Page 46 - Retail Pharmacy Assistants September 2020

44 SMOKING CESSATION
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Michael Blaha, says many users take in more nicotine from an e-cigarette than they would from a tobacco product.
“You can buy extra-strength cartridges, which have a higher concentration
of nicotine, or you can increase the e-cigarette’s voltage to get a greater hit of the substance,” he said.
“With e-cigarettes, you’re exposing yourself to all kinds of chemicals we don’t yet understand and that are probably not safe.”
Seeds trigger success
Dissonant smokers have a conflict between a belief and behaviour: aware that ‘smoking could kill me’ (belief),
but they smoke anyway (behaviour). Before vaping, the only way for a smoker to reduce that conflict was to quit, or justify smoking with an internal narrative such as ‘it helps me control my weight’.
While dissonant smokers sometimes want to quit, they stagger on that
decision. In Australia, 70 per cent of surveyed smokers said they were either ready to quit or considered quitting at least once during 2019. So, what makes them think about quitting?
Results from the 2019 Australian household survey show concern about illness, future health, fitness and physical appearance, image and cost, as well as the suffering or death of a loved one and a request from a partner are among factors that can trigger quit attempts.
However, studies from several countries also show receiving advice to quit from
a health professional is among the key factors that can predict quit attempts.
Put another way, healthcare professionals can plant the seeds that a quit trigger could later bring to life.
Given that most of the quit triggers are recurring and unpredictable, healthcare professionals need to have the conversations that plant those seeds at every opportunity, asking patients about smoking, reinforcing the importance of quitting and offering appropriate support.
Quit Victoria Senior Clinical Advisor Emma Dean says of all the external triggers for quitting, having a health professional bring up smoking is “the big one”.
“When a pharmacist or other clinician talks to someone about their smoking, it’s more effective than warnings on cigarette packs or nicotine replacement therapy [NRT] ads,” she said.
“But the conversation can’t just be a box-ticking exercise. We need to think about the response we want. The health professional doesn’t have to take on everything to do with that patient’s smoking. They just have to plant that seed, offer support, then link the patient into wherever that support might be.”
When having these discussions, the patient’s smoking history, including vaping, should be explored. Where
an interest in vaping exists, helping a patient understand the risks of vaping compared with the effectiveness of approved quit tools may help to secure a better health outcome and limit the
RETAIL PHARMACY ASSISTANTS • SEP 2020