Smoking Cessation Overview

Smoking cessation is promoted by the NHS as smoking is harmful to the health of the smoker and the people around them. Before the ban on smoking in enclosed public spaces in the UK in July 2007, employers were legally obliged to compensate employees whose health was damaged as a result of colleagues smoking at work. Around 15% of UK adults smoke, but 1 million people are estimated to have succeeded in giving up smoking since the beginning of the Covid-19 pandemic.

What are the effects of smoking which can be reversed or alleviated partially by smoking cessation?

  • Fatigue
  • Reduced lung capacity
  • Impaired immune function
  • Stress
  • Reduced fertility
  • Impaired sense of smell and taste
  • Prematurely aged skin
  • Bad breath and yellowed teeth
  • Reduced life expectancy (caused by greater likelihood of developing life-threatening diseases such as heart disease, lung cancer and chronic bronchitis)
  • Pneumonia, asthma, ear infection and other illnesses in those subject to the smoker’s secondhand smoke

Giving up smoking during or at the beginning of pregnancy can help reduce risks to the unborn baby such as low birth weight, stillbirth and prematurity.

Symptoms of nicotine withdrawal (the addictive substance in cigarettes):

  • Tingling in hands and feet
  • Sweating
  • Nausea and abdominal cramps
  • Constipation
  • Headaches
  • Insomnia
  • Difficulty concentrating
  • Weight gain

How is smoking cessation achieved?

A GP or pharmacist can help someone decide the best method of stopping smoking for them.

Medicine can be prescribed, such as nicotine replacement therapy in a patch, gym or nasal spray, to control the person’s intake of nicotine and prevent side effects of complete withdrawal (such as those listed above), but without causing the damage that tobacco does.

Other medications can reduce nicotine cravings while blocking the reinforcing effects of smoking.

E-cigarettes can help people stop smoking by delivering vaporised nicotine into their system. It is also a way of coping with the urge to smoke, without the harmful effects of smoking caused by tar, carbon monoxide and the other substances in cigarettes. However, the potential negative effects of inhaling e-cigarette vapour are not fully known.

Cognitive behavioural therapy can be recommended and allows the person to talk through how their behaviours and thoughts are linked and what they might be able to do to stop thoughts and feelings (such as stress) leading to them continuing to smoke in the future.

Group therapy can also help some people give up smoking, as mutual support and discussion can help them feel like they are not alone. Mental health issues and feelings of isolation in people with addictions are common and are factored into treatment.

Self-help methods are also worth considering, such as listing triggers – for example, alcohol – and ways in which they could be avoided. Some people also like to tell people close to them that they are quitting for accountability.

There are a few ways to confirm what sort of reasonable adjustments should be made for an employee with smoking cessation:

Employers do not have a legal duty to make reasonable adjustments for employees who are stopping smoking or to help them stop smoking. However, an employer may choose to help an employee in certain ways, or by making certain adjustments to allow them to attend appointments relating to their smoking cessation, as it is in the employer’s interest to have a healthier workforce.

Studies have also shown that smokers disproportionately fall into less affluent demographic categories such as those with lower income and that as a result, employers must be careful not to discriminate against them, as stipulated in the Equality Act. 

What reasonable adjustments are possible for employees who are stopping smoking?

Reasonable adjustments should be made in accordance with the employee’s need for smoking cessation if their situation is covered by the Equality Act for other reasons, such as if their dependency on smoking is a result of another underlying condition, such as a mental health condition.

Some reasonable adjustments to facilitate smoking cessation in the workplace might include:

  • Flexible working hours to accommodate medical appointments and the side effects of withdrawal or any other medication which someone stopping smoking may be taking.
  • Adjustments to duties depending on other conditions or symptoms which may have developed as a result of the employee’s smoking, such as asthma, which may affect their ability to move around quickly.
  • Subsidising treatments or support group sessions, particularly if a significant number of employees would benefit.
  • Raising awareness so that colleagues understand the employee’s smoking cessation and can help ensure the employee feels comfortable at work, as well as raising awareness of the risk factors such as stress or other mental health issues which can lead to smoking addiction.

Smoking cessation Signposting

Action on Smoking and Health – public health charity working to eliminate the damage caused by smoking in the UK by raising awareness, disseminating information on the dangers of smoking and campaigning for improved policy (020 7404 0242).

Action on Addiction – charity providing advice, treatment and family support to those affected by all types of addiction, as well as conducting research into treatment and improving the provision of services in the UK (0300 330 0659). – charity working to reduce suffering as a result of smoking and to move towards the smoke-free UK in the future, offering helplines and community groups in 8 languages and expertise to health professionals and employers (0800 00 22 00).

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