Plymouth Uses E-Cigs To Reach Smokers

Plymouth finds a way to reach hard-to-reach smokers by adopting e-cigarettes into its quit program

Plymouth City Council tobacco control and smoking cessation officers have recognised the failure of traditional top-down quit smoking approaches. They decided something needed to change and so they conducted an experiment. They were concerned about the “entrenched” and “hard to reach” smokers who had been failed by the old ways of doing things – what on earth could have been the breakthrough?

Who was involved in this experiment?
Dan Preece, Advanced Public Health Practitioner in Plymouth City Council and lead for tobacco control and smoking cessation

• Gary Wallace, Public Health Specialist in Plymouth City Council, leading on complex needs and member of The Plymouth Alliance leadership team

What problem did they identify?
They considered the ‘noise’ they made about quitting smoking to an old phrase: “If a tree falls in a forest and no one is around to hear it, does it make a sound?”

What was their “noise”?
Plymouth utilised a traditional approach of counselling, anti-smoking medication, and nicotine replacement products such as patches, sprays, and gum. This was supported by advertising the services to the smoking public in the locality (¹).

What was the conclusion?
They said: “If we’re consistently and systematically failing to engage groups with greatest needs, are we making any noise? And if not, is the answer just to shout more loudly or should we reflect and change what we are saying?”

How do Preece and Wallace describe themselves?
“We see ourselves as the Barcelona of Public Health, and Tobacco Control our Lionel Messi.”

Why were the traditional cessation methods seeing fewer people quit smoking?
“People don’t like to be told what to do.”

What did they think might work to help smokers?
“People who smoke need a positive alternative proposition,” they think. “If you offer people a well-designed alternative proposition, they’ll buy (into) it. The nub is firstly in ensuring that the best alternative is less harmful than the current choice.”

What did they think might be a game-changer for tobacco cessation?
Electronic cigarettes.

Why do they think vaping works so well for smokers looking to quit?
“We think the reasons vapes work to challenge a traditional medical treatment for smoking is because their success is rooted in a social model. People like them partly because vapes aren’t prescribed, aren’t seen as treatment and nor as a health promotion intervention. People don’t tend to try vapes because they are healthier than smoking; they try them because they like them.”

What needed to change?
The pair believed much of the messaging from public health is from middle-class people to middle-class people. They decided rather than telling people to do something, they would simply open up the opportunity for smokers to try a different approach by making it attractive, affordable, and accessible.

What did they do?
They gave away around 300 vape starter kits during the Covid pandemic. They are offering free e-cigs to people in hostels, those who are seeking support for alcohol and other substance problems and looking at supplying kits to the local hospital.

Did vaping work for Plymouth smokers?
Yes. “People who smoke tobacco are telling us vapes work,” Preece and Wallace said. “And people that smoke who are in so called ‘entrenched’ groups whom public health have traditionally failed to reach are telling us this loudly.”

More smoking cessation services are discovering the power of vaping to help smokers break free from tobacco. More and more, it looks like we’ll see the end of smoking in our lifetime.

One You Plymouth – https://www.oneyouplymouth.co.uk/stop-smoking