Most methods for quitting smoking are doomed to failure because they are preoccupied with addiction to nicotine and pay little heed to the behaviour of individual smokers, according to a behavioural psychologist.
The only method that could claim a 100 per cent success rate was that deployed by "Murad the Cruel" in 17th-century Turkey who had all smokers beheaded, Mr Bill Mathews, of TCD, told the biennial conference of the Environmental Health Officers' Association.
There was no one reason why people smoke. Individual differences had to be taken into account in helping them to cope with quitting, he said. "In most cases, interventions consist of relatively brief attempts to change a very powerful and long-established piece of behaviour, frequently without any attempt to understand or consider whatever factors, other than nicotine, might contribute to the maintenance of this behaviour."
Following a short "interruption" of the behaviour, the person is placed back into the same environment, subject to all the factors which originally served to maintain it. "Recidivism in such cases is to be expected rather than wondered at," Mr Mathews said.
The main causes of relapse are anxiety, stress, anger, frustration, social pressures, weight gain, and lack of inner resources due to low personal satisfaction or adjustment, he continued.
Social pressure to smoke is the biggest single failure factor, with 43 per cent of smokers relapsing in inter-personal situations. It is possible to stop though it usually takes several attempts.
Behaviour in itself could be addictive, even without the presence of a pharmacological agent, he said.
In that context, "coping strategies" were important, including support contact after resuming "normal life". Stimulus control, while not considered important in enabling people to quit, could significantly help cut down on cigarettes. Put simply, this meant not having cigarettes close at hand.
Highlighting the immediate effects of smoking - such as impaired taste and bad breath - could be the most powerful way of control, rather than saying you will get lung cancer 30 years down the road, Mr Mathews said.
Mr Paul Hickey, of the Western Health Board, said new legislation required that at least half the seating in restaurants should be designated as non-smoking, or at least one quarter where health authorities are satisfied that tobacco circulation is effectively controlled.
Through a survey conducted with Galway Health Project, it was found that more than a third of Irish restaurant patrons do not know the present space requirements under the tobacco regulations, he said. "Nearly half of all non-smokers do not feel that the current regulation meets their needs, while only 10 per cent of smokers felt so aggrieved."
