WHO (2009) reported that tobacco use is considered the leading cause of preventable death worldwide. Most smokers know that smoking is harmful to their health in terms of causing or making worse conditions such as lung cancer, pulmonary diseases, coronary heart diseases, strokes, blindness, wrinkles and skin conditions, mental health problems, and yet they still do it. Having said that , most smokers do want to give up and have tried to quit this addictive behaviour as they are aware of the notion of ‘escalator of death’: smokers need to get off as young as possible as the risks never go down in absolute terms. However, self-help in terms of attempting to quit smoking on your own has thus far been rather ineffective, due to the lack of person-to-person intervention.
Therefore, in this essay we will focus on and discuss the effectiveness of the following intervention methods: nicotine replacement therapy (NRT), use of medication, government measures and policies (point of sale ban, plain packaging, advertising restrictions, anti-smoking campaigns) and cognitive behavioural therapy (CBT) in helping people stop smoking, hopefully for the long-term.
Methods: Nicotine Replacement Therapy (NRT)
NRT is used to get nicotine into bloodstream of smokers who want to quit without them actually smoking. This can be in the form of nicotine gum or patches. This method has thus far been quite effective, as Stead et al (2008) found that all forms of NRT made it more likely that their attempt to quit would succeed. Indeed, chances of stopping smoking increased by 50-70%, and also demonstrate a clear advantage of combination vs single product NRT use.
Methods: Medication in the form of Varenicline (Champix) and Bupropion (Zyban)
Since smoking is a physiological and psychological problem, medication has been used to help people stop smoking. Varenicline is used as it interferes with receptors in the brain that nicotine stimulates by mimicking the effects of nicotine, while preventing nicotine from attaching to receptors. This has been effective in increasing chances of quitting more than 2-fold compared with a placebo (Cahill et al, 2011). Meanwhile, Bupropion alters levels of some neurotransmitters, and seem to relieve withdrawal symptoms. This has been effective in significantly increasing long-term cessation (Hughers et al, 2007)
Methods: Government measures and policies
In an effort to reduce help people stop smoking, the UK government (and governments around the world may have similar policies) has introduced many tobacco control policies. For instance, the smoking ban was introduced in England in 2007, point of sale ban in large stores since April 2012, plain packaging of cigarette boxes, advertising restrictions and raising taxes on cigarettes. Use of fear appraisals in public health campaigns is a very common method, as evidenced by the mandatory health-related warning labels used in the packaging of cigarette boxes, with the purpose of increasing smoking-related risk perception and inducing feelings of fear to motivate quitting. However, these might have the unintended effects of leading to defensive responses (Glock & Kneer, 2009) or psychological reactance (Erceg-Hurn & Steed, 2011), particularly when it does not recommend a protective action or due to the reaction of smokers based on the protection motivation theory.
Albarracin et al (2005) found that perceived fear/threat may be less readily translated into behaviour change than assumed, and is usually ineffective. Indeed, these campaigns may be ineffective for smokers as their risk perception is already quite high (Hhn & Renner, 1998), and most already know the health risks of smoking. The protection motivation theory suggests that fear appeals should incorporate threat and efficacy messages emphasizing perceived susceptibility and severity, coupled with