This pandemic could help England meet its smoke-free goal

The pandemic has made many people reassess their lifestyles and successful quitting attempts have been increasing. In Greater Manchester, the number has been higher than in England.

One of the few positive outcomes of the COVID-19 pandemic has been an increase in the amount of people who quit smoking. 

Between 2019 and January 2021, the number of people who said they tried to quit smoking in the past year increased 11,6%, according to the Smoking Toolkit Study. 

Furthermore, the success rate in those who tried to quit increased from 14,2% in 2019 to 29,6% in January 2021. 

Since the start of the pandemic, the NHS has warned of the relatively higher health risk faced by smokers. 

Smoking harms the immune system which leads to an increased likelihood of contracting respiratory infections, infections lasting longer and infections being more serious for smokers than non-smokers. 

Evidence from Wuhan, China cited by Public Health England shows that smokers with COVID-19 are 14 times more likely to develop severe respiratory disease.

But increased concerns over health is not the only reason people have been more successful in their attempts to stop smoking.

According to Hazel Cheeseman, Director of Policy at Action on Smoking and Health, financial hardships brought on by the pandemic and changes to people’s daily routines have also contributed to this trend.  

The national lockdown last year meant that people were no longer having a cigarette during their walk to the bus stop or train station in the morning, while taking a break with their colleagues at work or at the pub. 

“When those places and environments that trigger smoking are taken away, it is easier to stop smoking,” says Hazel.  

Before the pandemic, smoking prevalence had been reducing further and faster in Greater Manchester than in England, particularly in more deprived smoker populations. 

Quit attempts during the 12 months before the pandemic were 10% higher in Greater Manchester than in England. 

There is indication that there has been even more quitting activity in Greater Manchester during the pandemic than in the previous years and this rate has been slightly higher than England. 

The reduction is due to a successful campaign led by a partnership between Greater Manchester Combined Authority and the NHS.

Greater Manchester Health and Social Care Partnership started the “A Tobacco Free Manchester” campaign in 2017 in an effort to make Greater Manchester “smoke-free” by the end of 2027. 

This is a more ambitious goal than the Government’s, which plans to make England smoke-free by 2030.

“Our ambition is to make smoking history in Greater Manchester,” says Andrea Crossfield, Population Health Policy and Strategy Specialist at GMHSCP.

The campaign in Greater Manchester is aiming to reduce smoking prevalence by a third by the end of 2021 so whether people can maintain abstinence will prove crucial.

The partnership also had a special campaign during the pandemic which ran across a range of different media channels and evaluation showed that nearly 1 in 10 smokers who engaged with this campaign made a successful quit attempt. 

Hazel suggests that the most effective way to quit is a combination of e-cigarette use and behavioural support such as counselling.

Lisa Fildes, 49, from Wigan had been smoking for 30 years but quit last July after a chest infection lasting four months left her almost hospitalised. 

Because Lisa was homeschooling her children due to the pandemic, she could not leave them and stay at the hospital so she contacted her doctor who set her up with a smoking cessation advisor. 

“I didn’t have time to be ill so I just decided that that was it; I’m going to give up for good.” 

She first started using a nicotine patch, then a nicotine gum and then the inhalator.

A friend of hers advised her to use a vape and that was what eventually worked for her. 

“I use the vape now but I don’t have any nicotine in there at all so it’s purely just the liquid on it’s own,” said Lisa. 

Public Health England’s independent report shows that using nicotine vaping products as part of quit attempts increases the likelihood of success. 

Vaping also seems to be significantly more effective than nicotine replacement therapy. 

GMHSCP suggests using e-cigarettes as an alternative for those unable or unwilling to quit their nicotine habit immediately.

According to the report by PHE, vaping has plateaued since March 2020 which suggests that more people were able to quit without its help during this pandemic.

However, according to Hazel, false public perception about the harms of e-cigarettes undermines people’s efforts to successfully quit smoking.

Lisa had heard what she calls “horror stories” about vaping before she started but thought the risks couldn’t be as bad as cigarettes.

PHE’s data shows that 38% of smokers in 2020 believed that vaping was as harmful as smoking and 15% believed that vaping was more harmful. 

While vaping is not without its risk and PHE advices against non-smokers taking up vaping, it is still far less harmful than smoking. 

Moving forward it seems like vaping will play an important role in maintaining people’s abstinence as well as getting more people to quit smoking; especially when restrictions are lifted and we are no longer faced with a public health emergency.

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