Treatment/Support

For information and support in quitting smoking you can

• Visit www.quit.ie the HSE Quit website which aims to encourage smokers to quit. The website includes a Quitplan which you can sign up to that will support you during the quitting process
• Join www.facebook.com/HSEquit
• Call the National Smokers Quitline 1850 201 203
• Contact your local HSE smoking cessation counsellor (see www.quit.ie)
• Talk to your GP or Pharmacist who may advise on using nicotine replacement therapy or other medications to help you make that quit attempt successful

   

  Treatment and support from your GP

  If you do not want to be referred to a smoking cessation service service, your GP can still provide treatment, support and advice to help you quit smoking.

  At your first appointment, they will ask you about your smoking habits to assess your level of addiction and to outline the benefits of quitting. They can also help you identify any factors that may make quitting difficult for you, such as living with others who smoke, or any stress that you experience in day-to-day life.

  Your GP can prescribe a smoking cessation treatment to help you quit. There are several different treatments available from your GP. The type you are prescribed will depend on your own personal preference, any previous smoking cessation medication that you have taken and any side effects they may cause. The different types of smoking cessation treatments, their side effects and the way they will be prescribed are detailed below.Nicotine replacement therapy is available over the counter in your pharmacy but you will need a prescription from your GP to get it free on the medical card.

   

  Treatment and support from a Smoking Cessation Advisor

  One-to-one support

  This form of intensive support combined with drug treatments has the highest success rates. This service is usually free of charge and is run by health services. Smoking cessation advisors are specially trained to support you through the quitting process. You can attend smoking cessation clinics for one-to-one sessions that are tailored to meet your needs. They usually take place for 1-4 weeks before your quit date and continue for up to one year after you quit.

  These sessions will:

  look at your desire and readiness to quit,

  take a history of your smoking habit,

  assess your nicotine addiction,

  identify your reasons for quitting and any difficulties or risks of relapse,

  create a personal plan for your quitting,

  measure your carbon monoxide levels,

  recommend suitable medical treatment, refer you to doctor for prescription and follow-up.

  Contact the National Smokers’ Quitline on callsave 1850 201 203 to talk to an advisor or to find you nearest HSE stop smoking service.

   

  Group support

  Group courses are usually six weeks long and meet once a week for about an hour. They are usually run by smoking cessation advisors and can be very effective. In the first session the members of the group introduce themselves, they review past attempts to quit, determine reasons for quitting and set a quit date for the group. At follow-up meetings, members discuss their progress, address any difficulties, swap coping tips, and encourage one another to stay quit. The advisors will measure each member’s carbon monoxide levels (before and after quitting), their level of nicotine addiction, and recommend medical treatment. Contact the National Smokers’ Quitline on callsave 1850 201 203 to talk to an advisor or to find you nearest HSE stop smoking service.

   

  Self-help

  There are leaflets and books available which give you information on how to give up, what to expect when you give up smoking, the health effects of smoking and tips on how to stay stopped. Others focus on changing your attitude towards smoking. These are better than having no form of support but you are more likely to succeed with one-to-one or group support.

   

  Nicotine replacement therapy (NRT)

  Nicotine is highly addictive, and it is the nicotine in cigarettes that causes people to become addicted to smoking. Nicotine replacement therapy (NRT) works by releasing nicotine steadily into your bloodstream at much lower levels than in a cigarette, without the tar, carbon monoxide and other poisonous chemicals present in tobacco smoke.

  This helps to control the cravings for a cigarette that occur when your body starts to miss the nicotine from smoking.

  NRT is the most common smoking cessation treatment and it comes in many different forms, including:

• transdermal patches (which stick to your skin), available in formulations that release nicotine for either 16 hours or 24 hours
• chewing gum that is available with either 2mg or 4mg of nicotine
• inhalators, which look like plastic cigarettes through which nicotine is inhaled
• tablets and lozenges, which are placed under your tongue
• nasal spray, which passes nicotine through the lining of your nose

  NRT can be prescribed by your GP. All forms of NRT can also be bought from a pharmacist over the counter.

  There is no evidence that one particular type of NRT is more effective than another, so the one you choose is largely a matter of personal preference.

  When deciding, think about the type of smoker you are. For example, are you a heavy smoker who needs a cigarette as soon as you wake up, or are you an occasional smoker who only smokes when they are out having a drink, or after a meal?

  Some heavy smokers find a 24-hour patch useful, as it helps to relieve the cigarette craving when waking up. Others prefer using a NRT nasal spray, because it is the fastest-acting form of NRT.

  Some smokers find it useful to combine NRT products. For example, they wear patches throughout the day, then use gum or an inhalation to help relieve a sudden craving for a cigarette.

  Most courses of NRT last eight to 12 weeks before you gradually reduce the dose and eventually stop. Most people stop using NRT altogether within three months, although heavy smokers may need to use it for longer.

  Side effects of NRT include:

• skin irritation when using patches
• irritation of nose, throat or eyes when using a nasal spray
• disturbed sleep, sometimes with vivid dreams
• upset stomach
• dizziness
• headaches

  Side effects are usually mild to moderate, but if they become particularly troublesome, contact your GP as your dosage or type of NRT may need to be adjusted.

  Also, use of the nasal spray can cause sneezing and watering eyes for a short time after use. For this reason, if you are prescribed an NRT nasal spray, do not use it while driving, or just before driving.

   

  Nicotine replacement therapy and pregnancy

  If you are pregnant or breastfeeding and you want to quit smoking, it is best for your and your baby’s health that you stop completely and immediately without any smoking cessation treatment.

  However, if you feel you cannot stop smoking without help from smoking cessation treatment, your GP may recommend that you stop smoking completely and use NRT to control your cravings.

  Nicotine is not good for your baby, but the greatest risk to an unborn baby’s health from smoking is posed by carbon monoxide, which can cause foetal hypoxia (a severe lack of oxygen). So although using NRT is not ideal for your baby, the risks of nicotine are far outweighed by the risks of continuing to smoke.

  As with any other patient who wants to stop smoking, the form of NRT you are prescribed will depend on your personal preference, ease of use and your level of addiction.

   

  Medication

  There are two medications that are currently licensed to help people give up smoking. Contact your GP for advice.

  Nicotine-assisted reduction

  If you do not yet feel ready to stop smoking completely, your GP may suggest a method of quitting known as nicotine-assisted reduction to stop. This involves using NRT to progressively reduce the number of cigarettes you smoke, before eventually stopping smoking altogether.

  If your GP suggests using nicotine-assisted reduction to stop, you will be prescribed NRT gum or an inhalator to use in between cigarettes. These forms of NRT are best for use between cigarettes because they release a short burst of nicotine rather than a steady, constant supply.

  It is necessary to use short-release NRT when you are still smoking, because taking in the nicotine from your cigarettes combined with that from a steady-release NRT could make you feel very unwell.

  For this reason, you must only use your prescribed NRT in between cigarettes to combat cravings.

  You should also try and prolong your smoke-free intervals for as long as you can, and steadily reduce the number of cigarettes you smoke. By six weeks of NRT treatment, you should aim to have cut down on your usual cigarette consumption by half.

  With the advice of your GP, you can stop smoking whenever you feel ready, but this should be no more than six months after the start of your NRT treatment.

  Useful Links

• Health A-Z: COPD
• Health A-Z: cancer
• Health A-Z: heart disease
• Health A-Z: lung cancer
• QUIT
• ASH

  Source: www.hse.ie