Helen Poole is a smoking cessation counsellor based at University Hospital of Wales in Cardiff who has been enabling smokers to quit the habit for 20 years.  We met her to find out more about the patients she supports and how even long-term heavy smokers can give up for good.

The main qualities you need to do this job are empathy and understanding. You don’t need to agree with somebody’s behaviour, you just need to have empathy with what they are going through.

Many of the hospital patients we work with are very vulnerable and they feel judged. We are not there to judge them we are there to motivate them.

The smokers I work with are already patients in the hospital and they come to us because they’ve become so ill from smoking that they need to stop to protect their health.  They come from all walks of life – everybody is different and we have to respect what they are going through.

We sometimes meet drug addicts and alcoholics and hear about what they have gone through in their lives and it really is quite tragic. Often people come across as aggressive but actually this is just because they are frightened.

In our work we use a combination of a cognitive behavioural therapy (CBT) approach and motivational interviewing.  This involves providing empathy and support and empowering people to believe in themselves again.

We encourage them to change their behaviour but a lot of our patients can’t drastically change their lifestyle as they may already be in a wheelchair or with chronic respiratory problems.   So instead, we encourage them to find a new hobby that fits their lifestyle. Such as playing cards or board games. One patient I worked with even took up matchstick making.

Most of our patients started smoking around 10 or 11 years old. We had one who had first tried cigars at 3 and was smoking by the time he was 6.  They just don’t know life without a cigarette and they don’t know how to get through the day without one.  They were brought up as part of a generation where it was normal and it is that generation that is coming through now and being hospitalised with respiratory problems.

It’s very difficult to change that mindset which is why we offer long term support. We see them every week for first month then every three months, every six months, every 9 months and every 12 months. We also provide nicotine replacement therapy products on a long-term basis.

I’ve seen numerous success stories of even really long-term heavy smokers giving up for good so we know it’s possible with the right support.

I worked with a grandma in her 70s who loved spending time with her grandchildren.  But she was wheelchair bound and could no longer walk on the sand with them on family holidays. She stopped smoking and her circulatory problems improved. Four months later she managed to kick a football to them.

I also worked with a patient recently who had really suffered with mental health problems and had made several suicide attempts.  Since she stopping smoking there have been no more suicide attempts and she is just so proud of what she has achieved.

Stopping smoking changes people lives and I’m proud to have played a part in that.  Our hospital patients they are very vulnerable and smoking is at the front of their minds. This provides a really good motivational opportunity to engage with them which is why hospital-based smoking cessation support is so effective.