Don't give up giving up smoking: An expert's guide to quitting

Why is it so hard to quit smoking? Professor Robert West, world expert on nicotine and addiction, has spent a lifetime finding out. Here’s his advice for die-hard smokers

Having started smoking as a teenager, Professor Robert West managed to kick the habit while at university, on a girlfriend’s urging. He has gone on to devote his 30-year career to discovering what works when it comes to giving up smoking. Heading a team of researchers at University College London, where he is Professor of Health Psychology and Director of Tobacco Studies at Cancer Research UK’s Health Behaviour Research Centre, he has one aim: to find better ways of helping smokers who want to stop.

“There is a lot of stuff out there: Allen Carr, Paul McKenna, numerous websites,” says West. “But what smokers don’t have is the real story of the best ways of stopping, from the billions of pounds worth of research that has actually been done.”

Instead of suggesting just one sure-fire way to quit, West discusses the many things that can help someone forgo the fags: electronic cigarettes, nicotine replacement therapy, professional support, and so on. With other positions West currently holds, including  co-director of the NHS Centre for Smoking Cessation and a board member of QUIT, he is one of the leading experts in the field.

In his new book The SmokeFree Formula: A Revolutionary Way to Stop Smoking Now each factor that could contribute to someone  stopping is viewed as an “ingredient”. West advises how to combine these ingredients into a personalised “formula”. His motto is “I  guide – you decide”. Here, West explains a  few of his many findings.

Nicotine doesn’t work like you think it does

The way people think about addiction is that you need to take a drug to stay normal and to stave off withdrawal symptoms, nicotine addiction isn’t that simple. You smoke because the nicotine you have been inhaling for all those years has changed your brain chemistry to create powerful urges to smoke. The urges come about because every puff on a cigarette sends a rapid nicotine hit to the part of your brain that makes you do things, creating an association between the drug and the action.

These urges are triggered because nicotine has trained the part of your brain that gets you to do things to light up a cigarette whenever you find yourself in a situation where you would normally smoke, be it with drinking alcohol, at a bus stop, after a meal.

Crucially, this helps to answer a conundrum that a lot of smokers have: why do smokers who don’t smoke every day often find it really hard to stop? And the reason is because they encounter situations in which they normally smoke. The nicotine in the cigarette has forged that link, so that they then get this unaccountable urge to smoke. People think it must be psychological because it doesn’t fit their model of how drugs should work, but actually it isn’t – it’s down to the way nicotine acts on the brain.

You don’t have to enjoy smoking to find it difficult to give it up; it can do absolutely nothing for you. 50 per cent of smokers say they don’t get any enjoyment from smoking and the chances of success when they stop bear no relation whatsoever to how much they enjoy it.

Nicotine attacks the animal part of the brain that you don’t need to have any conscious awareness of; all your brain knows is that you’re in a situation in which you normally smoke, so light up a cigarette. The job of the conscious part of the brain is to find a way of countering that.

London Mayor Boris Johnson joined the campaign to ban smoking in cars carrying children London Mayor Boris Johnson joined the campaign to ban smoking in cars carrying children Give up by your mid-thirties

For every day you carry on smoking after your mid-thirties, you will lose an average of six hours of life. Smokers are basically living an 18-hour day until they stop. The moment you stop then you start to recover life expectancy at a rate of six hours a day. That means it’s always urgent, but it’s never too late. It doesn’t matter how young or old you are, you’ll always benefit from stopping today rather than tomorrow, or tomorrow rather than the day after.

However, this is not a licence to smoke until your mid-thirties. Your chances of stopping at any one quick attempt are not that high. If you start trying to quit in your thirties, on average you’re going to be in your forties before you succeed. It’s a good idea to try to start in your twenties so that by the time you get to your thirties, you’ve stopped. And, of course, there are other effects that don’t kill you but are not nice, such as effects on your respiratory system, and your appearance.

Harm reduction is effective

Reducing the amount you smoke has a very small benefit. However, the reason why we’ve all suddenly got very excited about harm reduction (essentially, reducing the amount you smoke) is that evidence shows that when people cut down, without necessarily wanting to stop, we find that more of them will have stopped a year on. If they do it with a nicotine product, they’re even more likely to stop.

What I would recommend to any smoker is if you’re not ready to stop, then it is worthwhile trying to reduce the amount you smoke. If you’re going to do it, use a nicotine product as well to help you. The more nicotine you get from something that isn’t a cigarette, the weaker the association between smoking  and the nicotine hit becomes.

