Giving up’s no longer just for Lent. Campaigns asking us to quit vices like drinking and smoking for a month, sometimes in aid of charity and sometimes for our own good, are now frequent features of our calendar. As well as an annual post-new year detox in January, in the autumn we’re now encouraged to “Go Sober for October” or put down the cigarettes for “Stoptober”.
But does making short-term lifestyle changes in this way carry any real health benefits? Some argue that a month is far too short a period for your body to recover from years of chemical punishment and can lead to a false sense of security about your health. Similarly, the NHS advises that crash diets are both bad for your health and don’t help sustain long-term weight loss.
Public health campaigns also have their work cut out for them. Despite the millions Stoptober spends on advertising, it remains a David to the Goliath of the tenacious and cunning tobacco industry that invests billions of pounds a year on promoting itself.
Anti-smoking initiatives are usually based on one of three broad strategies: shocking, informing or encouraging people. But knowing that smoking is bad for you is not the same as understanding how you can stop, so simply reading a leaflet explaining the harms of smoking won’t make you quit – it’s a cheap, but flawed idea. Instead, Stoptober uses the encouraging approach.
Spontaneity or planning?
Our motivation to change a habit such as smoking, drinking or eating too much is not in a binary state. At any given moment we can’t simply be described as motivated or unmotivated to do something. Instead, our level of motivation fluctuates and, crucially, can be altered. So it is possible for a public health campaign to tap into these fluctuations and act as a catalyst by encouraging us to make a change.
While some people make specific plans to stop smoking, others give up spontaneously, and there is evidence that unplanned changes are effective and can be sustained. However, whether planning or impulsive, we need to be warmed up in some way, to have a trigger thought or event that makes us receptive to the idea that we need to do something.
We need a push-and-pull effect. We are pushed into making a change because of something we don’t like such as the smell of smoke on our clothes. And we are pulled by a perceived benefit, such as the money we will save by quitting or improved health.
So does the approach of Stoptober and similar campaigns actually make a difference? One analysis showed that the first year of the campaign led to a 50% increase in the number of people attempting to quit smoking compared to the other months of the year, whereas the previous five years had seen no significant difference. This is encouraging, but is the effect temporary?
Unfortunately, we don’t yet have any data on the success of Stoptober in encouraging people to quit smoking in the long-term. Research also suggests that it can take on average over 20 attempts for a 40-year-old smoker, who started in their teens, to become abstinent.
But other research suggests that the chances of quitting are indeed higher if you can reach one month without a cigarette, although a far more important milestone is three months. Around 90% of former smokers in one study who had quit for three months were still abstinent when contacted over a year later.
The research into Stoptober itself also highlights that reaching the end of one month without relapsing is a crucial point for would-be quitters, after which your experience and needs change. Instead of concentrating on the push-and-pull factors that motivate you to stop, such as the benefits to your health or finances, you need to move to a strategy of bolstering your self-belief that the change can be maintained.
The other issue with broad public-health quitting campaigns is that they don’t address the specific needs of different groups. For example, if you have mental health problems you are three times as likely to smoke than the general adult population. In fact, mental illness sufferers consume 42% of all tobacco in the UK. Despite this, little is known about how well Stoptober and similar initiatives can reach this significant subgroup of smokers.
On the whole, however, I believe campaigns like Stoptober are a sound investment for both individual smokers and the population as a whole. Even if someone starts smoking again in November, they have gained a month free from the habit and learned from their experience, ready for the next attempt.