your phone that keeps track of your progress
  • Avoiding foods that make cigarettes taste good when you’re having a craving (that means swapping out meat for cheese, fruit and vegetables)
  • Avoiding drinks that make cigarettes taste better when you’re having a craving (that means avoiding fizzy drinks, alcohol and caffeine – sorry!)
  • Creating an action plan for dealing with your worst cravings
  • Exercising to combat cravings, withdrawal symptoms and low moods

Lastly, remember that asking for help is the best way to stop smoking for good – according to the NHS, smokers are four times more likely to quit if they use NHS services and resources.

You can also start your smoking cessation journey by requesting a prescription for Champix tablets through The Online Clinic. Click here to find out more.

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by Marijana Domazet, Monday, 28 January 2013 | Categories: Smoking

It would be hard to find a person today that is not aware of the health risks smoking brings with it. Every now and then a study comes out with a fresh perspective of how these risks have changed and reminds us why smoking risks should not be ignored. One of those is a recent large-scale study suggesting that since the 1960s female smokers have caught up with male smokers in terms of the risks of death due to lung cancer.

The study, which was published in New England Journal of Medicine, measured mortality trends during three time periods (1960s, 1980s, 2000s) and compared the findings with results from historical and current cohort studies concerned with smoking status. In total, the cohort data included 900,000 men and 1.3 million women from the US, who were classified as current smokers, past smokers and never smokers. The key findings indicated that there were gender differences in how the pattern of the risk of death due to lung cancer among smokers had changed over the years. Among women, the risk of death due to lung cancer had increased from 30/100000 in the 1960s to 506/100000 during the 2000s. In contrast to that, the risk of death due to lung cancer among men peaked during the 1980s but remained similar among the smokers of 2000-2010 and their past generation. These findings led the researchers to conclude that the risk of death was increasing among female smokers and reaching similar proportions to the current risk of death among male smokers. Although some newspapers have speculated as to why this may be, there is not enough data in the current study to verify any of those suggestions.

There are several issues worth considering when reading about the findings. The most obvious may be that this study covered an interpretation of findings from several other studies conducted during different time points and with different teams. No scientific study is ever perfect, so it is likely that each of those cohort studies came with their own flaws such as not following up whether the participants smoking status changed during the course of the study. Similarly, how smoking was seen and reported in the 1960s may vary from how it is seen today. Therefore, it would be worth critically considering how participants were selected, and what measures were taken to ensure that their reporting was reliable. Nevertheless, it is worth commending the researchers analysing enormous amounts of data across time periods in the United States. Given that all the studies were conducted in the US, the researchers managed to circumvent many obstacles that cross-national studies may have had. However, it came at the expense of the data being most applicable to Americans. You can read more information here.




by Robert MacKay, Wednesday, 23 January 2013 | Categories: Asthma | Smoking

You really cannot argue with the facts. Asthma hospital admissions involving children have fallen significantly in England and Wales since the introduction of the smoking ban in public places. I have to put my hands up and say that I had argued on these pages that this was unlikely to happen as most of the second hand smoke to which children were traditionally exposed was in the home and of course this was one area not covered by the smoking ban.

The figures from the NHS are clear however: there was a drop in child asthma admissions of around 12% in the first year from 2007 when the ban was introduced and further year on year falls of around 3 % have been recorded in the two subsequent years following the initial impressive fall of 12%. This should be seen against a backdrop of rising admissions in the years before the smoking ban was introduced.

Passive smoking does not just trigger asthma attacks; there is evidence that the inhalation of second hand smoke can actually cause the condition to develop in the first place. Regardless of whether or not you agree with a smoking ban on political grounds, the health-related case is incontrovertible. Children should not be exposed to passive smoking and responsible parents would ensure that was the case in the home anyway. But with the smoking ban in place, parents can be sure that their children are not inhaling second hand smoke in shopping centres and other public places.

