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.

The pharmacist just gave Cassie forms to fill in when she asked for an NRT inhaler. She expected more support and interest.

Age at interview 22

Gender Female

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When Andrew learned there was a 6 week wait for support at his GPs, he went to his local pharmacy and found flexible and personalised support.

Age at interview 32

Gender Male

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Peter went to Boots to get advice and support on giving up smoking. He tried chewing gum as well as patches.

Age at interview 39

Gender Male

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After falling ill with cellulitis and temporarily not wanting to smoke, Blodwen went to the chemist to ask about products to help her quit.[TEXT ONLY]

Age at interview 55

Gender Female

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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.

Dr Helen Salisbury, a GP, talks about what they would do if somebody mentions that they would like to give up smoking.

Gender Female

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Dr Helen Salisbury, a GP, explains what the smoking cessation nurses do.

Gender Female

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People who went to a GP for help were offered a range of types of treatment and encouragement to help them stop.

Munir was referred to a nurse in his GP’s practice. She offered him support, and prescribed NRT patches and varenicline.

Age at interview 54

Gender Male

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On her second attempt to quit Carol got further support through her GP. A nurse prescribed Zyban (bupropion) and coached her through a 9-week programme.

Age at interview 54

Gender Female

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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.

Chris saw a smoking cessation nurse who supported her through many attempts at giving up. Nicotine gum helped her.

Age at interview 65

Gender Female

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Roger’s smoking cessation nurse suggested a mindfulness technique to help him avoid relapse.

Age at interview 66

Gender Male

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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.

Cassie thought that her GP wasn’t supportive; the nurse who treated her asthma was much better.

Age at interview 22

Gender Female

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Khan went to a smoking cessation clinic and liked finding that his carbon monoxide levels had decreased and that his physical health was improving.

Age at interview 29

Gender Male

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When Abdul went to the GP after hed given up smoking he was surprised that there wasn’t more support and information available to reinforce the health benefits.

Age at interview 37

Gender Male

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Sues GP had been advising her to quit on and off over 30 years period, but he recently forgot that she had already stopped smoking three years ago.

Age at interview 57

Gender Female

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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.

Caroline was offered support through a smoking cessation clinic and pretended she had stopped. She said she wasn’t offered much practical advice.

Age at interview 53

Gender Female

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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.

Sarah tried NRT gum and patches, and chose patches as she didn’t have to taste anything.

Age at interview 33

Gender Female

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Blodwen had a chewing gum whenever she would usually have had a cigarette for example with morning coffee.[TEXT ONLY]

Age at interview 55

Gender Female

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Bethan gave up with the help of NRT patches, an inhaler on prescription, and ordinary chewing gum.

Age at interview 53

Gender Female

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Chris tried different types of NRT: the gum and patches in combination worked for her.

Age at interview 65

Gender Female

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Keith, Roger and Jules said that NRT met the immediate need but didn’t help them in the longer term.

Caroline used nicotine lozenges and patches, but disliked the taste of the lozenges and reacted badly to the patches.

Age at interview 53

Gender Female

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Neil went on smoking while using high dose nicotine patches. He soon felt ill and a doctor told him it was due to nicotine poisoning.

Age at interview 64

Gender Male

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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.

Tom didn’t try patches or gum because he focused on why he wanted to quit.

At first Judith wanted products to help her quit, but then decided she didn’t want to have to quit nicotine after she had given up smoking.

Age at interview 36

Gender Female

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