Rethink needed for smoking cessation services

Caroline White

Wednesday, 10 September 2008

Smoking cessation services for young people need a radical rethink and appeal more to their target group, claims an editorial published on bmj.com today.

Current efforts to help young people stop smoking just don’t work that well, write Gill Grimshaw from the University of Warwick and Alan Stanton from the Solihull Care Trust.

And the evidence on how well smoking cessation programmes help young people quit before smoking becomes addictive and habitual is poor.

In the UK around one in 10 teenagers is a regular smoker, rising to more than one in three in some parts of the world.

Smokers who start young are more likely to smoke for a long time and to die prematurely from smoking related disease, the evidence shows.

But studies show that young smokers repeatedly try to give up and around 70% say they want to give up shortly after taking up the habit. But young people don’t find services very appealing.

The authors point to a review of several Scottish NSH smoking cessation programmes which found that few young people wanted to take part in them. After a year, only 11 young people (2.4%) from all seven projects had managed to quit long term, which is probably what would be expected when smokers try and give up by themselves.

Part of the problem is one of image, say the authors, and young people don’t see themselves as lifelong smokers or quitting as an urgent priority, while smoking cessation services are often viewed as being for older more addicted smokers.

It is well known that smokers tend not to reuse strategies that have failed in the past, say the authors, who suggest that it may be better to save strategies such as nicotine replacement therapy for when success is more likely.

“Smokers are extremely unlikely to quit using cigarettes while continuing to smoke cannabis mixed with tobacco, and for some people this may be an insurmountable barrier to quitting,” caution the authors.

They conclude that although it is not known exactly what works, young people still need support when making attempts to quit, with privacy, confidentiality, and a non-judgemental approach are all important factors.