Better ways to call it quits

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You likely know the reasons why you should quit smoking.

If you didn’t, here’s a fact sheet from the World Health Organization. You’re probably aware that stopping smoking reduces your risk of lung cancer, heart disease, and chronic obstructive pulmonary disease more commonly referred to as COPD (more facts here). A recent study has further shown that long-term smoking causes your brain’s cortex to thin. The good news is that stopping smoking will restore part of your cortex.

You probably also know that you can receive support from the Health Promotion Board on the Quit Smoking Helpline (1800 438 2000) and the I Quit mobile app. But you may not be aware that some ways to quit are better than others. Here’s what the experts say:

1. Cut back on nicotine slowly
A 2015 study shows that brain oxygen uptake and blood flow decreases up to 17% just 12 hours after people stop smoking. This nauseatingly unpleasant sensation is a likely obstacle for many aiming to stop smoking entirely. So actually, it seems that quitting gradually may be better in the long run than going cold turkey.

2. E-cigarettes are one way to quit smoking
recent study found that as many as a fifth of participants had quit smoking and were smoke-free 8 months after a 2-month study, during which they could use e-cigarettes. In another recent study involving randomized trials, more participants were smoke-free by the end of the year with e-cigarettes (9% quit smoking) than a placebo (4% quit smoking). It also turns out that the kind of e-cigarette you use and how often you use them may be more important than you thought. Recent reports suggest that e-cigarettes are effective if used regularly and if you use the refillable tank versions. The jury’s still out though, according to a 2015 meta-analysis of research: This analysis says that on the whole, e-cigarettes helped people stay smoke-free for a month but not 3 or 6 months after quitting.

3. Use concrete rewards
Give yourself an incentive to stop smoking. Don’t laugh. It works. Participants who earned a $20 gift card on their quit date and additional $5 each week for the following 12 weeks after the quit date, were much more likely to stay smoke-free than those who didn’t have a financial incentive to do so. In this 2014 study, about half were smoke-free a month after their quit date, and a third remained smoke-free 2 months after they stopped receiving any financial incentive.

A 2015 study found that adding a financial disincentive further improved quit rates. More people stayed smoke-free for 6 months if they received US$800 than if they had counselling or nicotine-replacement therapy (gum, medication, patches). But even more people stayed smoke-free if they not only received US$650 but also had to forfeit a US$150 deposit for not staying smoke-free 6 months after the quit date. So here’s a way for your supporters to do something concrete to up your chance of success. It’s better, of course, if your friends and family have deep pockets.

4. Consider coaching and counselling options
Getting help and support from an stop smoking specialist advisor has been shown to be one of the most effective strategies for helping smokers stay smoke-free. But not everyone wants or has time for one-to-one sessions. A 2014 study found that providing smokers with support through a virtual stop-smoking advisor via the interactive “StopAdvisor” website doubled quit rates among those from lower income groups. Unfortunately, that’s not an option here.

You can however receive support from smoking cessation programmes at the polyclinics — both the National Healthcare Group and SingHealth polyclinics offer them. Smoking cessation advisors can also help at the Department of Pharmacy at Changi General Hospital, Khoo Teck Puat Hospital, and National University Hospital, as well as at Singapore General Hospital (Department of Respiratory & Critical Care Medicine), Tan Tock Seng Hospital (Clinic 4A), and the National Skin Centre.

And everyone can get involved. Family and friends can getting involved too. Anyone can learn the basics of smoking cessation counselling — HPB provides Level 1 and Level 2 training, and continuing education Level 3 workshops.

There may also be a smoking cessation programme at your workplace: Check with your HR to find out more. And if there isn’t, consider seeking support from a professional counsellor — the Employee Assistance Programme or EAP at your workplace may be a good place to start.

5. Watch out for your cravings
A 2015 study found that brain areas associated with smoking cravings were much less activated for women during the ovulation period than a later part of the menstrual cycle. Even if you’re not planning to time your exit from nicotine, you could be mentally more prepared to do battle with your cravings before you get to that time of the month.

You can have all resources about how to best quit, but it’s the emotional support that’s most crucial to staying smoke-free. Just remember, there’s no one-size-fits-all solution to quitting. Have a happy smoke-free No Tobacco Day!

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