1 in every 2 smokers?
Smoking is the single biggest cause of ill-health and death in our society. Ireland’s 1 million smokers, their families and friends, and our health services all pay a huge price as a result of smoking. Worldwide, it is estimated that 5.5 million people die every year from tobacco related diseases.
QUIT is a HSE health education campaign aimed at encouraging smokers to quit. We want to reduce the numbers of smokers in Ireland and reduce the level of illness and deaths caused by tobacco use. The campaign is based on a fact that is not well known among the public. That fact is that 1 in every 2 smokers will die of a tobacco related disease.
How do we know it’s 1 in every 2 smokers?
The evidence comes from a study which is often called “The Doctors Study” (Doll R, Peto R, Wheatley K, Gray R, Sutherland I. Mortality in relation to smoking: 40 years observations on male British doctors. British Medical Journal 1994; 309:901-911).
This study started in 1951 in the UK, had a 40 year follow-up, and was finally published in 1994. It found that we had substantially underestimated the hazards of long term tobacco use. It showed that half of all regular cigarette smokers will eventually be killed by their habit.
A further study 10 years later on the same study participants confirmed the findings. In fact, it suggested that the situation might be worse, in that up to two thirds of smokers could be killed by their smoking (Doll R, Peto Boreham J, Sutherland I. Mortality in relation to smoking: 50 years observations on male British doctors. British Medical Journal 2004; 328(7455):1519).
What are tobacco related diseases and how do we know?
Most smokers will lose between 10 to 15 quality life years before they die. Smoking is the single biggest cause of cancer and chronic chest diseases and is a significant cause of cardiovascular disease and exacerbation of diabetes. This major cause of illness, chronic disability and death, is preventable, yet accounts for some 5,500 deaths in Ireland each year.
Over the years there have been many epidemiological studies carried out to ascertain what diseases tobacco consumption causes. These studies have been reviewed by the World Health Organisation and the Surgeon General in the United States amongst others (WHO Report on the Global Tobacco Epidemic, 2008. The MPOWER package).
They agree that the evidence is overwhelming that tobacco consumption causes a range of diseases, most circulatory, chest and cancers, but other diseases are also caused by smoking.
These are listed below:
- Heart attacks
- Aortic aneurysms
- Peripheral vascular disease
- Chronic Obstructive pulmonary disease
- Cancer of the Larynx
- Cancer of the Oropharynx
- Cancer of the Oesophagus
- Cancer of the Trachea
- Cancer of the Lung
- Cancer of the Stomach
- Cancer of the Pancreas
- Cancer of the Kidney
- Cancer of the Ureter
- Cancer of the Cervix
- Cancer of the Bladder
- Acute myeloid leukaemia
- Stomach ulcers
- Hip fractures
- Reduced fertility
Why don’t smokers just quit if it is so dangerous?
Our research tells us that most smokers – 8 out of 10 - want to quit, and that 4 out of every 10 smokers try to quit each year. Unfortunately, for some people, their addiction to nicotine can be very difficult to overcome. However, it is not impossible.
Of those who have quit- just over a third (35%) quit on their first attempt- and overall half of them succeeded after their second attempt. The trick is to keep trying. Whilst most smokers want to be smoke free, many are wary of the chances of success and so avoid trying again.
Campaigns that remind smokers why to quit, and then help show them how to quit, can help to spur smokers towards a new or renewed quit attempt.
What help is there for people who want to quit?
We offer phone support to quitters via the National Smoker’s Quitline, which we run in conjunction with the Irish Cancer Society. We have this dedicated website, and a Facebook page at www.facebook.com/HSEquit , which offers information and advice to take smokers through the first important weeks and months. Smoking Cessation services are provided by the HSE in locations nationwide, in hospitals and in primary care, and these offer personal or group support courses for quitters. GPs and pharmacists and other healthcare professionals also play a key role in helping smokers to quit.
Do tobacco related diseases cost much to our health services?
Data from other countries and the WHO says that in developed countries, between 5-15% of the total health budget is spent on treating tobacco related disease – in Ireland, this amounts to between 1 and 2 billion euro every year. Recent Irish data shows an average cost of €7,700 every time a smoker is admitted to hospital with a tobacco related disease. In 2008, there were over 36,000 such admissions. That cost does not include out-patient costs, GP visits, medicines and other supports provided by the HSE.
The QUIT campaign is costing €840,000 in 2011 and is a major preventative health education priority for the HSE. If we can prevent just 100 of the 36,000 annual admissions to hospital with tobacco related disease, the campaign will pay for itself.
Do these campaigns work, are they evidence based?
Yes. There has been a lot of research done in this area. A recent review published in 2008 found that tobacco control programmes that include a mass media campaign can help to reduce levels of smoking among adults (Bala M, Strzeszynski L, Cahill K. Mass media interventions for smoking cessation in adults. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD004704. DOI: 10.1002/14651858.CD004704.pub2).
A further report, published by the National Cancer Institute in the US in 2008, which looked at the role of the media in promoting and reducing tobacco use, also found evidence of the effectiveness of such campaigns, however, they advised that the need to be properly developed and funded if they are to have an impact (National Cancer Institute, The Role of the Media in Promoting and Reducing Tobacco Use. Monograph 19, Bethesda MD US DHSS, NCI, 2008).
The World Health Organisation and the US Centers for Disease Control (WHO Report on the Global Tobacco Epidemic, 2008. The MPOWER package) recommend that governments spend US $2-4 per person per year on anti-tobacco health communication and counter advertising efforts. This would mean that in Ireland we might aim to spend between €6million and €12 million annually on such campaigns.
Who else is involved in this campaign?
Our partners in the QUIT campaign include the Irish Cancer Society, Irish Heart Foundation, Irish College of General Practitioners, Pharmaceutical Society of Ireland, Irish Dental Association, ASH Ireland, Asthma Society of Ireland, TobaccoFree Research Institute, Environmental Health Officers Associtation, National Youth Council of Ireland, Irish Thoracic Society, Royal College of Physicians in Ireland and Royal College of Surgeons in Ireland, Irish Pharmacy Union , Heads of Psychology Services Ireland, Psychological Society of Ireland, Alpha One Foundation Ireland.
How can all of us help people to stop smoking – maybe our loved ones?
Smokers know that cigarettes are bad for them and remember that about 80% of smokers want to quit. Many of them feel that quitting is too hard, that they won’t succeed, that they will do it tomorrow, next month, when they’re 30, or when they’re 40. We can remind smokers that it’s never too late, that most people have to try a few times before they succeed, and that quitting is worth it.
We are saying to all smokers in Ireland: 1 in 2 smokers will die of a tobacco related disease, but it doesn’t have to be that way for you.
You can QUIT. We can HELP.