How to support smokers to quit

Smoking is the leading cause of preventable illness and premature death in England and causes progressive harm to the musculoskeletal system. It has a negative impact on bone density and is associated with an increased risk of osteoporosis, bone fractures, back pain and degenerative disc disease.

Smoking is a significant cause of rheumatoid arthritis, especially among men. Much of the harm and risk caused by smoking arises from smoking in the middle years and can be prevented by cessation as a young adult or partially reversed by quitting in later years.

Over half of smokers want to quit

Smoking is not a lifestyle choice but a dependency needing treatment. Supporting a smoker to quit is one of the most effective ways any healthcare professional can help improve a person’s health.

Over half of current smokers say they want to quit, with 1 out of 5 intending to do so within 3 months.

Willpower is not enough

Smokers often make many quit attempts before managing to stop for good. Currently, around half of all smokers in England try to quit unaided using willpower alone, despite this being the least effective method.

Prompts by healthcare professionals

Prompts by healthcare professionals are one of the most important triggers for a quit attempt and the success of these attempts can be significantly increased by helping patients identify appropriate quit aids and access further support:

• using over-the-counter nicotine replacement therapy products or e-cigarettes makes it one and a half times as likely a person will succeed;
• a person’s chances of quitting are doubled if using a stop smoking medicine prescribed by a GP, pharmacist or another health professional;
• combining stop smoking aids with expert support from local stop smoking services makes someone 3 times as likely to quit

Learning to quit smoking resources

For more information on quitting options and their effectiveness, see Health Matters: Stopping smoking – what works? and Stop smoking options: guidance for conversations with patients.

The National Centre for Smoking Cessation and Training (NCSCT) provides free online training modules on stop smoking medications and e-cigarettes.

Providing Very Brief Advice on stopping smoking

NICE guidance NG92 Stop smoking interventions and services acknowledges that some healthcare professionals worry that people who smoke may feel they are being given too much advice.

However, it is clear that missing the chance to give appropriate advice carries a greater risk of harm. Talking to people about smoking in a way that is sensitive to their preferences and needs will ensure they are more likely to think about stopping when asked.

The National Centre for Smoking Cessation and Training (NCSCT)

The National Centre for Smoking Cessation and Training (NCSCT) Very Brief Advice (VBA) model is recommended by NICE and consists of three steps:

• ASK and record smoking status: is the patient a smoker, ex-smoker, or non-smoker?
• ADVISE on the best way of quitting: the best way of stopping smoking is with a combination of stop smoking aids and specialist support
• ACT on patient response: build confidence, give information, refer, and prescribe

Delivering VBA can take as little as 30 seconds and has the power to transform the future life chances of someone who smokes. Every healthcare professional should be doing this as part of routine care and should know about local specialist support and how to refer smokers for the expert help that will give them the best chance of quitting for good.

The NCSCT provides a free online training module on Very Brief Advice on smoking and training is also available on the e-Learning for Healthcare platform.

For a one-stop resource on smoking, quitting options and the role of all healthcare professionals in supporting smokers to stop, see Smoking and tobacco: applying All our Health and its associated e-learning module.

MSK Health Across the Life Course. This looks at Physical Wellbeing, Mental Wellbeing, Healthy Eating, Smoking and Sleep.