Smoking in cars with children present will be made illegal before 2015 elections  

It’s best to stop abruptly

About 30 to 40 per cent of smokers try to stop gradually and you can see why because it fits our ideas of how addiction works. What we find is you’re about half as likely to succeed in the long run if you stop gradually rather than abruptly. So why is it better to stop suddenly? We must return to the way nicotine works. It’s not about keeping the levels topped up in your body, so much as the link that’s formed between smoking and the situation in which you find yourself smoking.

When you try to stop gradually, what happens is that each remaining cigarette becomes more rewarding and it creates a stronger link with the situation you smoke it in. What we find is that, actually, fewer people who try to stop gradually ever get to the point where they can cut it out altogether. Whereas if you tell smokers they can puff away until their quit date, it creates this very clear break in your life between your smoking past and your non-smoking future. It’s not a guarantee of success, but it does make a big difference.

Chewing glucose tablets helps

In one of the first studies on nicotine gum back in the Eighties, smokers would tell me that the craving for cigarettes felt like a hunger in the pit of their stomach. I wondered if they were mislabelling hunger as craving. Therefore anything you can do to take the edge off that hunger ought then to reduce the craving. In our study we got people in the smoker’s clinic to chew either glucose tablets or a low-calorie sweet. I wasn’t going to bother analysing the results as it seemed such a crazy idea. But, lo and behold, glucose does reduce cravings for cigarettes. We then investigated whether it translated into helping people actually stop smoking. We did a larger trial looking for long-term effects and we found that it was only in the smokers who were also taking nicotine gum or similar. But it’s a booster in the long term. Given they are very cheap, I’d give them a go.

Just breathe

We wanted to find a way of helping people in the slum areas of India to stop smoking that didn’t cost anything. In India, they’re keen on yoga and part of yoga is pranayama, or breathing control. There has been some research done in the States looking at a particular part of the brain called the insular and it might be linked to cigarette craving (they found that people who had suffered a stroke that had damaged the insular tended to crave cigarettes less).

The insular is important in controlling breathing, so we did a study in which we asked half the people to do very simple breathing exercises while they were abstaining from a cigarette, while the others just watched a video about the exercises as a sort of control. What we found was that the people who did the exercises craved less for their cigarette.

Try an electronic cigarette

We’re studying these quite intensively in my research group, trying to come to a view as to whether they’re helpful or just a fad. There’s every reason to believe that those e-cigarettes that give decent amounts of nicotine (maybe half that you get from a regular cigarette) can help. There are debates over their safety. But a study that has just been published shows that they have very low levels of any kind of toxin.

They’re more than 100 times safer than smoking a tobacco cigarette. If I was a smoker and tried everything then I would definitely give them a go. However, smokers might well find the first one they try doesn’t suit them; they’re hugely variable. Shop around and find one with a profile that suits you. Treat it like buying a mobile phone.

The SmokeFree Formula: A Revolutionary Way to Stop Smoking Now by Professor Robert West. £9.99; Orion Books

Voices
A Russian hunter at the Medved bear-hunting lodge in Siberia
Save the tigerWildlife charities turn to those who kill animals to help save them
News
Davis says: 'My career has been about filling a niche - there were fewer short actors and fewer roles – but now I'm being offered all kinds of things'
PeopleWarwick Davis on Ricky Gervais, Harry Potter and his perfect role
News
i100
Sport
Frank Lampard will pass Billy Wright and equal Bobby Charton’s caps tally of 106 caps against
sportFormer Chelsea midfielder in Etihad stopgap before New York contract
PROMOTED VIDEO
Life and Style
ebookA wonderful selection of salads, starters and mains featuring venison, grouse and other game
Life and Style
ebookAn evocation of the conflict through the eyes of those who lived through it
Arts and Entertainment
The first film introduced Daniel Radcliffe to our screens, pictured here as he prepares to board the train to Hogwarts for the first time.
booksHow reading Harry Potter helps children grow up to be gay-friendly
Arts and Entertainment
A scene from Aladdin is performed at the Tony Awards in New York in June
theatreBrit producer Lythgoe makes kids' musical comedy a Los Angeles hit
Sport
Usain Bolt of Jamaica smiles and shakes hands with a competitor after Jamaica won their first heat in the men's 4x100m relay
sport
News
Chancellor George Osborne, along with the Prime Minister, have been 'complacently claiming the economy is now fixed', according to shadow Chancellor Ed Balls
i100... which is awkward, because he is their boss, after all
Life and Style
A small bag of the drug Ecstasy
Health
Life and Style
Floral-print swim shorts, £26, by Topman, topman.com; sunglasses, £215, by Paul Smith, mpaulsmith.co.uk
FashionBag yourself the perfect pair
News
news
News
Netherlands' goalkeeper Tim Krul fails to make a save from Costa Rica's midfielder Celso Borges during a penalty shoot-out in the quarter-final between Netherlands and Costa Rica during the 2014 FIFA World Cup
newsGoalkeepers suffer from 'gambler’s fallacy' during shoot-outs
News
people
Arts and Entertainment
Standing the test of time: Michael J Fox and Christopher Lloyd in 'Back to the Future'
filmReview: A week late, Secret Cinema arrives as interactive screening goes Back to the Future
Extras
indybest
News
i100
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    (Senior) IT Support Engineer - 1st-3rd Line Support

