Science is magic that works; follow the science and get that booster jab!

These days I’m beginning to search the TV for something to watch in the evenings – it’s a sure sign the nights are drawing in! In our house, like most people I imagine, we literally have 100s of channels to choose from, plus everything that is also available online and on catch up TV. However, it can still be a challenge to find something interesting to watch. Last week, I rediscovered the wonderful series, ‘Endeavour’. Now I loved ‘Morse’, and to a lesser extent ‘Lewis’, but the 33 episodes of ‘Endeavour’ are simply sublime examples of great television storytelling. Each episode is a work of art, although some of its connections and photographic links are subtle to be fair. Watching last week’s episode, I was once again struck by how many of the cast smoked as part of the storyline. It took me back to my early days as a mental health nurse, where many staff (including me) and patients smoked, and often did so together. I gave up over 15 years ago.

Such memories felt somewhat ironic, giving we are entering the last week of this year’s #Stoptober campaign. This year was the 9th anniversary of this annual event that aims to help folk stop smoking. Over this time, the Office for Health Improvement and Disparities (formerly Public Health England) estimate that over two million smokers have managed to quit smoking. This is good news for them and for the rest of us. However, the good folk over in the Office for National Statistics also note that there are still nearly 7 million adult smokers in the UK. This is not good news for them or for the rest of us.

This year the focus has been on two different groups in the population. The first is the large group of folk aged 35 – 60 years old who continue to smoke, despite the widespread knowledge about smoking related causes of illness and premature death. The second group are those aged 18 – 35. During the pandemic, the number of new smokers in this latter group grew. This growth reversed the trend over the past 7 years which had seen a decline in young people taking up smoking. It’s perhaps understandable that as we went into lockdown some people turned to smoking (and increased alcohol consumption) as a way of dealing with the stress and anxiety each lockdown brought. It is never the right answer, but I understand why some folk might think so.

The campaign draws on the notion that if you can stop smoking for 28 days, you are five time more likely not to restart again. However good the campaign is, there will be many smokers who will simply ignore it, and won’t even try to stop smoking. The fact that often smokers have tried to give up in the past and failed is also a major reason many smokers don’t engage with the #Stoptober campaign. Like other health and wellbeing issues, sadly folk living in more deprived communities and/or those who live with mental health issues, are more likely to continue smoking, adding to their overall health and financial problems in so doing.

Indeed, as I walk around our ‘strictly no smoking’ hospital grounds, I’m amazed at the number of people who continue to smoke despite clearly having a health problem being investigated or being treated. I have been subjected to much abuse from those I have asked to respect the smoke free rules. And don’t get me started on those folk who refuse to wear masks while on the hospital site! The whole notion of why some people persist in engaging in activities that are known to be harmful and/or risky, made me think of my time in clinical practice where I had been asked to work in a drug misuse service in Manchester.

That was back in 1984, and I think the service was struggling for staff, and as the service I had been brought in to work for wasn’t up and running at the time, I was seconded to the drug misuse service. It was an interesting experience, not least because the people who worked there were simply strange, and the often wretched and complicated lives of many of the patients were very challenging. The therapeutic/treatment approach was based upon methadone treatment and psychotherapy. The overall approach drew upon the work of James Prochaska. His is a fascinating story – catch a glimpse of it here.

At the time my knowledge of psychotherapy was pretty rudimentary, so when I was presented with Prochaska’s transtheoretical model of behavioural change, I was not an instant fan. All these years later, and thanks to the patience of Professor Sue McAndrew in educating me, my understanding and appreciation of this approach has, well, changed. His model refers to the temporal dimensions of change decision-making: Precontemplation (not ready for change); Contemplation (getting ready); Preparation (ready); Action; Maintenance; Termination (folk will not return to previous behaviours). Interestingly, he developed his work as the underpinning approach to making smoking cessation programmes more effective.

As the Covid 19 infection rates continue to rise, I guess I can’t help but think about the current apparent reluctance of folk to get their booster jab. After the success of the original vaccination programme, why are so many people apparently in the precontemplation stage in their decision making? Prochaska talked about this stage perhaps lasting up to six months. Dear reader, we don’t have six months to think about getting a booster jab – tell as many people as you can to find out today where they can get their booster, and get it done! Science is magic that works; follow the science and get that booster jab!