What's the NHS smoking cessation program like, and how can I prepare for my first meeting?

May 24, 2007 1:14 AM

I'm going to see the smoking cessation nurse at my local GPs surgery next week (UK). I have a 2 part question about this. Firstly, I'm interested in trying Zyban as an acquaintance said it was really good for them - is this easy to get on the NHS? And secondly, what's the smoking cessation program actually like and is there anything I can do to prepare now (for example, keeping a smoking diary or similar)? I'm fed up with my frequent unsuccessful solo quits and am really serious about making this one stick, so want to go prepared.
posted by handee to health & fitness (16 comments total)

I'm in the U.S., so I know nothing about the NHS system, but I can tell you that Zyban was like a miracle drug for me... It gave me a general sense of well-being, and after about 5 days, I was able to quit smoking completely... I was smoke-free for about a year, but I had MAJOR stresses in my life and I ended up smoking again (I had stopped the Zyban at that point)... I am eager to get back on it again, because it WORKED!... But, I think I am one of those people who will need to be on it indefinitely in order for it to really work (your mileage may vary).
posted by amyms at 1:20 AM on May 24, 2007

I strongly recommend Zyban in conjunction with a cessation program as well as a strong personal commitment to stop smoking. I tried Zyban without the program once, and despite the fact that it worked really well, I quickly discovered that nothing beat popping a Zyban and smoking a cigarette. Whereas smoking with Nicorette was an impossibility.
posted by phaedon at 1:27 AM on May 24, 2007

For me I was eventually able to stop only by doing so at the same time as adopting a rigorous exercise programme and a diet. That might seem counter-intuitive but I think the task becomes easier if you have trained your body and mind to be more disciplined before quitting. You might want to consider that. If you have any stressful events that you anticipate in the next few weeks (exams, etc) then I would also wait until they are out of the way. Smoking addiction is part physical and part psychological. For each person the combination and strengths of these draws will differ. So will their reaction to a drug like Zyban - so it is probably difficult to predict how it will work for you in advance.
posted by rongorongo at 1:57 AM on May 24, 2007

Zyban is available on prescription in the UK, but as it's a branded drug and is quite expensive you might encounter some resistance from your GP, who may want you to try something cheaper. If you stamp your feet about it you should be able to get it, though. It may well be worth doing that, because so much of giving up relies on your state of mind, and if you believe Zyban is going to give you that edge you're halfway there regardless of its actual efficacy.

In my (anecdotal) experience, the most effective way to give up is the Alan Carr book. I didn't use it myself, but all my friends who've managed to quit did. Some of them had to read it multiple times, but it's stuck eventually in all but one case I know of. So if you've not tried that, it might be worth a look.

Good luck!
posted by tomsk at 2:02 AM on May 24, 2007

I agree with tomsk about Alan Carr's books. I haven't read them, but I have a lot of friends, some of who were very heavy smokers, who have successfully quit after reading it (sometimes for the second or third time). Most of them also said that the book annoyed the hell out of them to begin with, but they got past that. Good luck.
posted by Elmore at 3:06 AM on May 24, 2007

Thanks for the Allen Carr suggestions but that's not really answering the question. Were I to have put [more inside] I'd have mentioned that I've tried:

• straight forward willpower,
  
• Allen Carr,
  
• The Nicotine Trick,
  
• Gum,
  
• Patches,
  
• Online support forums and programmes
  

I haven't tried zyban - hence my current question. My quits usually last 3-6 months. On the topic of Allen Carr, I think he works by some form of self hypnosis, and it is very strange, but it doesn't seem to work twice (I know of many other ex-ex-smokers who find the same thing). I also haven't tried proper hypnotism but expect for various reasons that won't work so well for me.
posted by handee at 3:14 AM on May 24, 2007

[I'm an NHS Primary Care administrator]. You should have no problem* getting a NHS prescription for bupropion (Zyban) if you're serious and motivated about quitting. NICE guidance recommends the use of bupropion or Nicotine Replacement Therapy in smoking cessation.

As for what your session will be like, this varies depending on who's taking it. But don't forget that your nurse really really wants you to quit. This is partly because s/he cares about you but also because s/he cares about her/his targets! I know patients who have found it helpful.

Good luck. I hope this works. The smoking ban in England starts on 1 July and this should help everyone trying to quit.


*Obviously, I'm not a doctor and can't speak to contraindications etc but the main exceptions are being under 18 or being pregnant which I'm assuming don't apply.
posted by boudicca at 4:45 AM on May 24, 2007

A friend of mine tried (and succeeded with) Zyban. However, it gave him wild and aggressive mood swings. He said that it was worth it, though I'm not sure the person he hit would agree.
posted by Shave at 4:52 AM on May 24, 2007

Bring that list of things you've already tried to the doctor - it will probably help considerably when selling him/her on the idea of trying zyban.

