Short Answer Questions

Chapter 5: Smoking

« Return to chapter list

1. Name three simple health messages you would give about smoking.

• The benefits to health from quitting
• The money saved from quitting
• You are four times more likely to quit if you join a cessation group than if you try to quit alone.

2. Roughly how many people are smokers in England?

In England, 22% of men and 20% of women aged 16 and over were regular smokers in 2009.

3. In which population group is smoking most common?

Smoking prevalence among adults is highest among those aged 20–24, and gradually declines with age, through quitting or dying. In England, almost a third (28%) of people aged 20–24 were smokers in 2009. The lowest level of smoking (14%) was among people aged 60 and over.
Bangladeshi men are 43% more likely (risk ratio of 1.43) and Irish men are 30% more likely (risk ratio of 1.30) to smoke cigarettes than the general male population after accounting for age.

4. What are the main risks of smoking during pregnancy?

Women who smoke, or who are exposed to second-hand smoke while pregnant, are more likely to have a baby with a low birth weight. Low birth weight is associated with higher risks of death and disease in infancy and early childhood. Smoking during pregnancy, and after pregnancy, also increases the risk of sudden infant death ("cot death").

5. Why is smoking among young people a key concern in attempts to reduce smoking prevalence?

Uptake starts in the teen years but after the age of 24 virtually no one begins smoking. Most young people will give smoking a try, but less than a third will go on to become regular smokers.

6. What are some of the features of the Tobacco Control Strategy for England (2011)?

Tobacco control is the term used to describe efforts to control the availability and access to the substance. Some of the more recent aspects include:
• The ending of tobacco displays in shops
• A ban on vending machines
• Using tax to maintain the high price of tobacco products at levels that impact on smoking prevalence
• Stopping the sale of cigarettes to anyone under the age of 18 and stopping the sale of loose cigarettes
• The use of plain paper packaging is being reviewed.

7. What are the elements of the very brief advice approach to smoking cessation?

Very Brief advice (VBA) is a simple piece of advice to be used opportunistically in less than 30 seconds in almost any situation with a smoker. It is not about advising smokers to stop, and you do not ask how much they smoke or even if they want to stop. There are three elements to VBA: establishing and recording smoking status (ASK); advising on how to stop (ADVISE); and offering help (ACT).

8. After initial booking-in, you identify a patient who smokes. What would you say to this patient if you had limited time?

It is best not to ask the patient if they want to quit or how much they smoke as this may make them anxious and defensive. It also takes time and can generate a conversation about their smoking, which should be saved for a dedicated stop smoking consultation. A simple statement advising that the best way to stop is with a combination of support and medication: "Did you know the best way to stop is with support and treatment through your local stop smoking service? They can make it much easier to stop than doing it by yourself."