Giving smokers a 50 per cent better chance of quitting for good 

To really improve a quitter's chances of giving up smoking, the best method is to use more than one support therapy at a time.

The evidence shows that if you use both nicotine replacement therapy and counselling together, you have a 50 per cent greater chance of quitting altogether.

It's never easy to give up cigarettes, as any smoker will acknowledge, but it does help to have access to therapies and support that are backed up by the latest medical research. That new thinking could make all the difference to those currently struggling to kick a habit that in Victoria causes 4000 deaths each year, and where the economy is dented to the tune of $2.4 billion in direct and indirect costs through tobacco-related illness and lost productivity.

It's not as if most smokers haven't tried at least once to stop, notes Emma Saleeba, Manager Alcohol and Tobacco at VicHealth. "Most people quit cold turkey which is great, but the evidence shows that if you use both nicotine replacement therapy (NRT) and counselling together, you have a 50 per cent greater chance of quitting altogether."

Researchers found a key factor in smoker recidivism is a lack of uniform and up-to-date information on the most effective use of nicotine replacement therapies.

Gathering the best evidence available


VicHealth has put its support behind Alfred Health's mission to gather the best evidence available on how to stay smoke-free successfully. Researchers reviewed the literature, consulted with national and international experts, and took input from consumers, and discovered that a key factor in smoker recidivism is a lack of consistent and up-to-date information on the most effective ways to use NRTs.

Dr Hayden McRobbie, a senior lecturer at the Auckland University of Technology and an international smoking cessation expert, says NRTs make the journey for an ex-smoker "a little easier, but accurate and realistic expectations should be set and information about how to use the medicine provided".


Outdated product information


When it comes to medicines, consumers usually faithfully follow the information they read on the packet, but that information may not be informed by the latest thinking.

Kirstan Corben, lead for population and health promotion at the Alfred, says: "More people are finding that putting one patch on isn't giving them enough coverage. It can take hours for people to feel the effects of the patch, which might deliver 30 to 40 per cent of the effect of a cigarette. It doesn't manage their withdrawal. And after a few hours, days or weeks of trying, they feel they don't work, they throw them away and resume smoking."

Many NRTs are older drugs and the information provided to the Therapeutic Goods Administration (TGA) at the time of registration may not be consistent with the most up-to-date evidence. In some cases, for example, it may be more effective to use NRTs in combinations, in higher doses or for longer durations than are currently recommended.

Under the existing system of pharmaceutical approvals, the TGA acts purely as a regulatory body. It has the power to approve or reject information provided by companies, but it does not have a remit to monitor research or to update information as new evidence emerges.

Taking the new findings on the road


In the meantime, Alfred Health is taking its newly minted research on the road to local health services, where it will provide coaching and mentoring support on best practice to help smokers kick the habit. It's a year-long, statewide initiative, with an initial focus on the Gippsland region and Melbourne, with the first forums starting in June. "We will make sure that health services have templated clinical guidelines that will help their health professionals provide the best possible support," says Corben.

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