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Ask The Experts: Smoking

It’s almost a year since England went smoke free in virtually all enclosed public spaces.

It was a massive step towards a healthier environment.

But, for those still struggling to kick the habit, Carmel Thomason questions the region’s top experts on the effects of tobacco smoke, to find out why they believe quitting is one of the best choices you’ll ever make.


THE FACTS ABOUT SMOKING
Dr Phil Barber - Consultant Respiratory Physician at the North West Lung Centre, Wythenshawe Hospital

When it comes to smoking and health what are the facts?
Cigarette smoking is undoubtedly the biggest killer of our age. Cigarettes have killed more people this century than all world wars put together, and cause over 100,000 deaths annually in the UK alone. The single biggest health improvement you will ever make is to stop smoking.

Is it safe to smoke just a few cigarettes?
It is not safe, for two main reasons: First, even low levels of smoke can be harmful to your heart and will gradually damage your lungs. For example, even the relatively low exposures caused by passive smoke have been conclusively shown to be a health hazard.
Second, nicotine is incredibly addictive and in practice very few people can control their habit in this way. The chemistry of tobacco addiction means that withdrawal symptoms recur every few minutes so that most smokers need around a pack a day to stay comfortable.

Many people smoke and don’t seem to come to any harm. Is it really so dangerous?
Yes it is. The people around you who smoke know they are damaging their health and nearly all want desperately to stop. They are multiplying by many times their risk of lung cancer, heart attacks and emphysema, while at the same time reducing their well-being, sexual potency and physical fitness.

I have been smoking for 30 years. Will giving up now really make any difference to my health?
Yes it will. The risk of heart attacks falls enormously within a few days of stopping smoking. If your lungs are damaged some of this will be irreversible but the process will be arrested and some symptoms, for example, coughing and wheezeing, are almost certain to improve.
The more damage has occurred, the more important it is to protect yourself from any further deterioration.

My girlfriend says that smoking in the house makes her asthma worse but I think she is making a fuss about nothing. How harmful can passive smoking really be?
Passive smoke is actually more toxic than “active” smoke, weight for weight. It is less harmful overall only because the concentration is lower. Asthmatics are vulnerable, and the public places smoking ban has already produced benefits in reducing the incidence of heart attacks.

All this doom and gloom, don’t you have a more cheerful message for us?
I certainly do: What single step can you take, today, that will make you feel fitter, put 10 years on your life, and present you with an index-linked, tax-free £2,000 bonus, every year, for ever? You’ve got it...


THE BEST WAYS TO STOP
Erica Kinniburgh - Stop Smoking Co-ordinator for Salford and Trafford

Is it possible to cut down gradually and then stop?
This is a good strategy for some smokers, as it helps their confidence in their ability to quit, but it is advisable to limit the time you take to do this and get some nicotine gum to help you.
Try cutting down to half your daily number of cigarettes over a few weeks, then over the next couple of months, plan to stop completely.

Why should I use nicotine gum, patches, lozenges, inhalator or nasal spray? Is there a charge for them? Also, I’m worried that if I try to quit this way I’ll still be addicted to nicotine.
Nicotine replacement is only free if you get free prescriptions. You won’t get addicted to it in the same way as smoking because it delivers nicotine into the bloodstream much more slowly.
When you smoke a cigarette, nicotine reaches receptors in the brain within 10 seconds because it’s absorbed through the lungs. When you chew gum it takes several minutes for the nicotine to get into the blood stream, so it helps prevent withdrawal symptoms, but doesn’t give you the ‘hit’ that you get from smoking.
Some people may become dependent on the gum for months or years because they are afraid that they might start smoking again, but this is relatively harmless compared with the long term effects of smoking.
The type of nicotine product you choose depends very much on you and what you feel most happy with. You can try all the different types, but research has shown that you will be more likely to stay off cigarettes if you use some form of nicotine replacement and get some support.
If you have tried quitting several times you should not feel bad about it, feeling bad does not help your confidence, you just might need more support from a specialist adviser. They will discuss with you how to break habits and help you to understand why you smoke and also why you might be having difficulty quitting.
Ring your local NHS Stop Smoking Service (details in our ‘What’s happening where you are’ column) for more information about their specialist advisers.

I want to stop smoking but I’m worried about putting on weight when I try to quit, is there anything I can do to prevent this?
This is a common concern. When you do quit you will find that food tastes better because your taste buds will start functioning properly. Your appetite may well increase in the short term, but you can help yourself by doing the following:
> Make sure you are not replacing cigarettes with food.
> Drink plenty of water and eat fruit rather than sweet or fatty snacks.
> Chew nicotine gum or sugar free gum.
> Increase your everyday activity levels by walking more or using the stairs.
And remember, although the average weight gain is 6-8 pounds, this doesn’t have to be the case and even if you do put on a few pounds, it is still healthier than smoking.


NEW CAMPAIGN WILL TARGET KIDS IN FIGHT AGAINST CIGARETTES
Cllr Pat Karney - Director of Smoke Free Greater Manchester

What is the new Quit for Kids campaign?
It is a new national NHS campaign running on radio and television throughout this month. It highlights the research which shows children with smoking parents are three times more likely to become smokers than those with parents who are non smokers.
Quitting makes it far less likely that your child will become a smoker. For teenagers if one parent stops smoking, this cuts the chances of teenagers starting by 25 per cent. If both stop, this cuts the odds by 39 per cent.