Also - one of the best predictors of quitting successfully is having tried multiple times in the past. Believe it or not. Every time you try to quit, it makes you more likely to be a successful quitter in the future. So you are probably frustrated by previous unsuccessful attempts, but just realize that those previous attempts actually make it more likely that you're going to quit for good this time. Best wishes to you! This is a great thing you're doing!
posted by selfmedicating at 5:04 AM on May 24, 2007

I saw the practice nurse for my cessation programme. The nurse will be able to prescribe you whatever you need, but be aware that Zyban does not mix well with many other anti-depressants. I went with nicotine lozenges for this reason. The programme consists of regular visits - iirc it was 3 X 2 weekly, then 2 X 4 weekly. The nurse took a CO reading at each visit, to check I wasn't a filthy recidivist, (or maybe flogging off the lozenges), and was very encouraging and forthcoming with information and reading material.
Good luck.
22 weeks clean and serene, and I thought I'd never quit.
posted by punilux at 5:24 AM on May 24, 2007

http://en.wikipedia.org/wiki/Bupropion says:

Bupropion (INN; also amfebutamone,[1] brand names Wellbutrin, Zyban, Budeprion and Buproban) is an atypical antidepressant, which acts as a norepinephrine reuptake inhibitor and dopamine reuptake inhibitor[2], and a nicotinic antagonist. [...] Bupropion is primarily used as an antidepressant and as a smoking cessation aid. [...] Wellbutrin SR and XL are now available in generic form. [...]

So if you have trouble getting the Zyban brand, maybe you can get a generic that will do the same trick. But IANAD, AFAIK, so YMMV.
posted by pracowity at 5:59 AM on May 24, 2007

My wife tried it. One the plus side, it seemed to alieviate all cravings. On the negative side, the cravings returned immediately she finished the course. More worryingly, she experienced unpleasant mental "issues" - depression, suicidal thoughts, etc, while she was on it. She's never tried it again.

If you do try Zyban, it's main use seems to be to get you out of the habit of subconciously lighting up - but be aware for darker symptoms, and stop immediately if you experience them.
posted by salmacis at 6:18 AM on May 24, 2007

It doesn't address your question directly, but a couple of points. First, bupropion is indeed the generic Zyban and can be used in the same way. If that doesn't work for you, then varenicline appears to be well on the way to approval in the UK and is a drug that works similarly to bupropion but is designed specifically as an anti smoking drug; the manufacturer claims a 40% success rate which for smoking is quite good. Interestingly enough, these drugs were described pretty well in Malcolm Gladwell's Tipping Point as a potentially useful way to stop smoking.
posted by TedW at 6:22 AM on May 24, 2007

I do not recommend Zyban. The instructions for use told me to continue smoking for a week while getting used to the drug and did not mention the withdrawal symptoms.

I challenge you to use Alan Carr's Easy Way to Quit Smoking. I read it and have been smoke-free since March 15. That same week, the second night of being smoke free I went to a bar and got hammered, went home and went to bed. I haven't even thought of smoking since i read it.
posted by parmanparman at 8:27 AM on May 24, 2007

zyban was awful for me--it made me hideously anxious and moody. like, the point where i couldn't go to school it was horrific.

i finally quit after a rapid tapering and stayed quit for about 3 months.

what i've done since is the slow-quit method. first i identify my smoking patterns and create a routine i can stick to pretty well. then i decide which cigarette to cut out of my routine. instead of cutting down one a day, cut down one a week or one a month, or whatever.

after a year, i was down to 2 a day, and after another few months, down to 1 a day. i can now skip that one without much trouble (and i often do), but i enjoy it, which makes it the hardest to break.

another thing i did was never smoke indoors. it made it easier not to mindlessly smoke--i had to stop what i was doing and go outside.
posted by thinkingwoman at 9:59 AM on May 24, 2007

I know three people who say they were helped hugely by a quit-smoking meter: a continuously-running software program that displays a current count of how many days cigarette-free days have passed, how much money you've saved by not buying cigarettes, and how much time you may have added to your life. They quitters said that after even a short time, the idea of having to reset the meter helped dissuade them from "having just one."

Here is a download page for one such meter, Silk Quit. It's free -- the donation is optional. You can find others, but this is the only one I've personally seen in use.
posted by wryly at 2:13 PM on May 24, 2007