There is definitely a correlation between the smoking ban introduction and the drop in hospital admissions but I am not sure how it is possible to demonstrate causality. However, given the established relationship between smoking and asthma, I think that it is a reasonable hypothesis and let’s face it, we are not going back to smoking in public places in any case so any argument about cause and effect is purely academic.




by Robert MacKay, Sunday, 06 January 2013 | Categories: Smoking

We have had sight of a study that examines the relationship between smoking and anxiety. It has traditionally been accepted that smoking relieves stress (based on anecdotal evidence).  I am not aware of any empirical study out there that would corroborate this hypothesis but as nicotine is a psychoactive drug, it is likely that it affords the perception of stress reduction.  A new study by researchers at the King’s College London however has suggested that giving up smoking actually reduces anxiety, whereas failure to give up smoking causes anxiety levels to increase.

While the headline caught my attention, the study is so full of holes that it is difficult to know where to start. Sure, anxiety levels were measured and discovered to be at a lower level in the group that had successfully quit and anxiety levels increased amongst those that had failed to quit but I could not see anything in the study that explored the possibility that the stress levels recorded might be related to any factors external to the study. The nature of this study meant that it this sort of interrogation was not possible but this avenue of investigation really would be necessary to corroborate the hypothesis. The study was also very small – only 68 participants had abstained from smoking after 6 months.

I think that the researchers are onto something: smoking puts a lot of stress on the body so a reduction in perceived stress after a period of time is probably a correctly observed phenomenon but this does not explain the increased stress levels amongst the group that failed to quit. Clearly more work is needed if a conclusion is to be successfully drawn but no doctor that I know would ever be advising a patient to continue smoking to reduce anxiety levels so I am not sure what utility such a study would provide.




by Robert MacKay, Monday, 26 November 2012 | Categories: Smoking

Most smokers are well aware of the many effects that smoking brings with it; these usually extend to respiratory and cardiovascular areas. However, a recent study from Kings College London now claims that smoking may even affect cognitive function such as memory, learning and reasoning.

The study, which was published in Journal of Age and Ageing, was a population based cohort study and included a total of 8850 participants over the age of 50. The participants were classified as either non-smokers or current smokers (with ex-smokers being categorised as non-smokers). The researchers carried out several surveys regarding health and lifestyle. In addition to that, the participants took part in several cognitive tests where it was required that they learn new words and name as many animals as they could think of in one minute. The participants were followed up four years and eight years since the initial testing and they provided the same data and did the same tests, which were then compared. The findings indicated that there was a consistent relationship between smoking status and poorer performance in the cognitive tests. This led the researchers to suggest that smoking may be a risk factor for affecting cognitive function in later life.

This study benefits from the substantial sample size and the extensive questionnaires that provided information on many aspects that could affect cognitive performance. This included highest educational attainment, level of physical exercise, depressive symptoms and age. Although the psychological tests may appear rather rudimentary, they do in fact have a history of providing reliable and valid results. What is interesting is that the cognitive decline reached statistically significant levels, as it could be argued that participants should have performed better in later tests as a result of learning what is expected of them.

However, there are several aspects of the study that make it challenging to directly apply the results to smoking as a key factor on its own. Firstly, it is unfortunate that smoking status was not more nuanced to separate the groups into ex-smokers, smokers and non-smokers and individuals extensively exposed to second hand smoking. It also appears that amount of smoking was not recorded, which would have been useful to consider dose-response relationships between smoking and cognitive decline. The study had sound theoretical basis as the relationship between cardiovascular risk factors and cognitive decline appears to have been proposed in the past and the relationship between smoking and cardiovascular health is not novel within research to date. However, this study cannot pinpoint if and how these may interact, or whether there is an alternative explanation that would turn both cardiovascular risk factors and smoking into mediators.

Nevertheless, the study adds weight to previous findings from limited studies that have considered the potential relationships between smoking and cognitive function. It does have a place in research for this particular demographic group and may be valuable in further considering how smoking might affect the mind.

We are not surprised that smoking affects both mind and body, as we often mention how complex the process of smoking cessation can be. But what fascinates us about this study is that smoking has been applied to specific cognitive functions that are valuable in an everyday life. Although the findings need to be interpreted with caution, it is still worth mentioning that smoking is a risk factor that individuals can affect and that we encourage cessation sooner rather than later.




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