Quit pro quo

Studies indicate that finding a sense of belongingness and drawing on altruism from people on similar journeys can have such a powerful impact on one’s tapestry of recovery that the quit rates make a mighty jump from 50% to 130%, writes Rashikkha Ra Iyer.

The National Tobacco Control Programme (NTCP) was introduced by the Government of India between the years of 2007-2008, as a part of the 11th five-year plan. One of the objectives of the NTCP was to aid people in quitting tobacco use. This is most certainly seeing increasing promise through significant quit programmes being developed and implemented by local health agencies across India. More people are accessing these services and attempting to understand the standard treatment programme, which provides acceleration for work towards a smoke-free nation.

As a service user, who is preparing to explore a smoking cessation programme, it is important to understand that a smoking cessation programme spans pharmacotherapy and behavioural support in conjunction, rather than a standalone of one of them.

Based on the organisation providing them, sometimes the service could predominantly focus on one specific type of intervention, which can thus affect the trajectory of the quit programme. Thus, it is pivotal for the service user to explore what is available and then express care related curiosity to understand the breadth of what they are about to receive. A care plan is always co-produced with the service user, and the service user must be involved in it every step of the way.

As a preliminary step towards preparing for behaviour support, it would be good to start reflecting on how and why your relationship with smoking evolved. Some reflective questions could include — “When was my first use? Who did I do it with? Did someone lead me to smoking, if so, what was it that they said, drew me to smoking? When did it become a habit? What positives do I draw out of the smoking experience? Do I smoke to feel the nicotine rush or do I smoke to combat withdrawals from it? Is smoking even a joyful experience for me anymore? Why do I feel I want to quit now? What are my goals from the behavioural support received around this?”

One of the issues that a service user is most likely to face during the programme, like in any other therapeutic intervention is a struggle for retention. A trained behavioural enhancement practitioner like a psychotherapist or smoking cessation specialist practitioner would be competent in working through resistances that show up during different stages of the treatment. Resistance often correlates with retention and consequently dropouts. However, as a service user, a certain level of personal commitment to remaining in the programme is required. You should ideally aim for a duration of a minimum of six months, as studies point to the highest rate of success when this period is persevered.

Psychosocial support does not have to be restricted to a 1:1 setting. You can search online for mutual aid groups in your locality that you could attend, to draw support within a group setting. Group therapy regardless of whether they are psycho-educational/ process-oriented/ medication adherence of nature has tremendous benefits to offer. Finding a sense of belongingness and drawing on altruism from people on similar journeys can have a powerful impact on one’s own personal tapestry of recovery. Studies indicate that within a smoking cessation group setting approach, the quit rates make a mighty jump from 50 per cent to 130 per cent.

A sense of camaraderie, universality and finding wisdom through peers within a confidential, safe space can be empowering. In comparison to other forms of addiction, smoking is often seen as something that someone is easily able to give up. It is seen as just a habit, a behavioural addiction, that could be reversed with moral policing and emotional sophistication. This often drives people to feel isolated in their journeys when in reality, smoking addiction requires the same level of psychopharmacological support similar to any other substance. Breaking free from this stigmatic web can be catalysed within a group setting where acceptance and encouragement are received from others on a similar journey.

(The author is a multidisciplinary professional who works in the UK.)