Smoking cessation in 2016

Abstract

Local support services, businesses, online forums, pharmacies, and health professionals across the country coordinate their efforts on No Smoking Day (9th March) to help people stop smoking by offering support and advice, and hosting activities. The first campaign was held on Ash Wednesday in 1983, and now takes place every year on the second Wednesday in March. Tobacco is seen as the most harmful product in the history of human civilisation. However, over 2000 years ago, native Americans were using tobacco for medicinal and ceremonial reasons. The discovery of tobacco by European explorers to the New World in the 1400s led to the belief that tobacco smoking had distinct medicinal properties. But concern about its harmful consequences grew in the 1900s and in 1939, researchers in Germany found a statistical link between cancer and smoking, which led to a strong anti-smoking campaign in Nazi Germany (Muller, 1939). The first comprehensive report on the harmful health effects of smoking was published in 1964, concluding that male smokers had a greater mortality from coronary artery disease than male non-smokers (US Department of Health, Education, and Welfare, 1964). Stronger evidence followed, with many prospective studies confirming a causal link between smoking and cardiovascular disease (Doll et al, 2004; US Department of Health, Education, and Welfare, 2014). Studies found that exposure to smoking triggers vasomotor dysfunction, atherosclerosis, thrombosis, and an inflammatory response in the blood and at the vessel wall (Bermudez et al, 2002; Ambrose and Barua, 2004). In 2013, the prevalence of smoking among adults fell below 20% for the first time in nearly a century (Office for National Statistics, 2014). However, that still means that 10 million people in the UK are smokers. About 100 000 people die each year in the UK from smoking-related causes (Health and Social Care Information Centre (HSCIC), 2015). Despite any success achieved through smoking cessation services, smoking remains twice as common among people in unskilled jobs compared with professional occupations, and much higher among the unemployed, the homeless, prisoners, and people with mental health problems (McManus et al, 2010). Help available for people includes stopsmoking services, nicotine replacement therapy (NRT), and medications. The general practice can offer help, support and advice and refer the smoker to an NHS Stop Smoking Service. Since 2012, general practitioners have been paid to offer smokers referral for behavioural support at Stop Smoking Services, and medication to help them give up smoking. A recent study found that this initiative has led to a 38% increase in referrals to Stop Smoking Services but not an increase in medication prescription (Szalkowski and Aveyard, 2016).