General Practice 10 Minutes Podcast on Smoking Cessation with Dr Roger Henderson

Dr Roger Henderson

Quitting smoking is the single biggest thing a smoker can do to improve their health, and with the right combination of support, medication, and determination, individuals can successfully overcome their nicotine addiction and enjoy a smoke-free life. For many, the journey to quitting smoking completely can be a challenging one due to the addictive nature of nicotine, but various strategies and treatments are available to help us support patients who are trying to stop smoking. Benefits are immediate, short-term and long-term and it is never too late to stop smoking. The rise in e-cigarette use has also contributed to increased numbers of smokers quitting their tobacco, but their use in younger people has also caused significant concerns. In this podcast we take an overview of smoking and its impact on health, the optimal ways of helping our smokers quit, and the pros and cons of e-cigarette use.

Key take-home points:

Smoking is still the leading cause of premature death and preventable illness in England
80 – 100,000 people in England die each year from a smoking-related disease
One person dies every 6 seconds somewhere on Earth from smoking
Each cigarette smoked takes 11 minutes off that smoker’s life
Almost 600,000 NHS admissions each year due to smoking (approx. 25% of all)
Around 14% of the UK population smoke
Receiving support from an HCP increases the likelihood that a smoker will make a quit attempt
Over 25% of smokers in England want to quit, but most who try without support are likely to fail
Smokers are up to 3x more likely to quit when offered specialist support compared with willpower alone
Smoking tobacco is an embedded behaviour, therefore the best outcomes for smoking cessation are achieved when pharmacotherapy and psychological support are combined
A combination of behavioural support and pharmacotherapy increases the likelihood that smokers will quit compared with those offered less support or advice alone
Combination NRT is 25% more effective compared with the use of a single NRT product
Tobacco harm reduction is a key concept.
The first e-cigarette went on sale in China in 2004
All e-cigarettes have three basic elements; a battery, which heats up a coil or atomiser, turning the flavoured e-liquid or juice into a vapour, which is then inhaled.
E-liquid comprises four ingredients: vegetable glycerine, propylene glycol, nicotine, and flavouring. (Some liquids can contain no nicotine.)
People using e-cigarettes should stop smoking tobacco completely, because any smoking is harmful
The evidence suggests that e-cigarettes are substantially less harmful to health than smoking but are not risk free
Since 2021 the proportion of 11 to18-year-olds vaping has been greater than those smoking. In 2024 8% of that age group vape regularly.(11% aged 19 to 24 out of a total number of 4.5 million British vapers)
Although it is illegal to sell vaping products to people aged under 18, many young people can buy these easily from sellers who do not enforce the law.
Adolescents can also be heavily influenced by social media platforms and influencers, along with intensive marketing campaigns promoting brightly coloured, highly flavoured cheap disposable vapes.
The sale of nicotine vaping products to under 18s is prohibited across the UK but children appear to be able to easily obtain illegal vapes, which often contain high levels of lead, nickel and chromium.
The health advice regarding vaping appears to be clear – young people and anyone of any age who has never smoked should not vape.
Vaping using regulated and licensed products can be extremely effective in helping adult smokers successfully quit smoking as part of an orchestrated quit attempt involving healthcare professionals and should be viewed in the same way as any other type of nicotine replacement therapy. However, they are inappropriate to be used in any form in children whose lungs and brains are still developing.
The more time spent on social media, the greater the likelihood that children and young people will both smoke and/or vape, suggests research just published online in the respiratory journal Thorax.
April 2024 US study; vapers are 19% more likely to suffer from heart failure than those who have never used e-cigarettes.