healthscotland.com

Encouraging smokers to stop: what you can do

The health risks

When you ask smokers Are you aware of the damage smoking can do to your health? most will know the answer expected of them‚ but probably don’t know how great the risk is.

However‚ you are not going to persuade them of the risks in a few minutes‚ especially if they are sceptical.

So your goal is not to persuade them that smoking is dangerous‚ but to offer information‚ in case they are receptive.

Keep this discussion short and base it on a leaflet that they can keep. Use the information below selectively and appropriately — for the setting‚ and the smoker. It is for all smokers: adapt it as necessary‚ especially for young people‚ who may be less worried about long-term health risks and more worried about short-term effects‚ like bad breath or discoloured teeth.

The two key messages to offer are that smoking is dangerous but that it is worth stopping . The risk of getting serious disease‚ like cancer or heart disease‚ starts falling as soon as smokers stop.

Both are important. Many smokers know smoking is bad for them but don’t try to stop because they believe they will fail. One of the most important things you can do for them in this consultation is to tell them that they can get effective help to stop.

Some facts that may have impact

Smoking causes lung cancer‚ chronic bronchitis and emphysema‚ and coronary heart disease. About 80% to 90% of lung cancers and bronchitis and emphysema are caused by smoking‚ and about 20% to 25% of heart disease.

The average smoker will lose about 10 years of life because of their smoking ⁽⁵⁾. For some this will be the difference between seeing their grandchildren growing up or not.

Approximately 13‚000 people die from their smoking each year in Scotland — that’s 250 every week.

At a more local level‚ in a street with 150 adults‚ of which about 45 smoke‚ about 20 will be killed by their smoking.

An excellent source on the health risks is the Royal College of Physicians report Nicotine Addiction in Britain ⁽⁶⁾.

Smoking and oral health

Smoking is associated with calculus‚ halitosis‚ leukoedema‚ premature tooth loss‚ staining and abrasion‚ periodontal disease‚ acute necrotising ulcerative gingivitis‚ and several potentially malignant oral lesions.

Smoking and pregnancy

Cigarette smoking is the largest single modifiable risk factor for pregnancy-related morbidity and mortality ⁽⁷⁾ and is a major cause of health inequalities.

Women who smoke during pregnancy:

• have a 27% higher chance of a miscarriage
• increase by 33% the risk of perinatal mortality
• are twice as likely to experience premature labour
• are three times more likely to have a low birthweight baby (on average 200gms or around 7oz lighter on average)
• are more likely to have children who suffer breathlessness and wheezing in the first six months of their life.

It is now accepted that stopping at any stage during pregnancy is beneficial.

Second-hand smoke

Exposure to second-hand smoke (sometimes called passive smoking) is associated with:

• acute respiratory illness in early childhood
• chronic cough‚ phlegm‚ and wheeze in children
• chronic middle ear effusions in children
• reduced levels and growth of lung function in children
• increased risk of sudden infant death syndrome (SIDS)
• increased bronchial hyper-responsiveness in asthmatics
• increased lung symptoms in asthmatics
• decreased lung function in asthmatics
• irritation to the eyes‚ nose‚ throat
• increased risk of lung cancer and heart disease with long-term exposure.

Also‚ there is now evidence that even short-term exposure to second-hand smoke causes an acute physiological response that can induce heart attacks in some people ⁽⁸⁾.