6. Advice and Support

Evidence suggests that advice and support from others makes a difference to long-term success in quitting smoking. Randomized controlled trials of commonly used techniques, including one-to-one, group, and telephone counseling, show they help smokers quit and remain abstinent. Even brief advice from a doctor has an effect on cessation rates. The World Health Organization (WHO) takes the view that any professional trained in the appropriate skill should be involved in helping smokers quit: that it is an activity for the whole health care system, providing as many access points as possible for smokers to connect with and benefit from support to help them quit. Many quitting practitioners employ techniques from cognitive behavioural therapy (CBT). These help you change your habitual thinking and behavior around smoking: for example, identifying and managing triggers (the things that make you want to smoke), developing and reinforcing alternative "good habits" such as exercise, relaxation, or self-rewards for each day without a cigarette or each cigarette or packet not smoked. The techniques should focus not only on the period leading up to and during quitting, but also afterwards, helping you sustain changes in thinking and behavior to remain abstinent. You don't have to go to a cognitive behavioral therapist to benefit from CBT techniques. Many other care professionals are trained in CBT because it complements how they deliver their own service. I have met doctors, nurses, social workers, physiotherapists, hypnotherapists, business coaches, Reiki healers and yoga teachers trained in CBT. An effective program also offers several ways or "modalities" to help you stay connected and on track. For instance, as well as offering one-to-one advice and support, such a program might include group discussions, access to online materials and knowledge bases where you can read articles on smoking cessation, tips and stories from successful quitters, as well as the opportunity to pair up with a buddy or a mentor. In the UK, under the NHS Smokefree campaign, there are free local services that provide expert advice, information and support to smokers who want to quit. They can help you get stop smoking aids such as nicotine patches and gum, or other prescription products from your GP such as Champix or Zyban if they are suitable for you. One such example is in Buckinghamshire, where support centres throughout the county offer confidential sessions for a minimum of six weeks. They also work with local employers and set up free workplace groups for staff who find it difficult to get to support centres.

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7. Measuring and Recording

Many quitting programs have an element where where you sit down and quantify the effect that smoking has on your life. For example, you work out how many cigarettes you smoke per day, per week, per year, and how much this costs you. For some smokers this is often their first "reality check". For instance, if you smoke 20 per day at a cost of 4.95 a pack, then you discover that:

• In a day you spend 4.95 on cigarettes.

• In a week you spend 34.65.

• In a month you spend 148.50.

• In a year you spend 1,806.75.

• In 5 years you spend 9,033.75.

• In 10 years you spend 18,067.50.

Some people find it helps to keep a quit journal. You can use it to jot down your plan or little notes to remind you about why you want to quit, and to record snippets of your quitting experience. For example, you may wish to list your triggers and your options for alternative action to avoid taking up smoking again. You could list what you think will be your biggest challenges, such as keeping the weight off: how might you prepare for and deal with that? Once you've reached your quit date, use your journal to keep track of how you are doing. How did you deal with those challenges? Some people find their journal helps them put things in perspective. On bad days things can look much bleaker than they really are. Looking back through the journal you can see that there have been good days too: what was it about them that you can use in the bad days to help you along? Many countries have "quitlines" where you can call an expert who understands the health effects of smoking, the quitting process, and how difficult it can be to give up.