    £40000 per annum: Ashdown Group: A successful IT service provider that has bee...

    Wind Farm Civil Design Engineer

    £55000 - £65000 Per Annum: The Green Recruitment Company: The Green Recruitmen...

    Principal Marine Mechanical Engineer

    £60000 - £70000 Per Annum: The Green Recruitment Company: The Green Recruitmen...

    Principle Geotechnical Engineer

    £55000 - £65000 Per Annum: The Green Recruitment Company: The Green Recruitmen...

    Day In a Page

    Save the Tiger: Meet the hunters tasked with protecting Russia's rare Amur tiger

    Hunters protect Russia's rare Amur tiger

    In an unusual move, wildlife charities have enlisted those who kill animals to help save them. Oliver Poole travels to Siberia to investigate
    Transfers: How has your club fared in summer sales?

    How has your club fared in summer sales?

    Who have bagged the bargain buys and who have landed the giant turkeys
    Warwick Davis: The British actor on Ricky Gervais, how the Harry Potter set became his office, and why he'd like to play a spy

    'I'm a realist; I know how hard this business is'

    Warwick Davis on Ricky Gervais, Harry Potter and his perfect role
    The best swim shorts for men: Bag yourself the perfect pair and make a splash this summer

    The best swim shorts for men

    Bag yourself the perfect pair and make a splash this summer
    Has Ukip’s Glastonbury branch really been possessed by the devil?

    Has Ukip’s Glastonbury branch really been possessed by the devil?

    Meet the couple blamed for bringing Lucifer into local politics
    Dress the Gaza situation up all you like, but the truth hurts

    Robert Fisk on Gaza conflict

    Dress the situation up all you like, but the truth hurts
    Save the tiger: Tiger, tiger burning less brightly as numbers plummet

    Tiger, tiger burning less brightly

    When William Blake wrote his famous poem there were probably more than 100,000 tigers in the wild. These days they probably number around 3,200
    5 News's Andy Bell retraces his grandfather's steps on the First World War battlefields

    In grandfather's footsteps

    5 News's political editor Andy Bell only knows his grandfather from the compelling diary he kept during WWI. But when he returned to the killing fields where Edwin Vaughan suffered so much, his ancestor came to life
    Lifestyle guru Martha Stewart reveals she has flying robot ... to take photos of her farm

    Martha Stewart has flying robot

    The lifestyle guru used the drone to get a bird's eye view her 153-acre farm in Bedford, New York
    Former Labour minister Meg Hillier has demanded 'pootling lanes' for women cyclists

    Do women cyclists need 'pootling lanes'?

    Simon Usborne (who's more of a hurtler) explains why winning the space race is key to happy riding
    A tale of two presidents: George W Bush downs his paintbrush to pen father’s life story

    A tale of two presidents

    George W Bush downs his paintbrush to pen father’s life story
    Restaurateur Mitch Tonks has given the Great Western Pullman dining car a makeover

    The dining car makes a comeback

    Restaurateur Mitch Tonks has given the Great Western Pullman dining car a makeover
    Gallery rage: How are institutions tackling the discomfort of overcrowding this summer?

    Gallery rage

    How are institutions tackling the discomfort of overcrowding this summer?
    Louis van Gaal has £500,000 video surveillance system installed to monitor Manchester United players

    Eye on the prize

    Louis van Gaal has £500,000 video surveillance system installed to monitor Manchester United players
    Women's rugby: Tamara Taylor adds fuel to the ire in quest to land World Cup

    Women's rugby

    Tamara Taylor adds fuel to the ire in quest to land World Cup