Smoking cessation specialist Louise Ross explains why the Stoptober campaign is a good opportunity to have conversations with patients about stopping smoking – and how nurses can support their patients to quit for good
The annual ‘Stoptober’ campaign is in its 13th year, providing thousands of smokers across the country with the tools, support, and motivation they need to quit for good.
Backed by the NHS and many health organisations, it is designed to help smokers focus on giving up cigarettes during the month of October and embrace a healthier, smoke-free future.
Stoptober has proven to be one of the most successful public health campaigns in the UK, with over 2 million people having made quit attempts since its launch.
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Research shows that smokers who quit for 28 days are five times more likely to stop smoking for good.
Nurses are a trusted source of information, and can make it a routine matter to slip in some encouragement about stopping smoking while seeing a patient, relating it to their presenting condition. Relevant all year round, stop-smoking advice is even more important during Stoptober, to reinforce the positive messages people may have seen in the media.
Here are my five top tips to help support your patients to quit smoking for good.
- Learn how to give very brief advice
NICE recommends all frontline healthcare staff are trained to give very brief advice on how to stop smoking. The National Centre for Smoking Cessation and Training (NCSCT) has a wide range of free online training for health care professionals, and one of the quickest and easiest to complete is the Very Brief Advice module, which also includes a ‘memory jogger’ for those who would like a refresher resource.
You may think that it takes too much time to get into a discussion about smoking with your patients, but it really is a very simple and quick intervention.
In a nutshell, you ask each patient if they smoke, and instead of asking if they want to stop, you explain that the most successful way of stopping is a combination of behavioural support along with a stop-smoking aid (nicotine replacement therapy, a nicotine-containing vape or a prescribed medication). You then tell them where to get this support.
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- Know the benefits of smoking cessation aids
The NICE guidance on promoting quitting lists the most strongly evidence-based quitting aids. These are combination nicotine replacement therapy (NRT), nicotine-containing vapes and varenicline. Varenicline is returning to the market after an absence of several years, and NICE has indicated Cytisine will be added to the list soon. The most contentious of these is vaping, but there is good evidence now that nicotine-containing vapes are effective as a way of stopping smoking. The NCSCT has a thorough briefing on this, which will help nurses familiarise themselves with the benefits of switching from smoking to vaping, and how to address concerns that patients may have had arising from media stories.
- Remember: ‘It’s never too late to quit’
Patients with long-term conditions may feel that it’s too late for them to quit – that the damage has already been done. However, we know in that despite years of smoking, quitting can slow the progress of illness. There is no condition where it is better to continue smoking than to stop; the harmful chemicals in tobacco smoke accelerate the progress of cancers, respiratory disease and heart disease, but as soon as smoking stops, the body starts to repair at least some of the damage. The sooner the quit, the faster the repair!
Stopping smoking also means that interventions and medications have a better chance of working, and nurses can tailor the information they provide to patients by referring specifically to the condition each patient is being treated for. For example, it can help to explain to people with leg ulcers who smoke that wound healing will be more effective if they quit. The poisonous carbon monoxide in tobacco smoke displaces oxygen in their blood, meaning wounds are less likely to heal and may even spread. Stopping smoking will result in improved blood supply and delivery of oxygen and nutrients to the site of the wound to support effective healing, while it will also improve their immune function to help prevent infections.
- Explain the mental health benefits
Nurses can inspire hope and optimism that this could be the time a person actually stops smoking for good. Instead of constantly trying and failing, getting it right this Stoptober and vowing never to smoke another cigarette ever again will mean the battle is won.
In addition, there is a common misperception that smoking provides emotional regulation for people with poor mental health, or those who are experiencing stress in their lives. However, the reality is that it is much more beneficial to quit. For people with poor mental health, this can be a big step for their mental health recovery, as stopping smoking can lead to improved mood and less medication being needed – a win all round.
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- Help patients find a suitable service
Nurses can help patients find support that will suit them. There may be a Stop Smoking Service in their area (worth checking with colleagues to find out, if you don’t already know), and patients can be assured that they will not have to join a group – most support is offered these days on a one-to-one basis. For those who do not want to attend an in-person service, there are now digital options such as the NHS Quit Smoking app and the Smoke Free app, which may appeal more to people who work awkward shifts, have carer responsibilities or simply don’t want to attend an in-person service.
Louise Ross is a clinical consultant at the NCSCT and smoking cessation lead for the Smoke Free app
