Covid-19 has surely been challenging for all, and though we have now hopefully crossed the peak, we will be seeing its implications for many months or even years to come. We are already seeing the negative impact of the lockdown and economic uncertainty on society’s mental health. Stress and boredom are known triggers for increased smoking and this is likely to predispose people to more addictive behaviours such as smoking and drinking alcohol. In these unprecedented times, we need to pre-emptively support smokers stay away from smoking more, and ex-smokers from relapsing back to smoking.

Despite the UK being at the forefront of global tobacco harm reduction policies, the gap between policy and practice remains massive, from even before the Covid-19 pandemic. Though UK’s national guidelines support long term use of safer nicotine to help people stay away from smoking, clinicians hesitate to recommend the use of stop smoking aids like dual NRT therapy or e-cigarettes for tobacco harm reduction.  In times when media stories often don’t give the real picture of safety of these stop smoking aids, people usually rely on influencers like their doctors to give a final verdict on the safety of a product. Multiple surveys have shown that significant number of health care professionals are still confused about the role of nicotine and tobacco harm reduction in smoking cessation. If healthcare professionals are confused then that translates into creating a doubt in smokers’ minds. This in turn can result in smokers not trying a quitting tool like e-cigarette, and vapers constantly being at a risk of relapsing back to smoking, especially in stressful times like the Covid-19 pandemic.

As a practising GP and a firm believer in preventive medicine, I have been involved in upskilling GPs and other clinicians on smoking cessation around the world. I have seen that when accurate information reaches them in a practice-friendly way from another clinician, they are very receptive and supportive of helping their patients quit smoking and manage cravings using the harm reduction principle.

In these times of global emergency, I know how busy the healthcare professionals are. Hence, I and my team at the Centre for Health Research and Education (CHRE, www.chre-uk.com) have been working overtime to empower clinicians by creating easy-to-use infographics and starting telephonic smokefree advice lines for mental health staff. The infographics were recently published by the Royal Society for Public Health on their website for wider dissemination and are already very well received by clinicians across the UK.

https://www.rsph.org.uk/about-us/news/covid-19-and-smoking-act-now-to-prevent-a-health-calamity-from-happening.html

We continue our work in this, mindful that whether a harm reduction tool is a prescription medication or not, if health care professionals are not empowered with the scientific evidence, there will always be a risk of a country’s policy not translating into practice.  Smoking will continue to take its toll globally unless this is addressed. As healthcare systems and professionals continue to buckle under the pressure of Covid-19, lets ensure that going smokefree does not get forgotten!

Dr Pooja Patwardhan
GP, and Clinical director
Centre for Health Research and Education
www.CHRE-uk.com

2020-05-26

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