Helping a Patient with COPD Become Smokefree
A patient was referred to the Pennine GP Alliance Stop Smoking Service through their GP practice. At the time of referral, he was smoking approximately 25 roll-up cigarettes per day and found quitting particularly challenging due to working night shifts, where smoking helped him pass the time and manage stress.
Living with COPD, he was increasingly concerned about the impact smoking was having on his health. He felt he was relying heavily on his inhalers, using his Salbutamol inhaler up to six times a day, and was worried about worsening his breathing problems. Although he was anxious about quitting, he was motivated by the desire to improve his health, reduce his dependence on inhalers, save money, and find healthier ways to cope with stress.
A Personalised Approach
During the initial assessment, PGPA’s Stop Smoking Advisor Ben, explored the patient’s previous quit attempts, what had worked well in the past, and the barriers that had prevented long-term success.
The patient had tried several nicotine replacement therapies before and was hesitant about using a vape due to concerns that it would make him cough. Through open discussion, the advisor was able to address these concerns and provide evidence-based information about vaping as a stop smoking aid.
Together, they agreed that a vape could be a suitable option and the patient was supported to access a free vape kit through the Swap2Stop programme. A quit date was agreed and regular follow-up appointments were arranged, with telephone consultations chosen to fit around his demanding shift pattern.
Overcoming Challenges
The patient quickly reduced his cigarette consumption using the vape but found it difficult to make the complete transition due to workplace stress. Through ongoing conversations, it became clear that he was not receiving enough nicotine from the vape during work hours, leading to cravings and occasional smoking.
Working collaboratively, a tailored plan was developed. The patient used a higher-strength nicotine liquid while at work and a lower-strength liquid at home. This approach helped manage cravings more effectively and gave him greater control over his nicotine intake.
When progress stalled around the four-week mark, further discussions identified another barrier: a supply of tobacco kept in his work desk “for emergencies”. After exploring the impact this was having on his quit attempt, the patient decided to remove the tobacco altogether, eliminating a significant source of temptation.
Throughout the programme, flexibility was key. Appointment times were adjusted around his changing work schedule, and regular communication via telephone and text ensured he remained engaged and supported.
Positive Outcomes
The patient reduced his smoking to just two or three cigarettes per day very quickly after starting the vape. Although he was not completely smokefree at four weeks, continued encouragement, problem-solving and viewing lapses as learning opportunities helped him stay motivated.
By the end of the 12-week programme, he had successfully become smokefree and had remained so for almost two months.
The improvements to his health were significant. Before quitting, he relied heavily on his inhalers and experienced anxiety if he left home without them. Following smoking cessation, he reported going weeks without needing to use his inhalers and no longer felt dependent on them.
The tailored vaping plan proved highly effective, and he is now continuing to gradually reduce his nicotine strength with the goal of becoming nicotine-free in the coming months.
Patient Feedback
The patient expressed immense gratitude for the support he received throughout his quit journey.
He explained that he would never have considered vaping without professional guidance and found choosing a vape device independently overwhelming. Having personalised advice and a recommended option made the process much easier and more manageable.
He described feeling proud of what he had achieved and said that becoming smokefree has left him feeling healthier, more confident and no longer constantly worried about his breathing. Most importantly, he believes he has smoked his last cigarette and does not see himself returning to smoking in the future.
This case highlights the value of PGPA’s personalised, flexible support and demonstrates how tailored interventions can help patients overcome barriers, improve long-term health outcomes and successfully become smokefree.
Find out more
You can find out more about PGPA’s Stop Smoking Service and our dedicated Stop Smoking Advisors here.
