Giving up smoking

Help from pharmacists, GPs, and Nicotine Replacement Therapies

Although many people decide to try to quit smoking by themselves others seek help from a pharmacist or their GP. Here we discuss the help they got, including their experiences of medical treatments and nicotine replacement therapies (NRT).

Support through pharmacies

Some people went to their local pharmacy for information and nicotine replacement therapy products to help them quit smoking. Pharmacists can offer follow up visits and NRT on prescription; some people were impressed with the service and the range of stop smoking products though Cassie expected a bit more personal help.
Gareth had a friend in a pharmacy and went there to check out what new products there were. His friend gave him some nicotine replacement inhalers, but he never opened the packet but didn’t want to use them in the end.

Support through GPs

GPs can give advice on how to quit smoking. They can also refer people to a nurse specialising in smoking cessation or to other NHS ‘stop smoking’ support services. In addition to advising on lifestyle and behavioural changes, GPs can prescribe drug treatments including:
 
  • nicotine replacement therapy (NRT),
  • bupropion (Zyban; Wellbutrin in the US) originally used for depression but in the UK now only to help people quit smoking,
  • and varenicline (Champix; Chantix in the US) which can help people quit by acting on nicotine receptors in the brain.

People who went to a GP for help were offered a range of types of treatment and encouragement to help them stop.
Raf had tried many different ways to stop smoking but he found out about Champix (varenicline) through a GP friend of his. It took away his desire to smoke and made cigarettes taste unpleasant. People sometimes expected the GP to just give them a prescription for a medication but they also got advice on behaviour change and support. This was welcomed by some but, others wondered why it was necessary.
Although people we interviewed sometimes found that their doctors were ‘delighted’ and eager to help them when they wanted to quit, others didn’t get the support they would have liked or got better support from someone else. Waiting lists for “stop smoking” clinics were sometimes a problem - especially for people with enthusiasm wanting to quit straight away. The advice to prepare and set a quit date at some point in the future was sometimes at odds with the approach that seemed most natural.
Some people admitted that they hadn’t always been honest with health professionals about whether or not they still smoked or tried to influence the lung function tests. Neil said he didn’t smoke for about a day before the level of carbon monoxide was measured and would smoke again directly after his appointment with the nurse.
Some GPs spoke about smoking when the patients themselves hadn’t brought up the issue. Several people like Haseen and Laura didn’t think giving up smoking was a ‘medical issue’; others like Miles, Tom and Peter said that they had avoided going to their GP over the years.

People had widely differing preferences about the kind of advice and information they wanted from professionals. Some they wanted kind, reassuring and motivational information, such as how much the lungs could be expected to recover in six months or a year after quitting, others felt they needed to be shocked into quitting. Judith said, “I always used to think that if I could get a photograph or an x-ray or something like that of my lungs and have a photograph of what they should look like if I was a non-smoker that would be a really powerful visual and would almost jolt me into actually trying to do something like giving up”.

(Also see ‘Unsolicited advice from health professionals, family and friends’).

Nicotine replacement therapy (NRT)

NRT is offered as skin patches that deliver nicotine slowly, as chewing gum, nasal spray, inhalers, and as lozenges/tablets, all of which work by reducing the intensity and frequency of the urge to smoke. The use of NRT makes it more likely that someone will quit smoking. They helped people like Jules, Andrew and Sarah when they quit. Some used these products on the NHS with advice from professionals (as mentioned) while others bought products over the counter at pharmacies. Many had seen ads for nicotine replacement therapy.
Keith, Roger and Jules said that NRT met the immediate need but didn’t help them in the longer term.
Sue’s skin reacted to adhesive patches. Mariam was prescribed patches but didn’t use them and didn’t like the taste of lozenges, whilst Val actually became addicted to the lozenges themselves. John tried the nasal spray and found it a nasty ‘body shock’ like having a shot of caffeine. Other people thought NRT merely fed their addiction to nicotine, and that instead of replacing nicotine they needed to face their deeper psychological reasons for smoking.


Last reviewed August 2018.

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