The number of people who smoke in the UK has declined to its lowest level since records began in the 1940s; however, it is estimated that some 9.4 million adults in the UK still smoke cigarettes.
The health risks of smoking tobacco are well-documented. Approximately half of all regular smokers will be killed by a smoking-related disease unless they quit and smoking causes over a quarter of deaths from cancer in the UK.
Approximately half of all regular smokers will be killed by their habit unless they quit; smoking causes over a quarter of deaths from cancer in the UK.
And it’s not just the smokers themselves who are at risk. It is estimated that passive smoking kills 12,000 people in the UK every year.
Most smokers say that they would stop smoking if they could, but it’s not easy. Nicotine is highly addictive, withdrawal symptoms can be uncomfortable, and it takes willpower, motivation and support to stop smoking. The good news is that a multitude of tools and self-help materials are now available, for example, nicotine replacement therapies (gum or patches), e-cigarettes, online support services, helplines and mobile phone applications (apps).
Campaigns can also be motivating; this month, smokers can sign up to Stoptober, a Public Health England campaign to help people quit the habit. In order to mark the occasion, and with the help of the ISRCTN registry, I decided to look at some of the clinical trials developed to help people to stop smoking, educate people about the dangers or prevent people from taking up the habit at all.
Help in your pocket
Mobile phone apps are increasingly being used as a tool to help improve people’s health. A quick search though Google play on my Android phone results in seemingly hundreds of apps claiming to help people stop smoking.
There are seemingly hundreds of apps claiming to help people to stop smoking
Studies investigating the effectiveness of such apps include the Physical over Smoking (PoS) application from Finland and a smartphone application funded by Bupa and the British Heart Foundation in the UK.
The Bupa application provides information on how to stop smoking, monitors progress (for example recording number of smoke-free days and money saved) and also an interactive “toolbox” for managing cravings. It is currently being tested against a “dummy” version of the application that does not provide the toolbox element.
The PoS application works on the premise that physical activities help people to resist the urge to smoke. After attending a quit smoking counselling program, participants are either given support via the app or not, to compare how many quit the habit.
Electronic cigarettes: poison or therapy?
Electronic cigarettes (e-cigarettes) are another popular aid to help people stop smoking. These battery-powered vaporizers are designed to mimic tobacco smoking and work by vaporizing a liquid solution known as an e-liquid containing nicotine and flavorings.
One recent study has investigated whether e-cigarettes deliver the same feeling of satisfaction and relief from nicotine cravings as tobacco. Smokers were asked to report how satisfied they were after smoking one of three e-cigarettes with different solutions compared to smoking tobacco and what effects they had on their urge to smoke.
Another study is comparing e-cigarettes to nicotine patches as an aid to quit smoking. All participants in the study are given support though the UK Stop Smoking Service but are then given either nicotine patches or e-cigarettes. The aim is to see whether e-cigarettes are as successful as nicotine patches in helping people to stop smoking.
One of the key questions surrounding e-cigarettes is whether they are actually safer than tobacco smoking. Public Health England say yes, even going as far as to suggest that they could be prescribed as a licensed medicine. However, others disagree, suggesting that there isn’t enough evidence to support the claim.
There clearly needs to be more research done in the area. This study looked at how using e-cigarettes rather than smoking tobacco for a week may affect the amount of nicotine in the blood, heart rate and carbon monoxide levels.
Reducing the risks for non-smokers
Smoking doesn’t just harm the smoker. People around them will breath in their secondhand smoke, otherwise known as passive smoking. Secondhand smoke contains more than 4,000 chemicals, some of which are known to be harmful to health. Children are at particularly high risk of harm from passive smoking; it is big news at the moment, with both motorists and passengers in England and Wales now at the risk of receiving a fine if they smoke in a car carrying passengers under 18.
Motorists and passengers in England and Wales are now at the risk of a fine if they smoke in a car carrying passengers under 18.
There are a number of studies included in the ISRCTN registry looking at passive smoking in children. A study in Bangladesh, for example, is currently looking at how teaching children about the dangers of passive smoking and encouraging them to talk to the adults in their family to persuade them to not smoke inside the home.
The best way of reducing the health risks associated with smoking is, of course, to not start in the first place. Bans on advertising tobacco smoking is considered to be one of the best ways to reduce the number of people that start smoking. In the UK, tobacco advertising has been completely banned since 2005. Adverts for e-cigarettes, however, are legal but have come under fire recently for glamourizing smoking and encouraging non-smokers to take up vaping and there is discussion as to whether e-cigarette adverts promote the smoking of real cigarettes. This study is looking at the possible impact of advertisements on children taking up smoking.
In England alone, over 81,400 deaths in people over the age of 35 is caused by smoking tobacco. Estimated costs to the NHS is £2.7 billion per year.
It is in everyone’s interest to give smokers all the help and support they need to quit their habit. Studies investigating the most effective ways to do this and programs designed to educate the next generation about the dangers of this habit are necessary to ensure that the number of people who still reach for a packet of 20 decreases every year.