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To help smokers quit during Stoptober we asked stop smoking experts for their top tips on how to give up

Dr Alex Bobak is the first GP in the UK to specialise in smoking cessation and is a passionate campaigner on the dangers of smoking. He has carried out extensive research into treatments for smoking cessation and now teaches the subject to other health professionals around the world. He currently works as a senior partner of a General Practice in Wandsworth, South London. He spoke to ASH Wales about will power, addiction and how to cope with cigarette cravings.

What first inspired you to specialise in smoking cessation?
My first job as a junior doctor in the 1980s was working under a Welsh chest physician called Stephen Williams at Stoke Mandeville Hospital. Most of the patients on the ward had one thing in common, they were smokers, more often than not dying from smoking related diseases such as COPD or lung cancer. My job was to tell them the bad news about their diagnosis and prognosis and I just thought how completely unnecessary all the suffering was. That inspired me to work on ways to help smokers to beat their addiction.

Can smokers kick the habit using will power alone?
Will power alone is definitely not the easiest way to stop. In fact, research has shown that it’s up to ten times more difficult for smokers to kick the habit if they use will power alone. Smoking is a powerful addiction, as or more powerful than, heroin or cocaine addiction. If you have been smoking for a while your brain changes so that it needs nicotine and continues to demand it even when you can’t afford it anymore or when people around you want to you stop. That is because smokers have three or four times more nicotine receptors in their brains than they were born with, all of which demand feeding.

Would you advise those hoping to stop smoking to seek help from their GP?
Smoking is a powerful addiction so why not get medical help. I don’t see any difference between smoking addiction and a physical illness. If you had diabetes for instance you would think nothing of seeking medical help. There is plenty of support out there so why make life difficult for yourself when giving up smoking is the most important thing you can do for your health.

What treatments are available to help smokers give up?
There are tablets called Champix that are designed to stop cravings by blocking the release of dopamine when you smoke. This takes away the pleasurable aspect of smoking. Also nicotine replacement therapy (NRT) can be highly effective and products range from patches, gum and lozenges to nasal and oral sprays. It is usually better to use two different types of NRT at the same time as one often isn’t enough.
And we know that all treatments to stop smoking work much better with support so the best first step is to contact your local stop smoking service or general practice who can go through all the treatment and support options with you.

What advice would you give on dealing with nicotine cravings?
As well as using NRT, my other advice is to use a displacement activity, such as going for a run or eating a healthy snack. Cravings don’t usually last more than two minutes but they can be very powerful. So doing an activity to distract yourself during that time can really help. Withdrawal symptoms can be horrendous but one way to deal with that is to up your dose of NRT. A lot of people under-use these products so they become less effective. It’s important to keep seeking advice and support if you feel the NRT you are using is not helping you to deal with your cravings.

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