Tobacco and Harm Reduction
There’s no question about it -if you don’t feel so well, if you are feeling stressed and anxious, smoking a cigarette will make you feel better for a while. Many a soldier for whom cigarettes were supplied as part of their daily rations, will tell you so. Smoking also helps keep you slim, gives you something to do with your hands and mouth and something to interact with other smokers around. It can also get you out of the office at regular intervals into the fresh air and sunshine (and the rain and the cold as well). Back in the day we even thought that smoking made you look sophisticated and cool!
How can we help people who can’t help themselves?
In the 21st century no-one would ever try to argue that smoking is not bad for you. We have such a huge body of knowledge about the deleterious health effects of smoking that there is no argument to be had any more.
Unfortunately, despite that knowledge many people are still smoking and many more people with mental health problems are suffering the physical consequences of their addiction to tobacco.
People around the world are talking about the value of harm minimisation for smokers. There’s an Australian website dedicated to quitting run by the Australian Tobacco Harm Reduction Association. https://athra.org.au/ That site provides very useful information for people wanting to stop smoking including a discussion of all the tools that enable you to reduce your intake if not give up completely.
Vaping
Vaping is a particularly hot topic in Australia, although it is a well-accepted alternative to other methods of smoking cessation in many parts of the world. It’s not a perfect solution and it is associated with some risks but it is infinitely less harmful than smoking cigarettes.
On the ATHRA website you can find everything you need to know about vaping including information about the legal aspects, the costs, the devices and how to prescribe nicotine solutions for use in vaporisers.
When you’ve read the evidence and arguments and made an informed decision ATHRA can help you (or your patients/clients) determine their own path for smoking cessation.
Reading
If you want to read more than the ATHRA site you might like to start by reading the Australian Medical Association’s position paper on vaping https://ama.com.au/system/tdf/documents/E-cigarettes-Use-and-marketing-electronic-cigarettes-personal-vaporisers-2017_1.pdf?file=1&type=node&id=46780 or about why the New Zealand government don’t think vaping is such a bad thing https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5885311/
Jan is Sydney GP, private psychological medicine practitioner in Sydney’s inner west and a GP educator for Black Dog Institute.
Have you ever been on your way to work and asked yourself “I don’t really feel well . . . should I really be working clinically today” – and yet still turned up and completed a full day’s work?
*In April 2021, approximately 619,000 older Australians (aged 65 and over) were employed in the labour force", and at 66 years, I’m proud to be included in this statistic. By Tessa Moriarty
For as long as I have been in practice (and that’s a long time!) I have done my best to avoid looking after old people.