What will the TV adverts show?
The TV advertising is set to the music of, ‘I Wanna Be Like You’, from Walt Disney’s Jungle Book movie and starts by showing harmless examples of how young children copy their mums and dads as they go about their daily life – relaxing at home, doing household chores and even watching TV.
The film then takes a sinister turn and ends with a little girl picking up a crayon to copy her mother as she takes a drag on a cigarette.

Have you any reservations about supporting such a hard hitting campaign?
Definitely not. We have to do everything possible to prevent children and young people taking up smoking in the first place. I personally find it upsetting and distressing when I see young kids smoking – it’s exactly what the tobacco industry wants and can lead to a lifetime of smoking or premature death.
The positive message for all parents and guardians is that one of the greatest gifts you can give to your kids is to give up smoking so that they don’t start smoking. I want all kids across Greater Manchester to grow up in a smoke free world.


HAS THE BAN REALLY WORKED?
Dr Peter Elton - Director of Public Health, Bury Primary Care Trust

We are coming up to the first anniversary of the smoke free legislation on July 1st, how has it all gone?
It has been a tremendous success and we started saving lives from day one. It’s still amazing to see smokers stepping outside so that they protect staff inside from second-hand smoke.
There have been minimal breaches of the law and we in the NHS are delighted at the impact of this smoking revolution. It also will have a much greater impact long term because it means young people in Greater Manchester are given extra reasons for not taking up smoking in the first place.

What are the next steps for tobacco control?
The government has launched a new consultation period to look at further measures we can take to protect children and young people from smoking. This includes:
1. Banning vending machines, which is where 17 per cent of 11-15-year-olds buy cigarettes when under the legal age to do so.
2. Banning packs of 10 cigarettes which are known to be bought by the majority of under-age/child smokers.
3. Putting cigarettes out of sight in shops and supermarkets.
4. Only allowing tobacco to be sold in plain packaging.
I am in favour of all these measures to further protect our children and young people from the health dangers associated with smoking.


QUIT IT
To find out more about any of the issues raised here – or for advice on how to start giving up smoking, call the Quit It quitline on 0800 4320303 or text Quit with your name and postcode to 81066.


WHAT’S HAPPENING WHERE YOU ARE
If you want to quit smoking, there is help on hand wherever you live in Greater Manchester. All NHS services listed below are free and confidential.

MANCHESTER
Manchester Stop Smoking Service is available at a wide range of venues including pharmacies, GP practices, community centres and local markets. Services are open to anyone who lives of works in Manchester.
For more information call 0161 205 5998. If you need an interpreter text ‘LANG’ plus the language you would like to be called back in to 81025. Visit www.stopsmokingmanchester.co.uk for more information.

SALFORD AND TRAFFORD
This joint service across Salford and Trafford offers help to anyone living or working in those areas. Smokers who want to quit can make an appointment to see the practice nurse at their local GP, or drop in to most community pharmacies for help with nicotine gum, patches, etc on a voucher scheme.
There is also a free specialist support service for smokers who have made repeated quit attempts.
For more information log on to salford-pct.nhs.uk or trafford.nhs.uk and click on Public Health. Or call 0161 212 4050.

BURY
Bury Stop Smoking Service offers a selection of free and confidential support sessions across the borough. Held in pharmacies, GP practices, community centres, you can meet with an experienced advisor to decide which quit methods are best for your.
Prescriptions for Nicotine Replacement Therapy (NRT) and other aids can be provided to support your quit attempt, if appropriate.
For more information call 0845 223 9001 or text your name to 81066.

WIGAN AND LEIGH
Wigan and Leigh Stop Smoking Service offers friendly and non-judgemental support for anyone wanting to quit in that area. As well as Nicotine Replacement Therapy and medication, if appropriate, they offer more intensive support for anyone suffering from chronic health conditions, pregnant smokers, young people , hospital in-patients, and mental health service users. For more information call 0500 7867 669.

ROCHDALE
TASK is the Stop Smoking Service for Rochdale offering support, advice, and information about easier ways to quit – with or without medication.
Local pharmacies, drop-in clinics and workplace groups provide support at hours to suit you. Call 01706 708000 or visit www.hmrpct.nhs.uk and follow the link for Healthy Lifestyles.

STOCKPORT
For free help contact Stockport Stop Smoking Service on 0161 426 5085 or email stopsmoking@stockport-pct.nhs.uk.
Choose from: drop-in support, one-to-one appointments, evening and Saturday appointments, telephone support, All GP practices and some pharmacies also provide a Stop Smoking Service. For more information call 0161 426 5085.

BOLTON
Bolton Stop Smoking Service runs community-based clinics giving high quality advice and support about the best way to qui smoking for life, with 23 sessions each week at different times of day.
There is no need to book, just visit any of the groups and the advertised time and an experienced advisor will start you on the process of becoming a non-smoker.
For more information visit bolton.nhs.uk or call 01204 462 345. Or test your name and postcode to 07900 918 264.

TAMESIDE
Tameside and Glossop Stop Smoking Service offers support to quit smoking at a number of venues at all times of day. Drop in whenever suits you, there is no need to book.
Experienced advisers are on hand to offer high quality advice and support to start you on your way to becoming a non-smoker. Some GPs and pharmacies also offer individual consultations. For times, venues, and other information call 0845 053 3302.

OLDHAM
Oldham has a specialist NHS service offering free and confidential support and advice to all local smokers who live, work or have a GP in the borough
A team of trained health professionals provide both one to one support and informal group sessions, and there is also telephone and text messaging support to keep you going when you need help.
We are a flexible service offering a choice of venue and appointment times, including evenings, although in some areas you can just drop in to see an advisor.
You have everything to gain and nothing to lose! Tel: 0800 328 8534 or 0844 873 0032.

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