Giving up smoking

Unsolicited advice from health professionals, family and friends

Smokers usually know that smoking harms their health; they often go of their own accord to seek professional advice and help with quitting smoking or talk to their friends and family about quitting. In this section we discuss people’s reactions to unsolicited advice about smoking.

Routine advice from Doctors

When people go to the doctor for something other than asking about smoking cessation, they are sometimes offered advice on giving up smoking or told about the risks of continuing to smoke. This type of advice is called ‘opportunistic’ and the current recommendation from NICE (National Institute for Clinical Excellence) is that health professionals should check their patients’ current smoking status and that everyone who smokes should be advised to quit.

People were sometimes irritated when their GP initiated a conversation about smoking, or they thought that the advice they were given was predictable or irrelevant. Sometimes the advice seems to have been counterproductive.
Some people honestly told their doctors how much they smoked, others deliberately said that they smoked less than they did. Some people had felt as if the doctor was ‘telling them off’ whereas others like Chris can’t remember ever being advised by her doctor that she shouldn’t smoke. Sue’s doctor had suggested that the amount she smoked was not likely to cause health problems. Munir had felt that because he smoked only 10-15 cigarettes a day he didn’t smoke much but his GP disagreed. Roger can even remember that in the 1960s he was told by a GP that the “death rate from breathing fresh air was 100%”.

Advice in the context of a health problem

Doctors and nurses had often advised people about smoking when they had a health problem related to smoking, such as Chronic Obstructive Pulmonary Disease (COPD), Transient Ischaemic Attack (TIA –a brief stroke-like episode) or pulmonary embolism.
When Miles went to see the doctor about his asthma, he told him he was already giving up smoking. This was “music to [the doctor’s] ears”. The doctor was nice to him and didn’t pressurise him.

Sometimes specialists were very blunt about people’s smoking, with different consequences. Both Chris and Judith said that respiratory doctors had used rather shocking predictions about what would happen to them if they continued to smoke; they reacted very differently to this approach.
Sometimes the connection was less obvious: for example, Sarah had osteoporosis associated with an eating disorder; her doctor told her that smoking affected the amount of calcium she absorbed. But some people thought that doctors just tend to ‘put everything on smoking’ whether or not there was a real connection. Unsurprisingly, advice that was seen in this light wasn’t taken very seriously.
Advice from family and friends

Giving up with someone else could be very helpful and supportive but many smokers had been highly irritated when non-smokers, or ex-smokers, in their social circle insisted on telling them about the risks of smoking, or nagged them not to smoke.
(Also see ‘Help from pharmacists, GPs and Nicotine Replacement Therapies’, ‘Smoking related diseases’ and ‘The role of other people in the decision to quit’).

Last reviewed August 2018.


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