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How to support your customers
The “Cycle of Change”
During smoking cessation your customer will go through different stages of desires. The Cycle of Change has been designed so you can better identify which stage your customer is currently in, so you can motivate them to keep going without pushing them around too quickly.
Of all the smokers it is estimated that 80% have tried quitting smoking. Although research has shown that people are more likely to succeed in smoking cessation if they receive support from health professionals, only 1 in 7 smokers tried quitting with the help of a treatment.1
Importance of supporting your customer in stopping smoking1
The importance of support in successful quit attempts
Though many smokers wish to quit, the rate of successful quit attempts is low if smokers try to stop smoking without support or drug treatment.2,3 65% of those trying to stop using willpower alone will relapse in the first week.4 Most of the smokers relapse in the afternoon or evening.5,6
A higher smoking quit rate may be achieved by supporting your customer with brief advice and smoking cessation medication.7 Compared to no treatment, nicotine replacement therapy (NRT) doubles the smoking cessation success rates8 and rises to an almost 6-fold higher success rate when combined with intensive behavioural support.3,4,9
Successful quit rate3,4,9
Adapted from Hilton et al. 20033
Ways of stopping smoking
Stopping abruptly
All of the OTC treatments can be recommended for customers who feel able to stop smoking abruptly. That is to say they feel able to make an attempt to stop smoking and not smoke any cigarettes. The best option should always be to encourage people to stop smoking abruptly in conjunction with a stop smoking product.
Using combination therapy
Importantly, some smokers may not be able to stop smoking using one format of NICORETTE®. As another option, combination therapy has been recognised as an effective treatment option. Recent NICE guidance says:
For example, NICORETTE® INVISIPATCH™ combined with NICORETTE® QuickMist can be used as a first-line choice when considering combination therapy. Furthermore, there are no specific safety concerns with use of NRT in combination therapy.12 This is supported by the understanding that smokers are able to titrate their nicotine levels and therefore the risk of overdose with NRT is minimal. When considering combination therapy, Nicorette® can be prescribed as a first-line choice
In terms of knowing which formats to recommend for combination therapy, you can suggest a ‘background cover’ using a patch to provide a substantial level of craving control with the additional support from a flexible format such as gum, inhalator or NICORETTE® QuickMist to provide immediate relief from breakthrough cravings.
The safer option to smoking
Some smokers are unable or not interested in stopping smoking but there are times where they are unable or unwilling to smoke.
79% of smokers are not planning to quit abruptly
Adapted from West and Fidler, October 201013
NICORETTE® QuickMist is indicated as a safer option to smoking for those unable or unwilling to quit.
By replacing some cigarettes with NICORETTE® QuickMist you’ll be providing your customers a safer option when they aren’t yet ready to break free from cigarettes.
Tailoring treatment for smokers who have different needs
The type of nicotine replacement therapy to best suit your customers needs depends on his smoking habits. To find the NICORETTE® treatment that best supports your customers attempt to quit, certain questions may be helpful:
- How many cigarettes does the customer smoke?
- Is the customer willing to change their smoking habits but not really willing to quit?
- Is the customer concerned about situational cravings?
- Does the customer enjoy the physical act of smoking?
Depending on the answers you may identify the appropriate treatment from the NICORETTE® Treatment Pathway.
Supporting your customer in his attempt to quit smoking
As the health professional you play an important role in giving your customer the right advice and instructions. Customers may find these topics helpful:
- Let your customer know what possible withdrawal symptoms to expect when quitting smoking
- Explain to your customer that nicotine replacement therapies have the most comprehensive body of evidence supporting their use in smoking cessation
- Help your customer understand why and how a nicotine replacement therapy can help them to quit smoking and emphasise the need for adequate nicotine substitution
- Explain to your customer the more common adverse events that might happen during oral NRTs, for example nausea
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Give your customer a list of advice on how they can prepare for stopping smoking
- Set a quit date and stick to it
- Throw away all smoking accessories (ashtray, matches, cigarettes) the night before
- Prepare a list of reasons why you want to quit
- Identify friends, family, colleagues who can provide support after you stop smoking
- Plan ahead & be prepared for the tempting times to light- up
- Change routines or avoid situations where you always smoke for a short while (the first few weeks) until you are over the worst period for withdrawal symptoms
Useful websites to help smoking cessation can be found here
- 1.
- Lader D. Meltzer H Smoking related behaviour and attitudes 2002.London Office of National Statistics.
- 2.
- Boyle P, et al. Eur J Pub Health 2000; 10(suppl 3): 5-14.
- 3.
- Hilton A. Prescriber 2003; 14(3): 14-20.
- 4.
- Fowler G, et al. Update Supplement; May 2000.
- 5.
- Fagerstrom KO, et al. Medical. Curr Pulmonol. 1995; 16:223-238.
- 6.
- Ussher M, et al. Hum Psychopharmacol Clin Exp.2003; 18:345-349.
- 7.
- US Department of Health and Human Services. Clinical Practice Guideline. Treating tobacco use and dependence: 2008 Update. Public Health Service, May 2008.
- 8.
- Silagy c, et al. Cochrane Review, Issue 3, CD000146.
- 9.
- West R, et al. Thorax 2000; 55: 987-999.
- 10.
- National Institute for Clinical Excellence. NICE public health guidance 10. February 2008.
- 11.
- Kornitzer M, et al. Prev Med 1995; 24:41– 47.
- 12.
- NICORETTE® QuickMist. UK Summary of Product Characteristics.
- 13.
- West R., Fidler J. Key findings from the Smoking Toolkit Study. Slide Presentation. 21 October 2010.