Given the poor prognosis in lung cancer patients, it is important to concentrate on preventing lung cancer. It seems a simple task; stop people smoking and they won’t get lung cancer, unfortunately this is proving to be a very difficult task. There are two important areas; reducing the number of people starting smoking and helping those who smoke to quit.

Education of the dangers of smoking, and its effect on health has been targeted to the public as a whole and to specific groups such as children and teenagers. In the White Paper ‘Smoking Kills’⁴⁰ the government outlines strategies for reducing smoking. The areas covered are; advertising bans, increased taxation combined with anti-smuggling initiatives, tougher controls on age limits, and health education strategies.

Workplace bans have been enforced by many businesses, especially by those who have continued public contact. It is thought that this may assist in helping people to quit smoking whilst minimising the health risk to other staff, however lifestyle changes and support are linked with greater success in quitting.⁷⁸

There are several campaigns to persuade people to stop smoking; The NHS has been running a campaign entitled ‘Don’t give up giving up’ and involves advertising and support material.

The BBC have recently been running their ‘Kick the habit’ campaign, a series of programmes on television aimed to inform and help people give up smoking, and follows the attempts of some celebrities in their attempts to quit smoking.

The ‘Quitline’ is one of many resources for people wishing to quit smoking. It is a telephone help-line providing information and support. The Internet also has a large number of support sites and discussion groups for people hoping to quit smoking.

These smoking cessation programmes are supported by guidelines⁸¹ to health practitioners. The guidelines suggest:

• Assessing patients’ smoking status at every opportunity.
• Advising all smokers to stop.
• Refer to specialist cessation service if necessary.
• Recommend and advise on NRT.
• Give niformation booklets on how to stop smoking.

The use of NRT has been shown to approximately double cessation rates compared with controls.⁸¹ NRT is a cost effective intervention and there is much debate as to whether it should be available on the NHS.⁸¹

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