Your interactive family guide to Spain as recommended by local mums | Last updated 7 months ago

Healthcare

Interview with the Stop Smoking Doctor Dr Alice Byram

"Children who are exposed to smoke are more prone to asthma, ear nose and throat infections. Higher rates of cot deaths are also recorded in smoky homes. Now there is talk of third hand smoke exposure which suggests that the residues of smoke on clothes and walls may also be toxic. Just think of the yellowing walls of a smoker´s living room. So saying you only smoke on the balcony is not valid. That goes for smoking in cars too, a recent study showed that the message about having smoke-free cars isn´t getting through. Something else parents often don´t think about is that children in a smoky home do less well at reading and reasoning skills compared to children in smoke-free homes, even at low levels of smoke exposure. And of course, every parent knows children do as they see and not as they are told, children of smokers grow up to become smokers themselves" (AB, June 2011)

  • What are the main smoking-related diseases?
    Although people often think of lung cancer, cigarette smoke causes cancers in all the parts of the body where it passes including mouth, stomach and urinary system. Cigarette smoke contains over 4000 toxic substances. Emphysema, an ilness in which the lungs are gradually and definitively destroyed is caused primarily by smoking and leads to people being attached to an oxygen bottle in order to keep on living. On a more positive note, there has been a 20% fall in heart attacks in the Murcia area since the smoking ban was introduced in January.

    How big a strain on the Spanish health service is this?
    If you think that one of every two smokers will die due to their smoking, you can imagine the strain it causes not only the health service but also on the economy in general. In many countries quitting smoking services are being funded by the government who realise that it is more economical to stop people smoking rather than treat them or pay sick pay.

    How much difference do you think the smoking ban in Spain has made?
    The fundamental difference is that it is now no longer "normal" to smoke, and those smokers who used to use the excuse that if it was that bad for you it would be banned now have to find another one. Only 13% less people are going to bars since the new ban here in Spain and in other countries where it has been going on longer, the hospitality industry has actually seen sales increased.

    How can passive smoking affect a child’s health?
    Children who are exposed to smoke are more prone to asthma, ear nose and throat infections. Higher rates of cot deaths are also recorded in smoky homes. Now there is talk of third hand smoke exposure which suggests that the residues of smoke on clothes and walls may also be toxic. Just think of the yellowing walls of a smoker´s living room. So saying you only smoke on the balcony is not valid. That goes for smoking in cars too, a recent study showed that the message about having smoke-free cars isn´t getting through. Something else parents often don´t think about is that children in a smoky home do less well at reading and reasoning skills compared to children in smoke-free homes, even at low levels of smoke exposure. And of course, every parent knows children do as they see and not as they are told, children of smokers grow up to become smokers themselves.

    How many people die of smoking-related diseases every year in Spain?
    50, 000 deaths are caused by smoking each year in Spain. To put that in perspective, it is the biggest killer. The fact that these are preventable deaths makes them all the more tragic to the family and friends left behind.

    What are the main smoking-related diseases?
    Although people often think of lung cancer, cigarette smoke causes cancers in all the parts of the body where it passes including mouth, stomach and urinary system. Cigarette smoke contains over 4000 toxic substances. Emphysema, an illness in which the lungs are gradually and definitively destroyed is caused primarily by smoking and leads to people being attached to an oxygen bottle in order to keep on living. On a more positive note, there has been a 20% fall in heart attacks in the Murcia area since the smoking ban was introduced in January.

    How big a strain on the Spanish health service is this?
    If you think that one of every two smokers will die due to their smoking, you can imagine the strain it causes not only the health service but also on the economy in general. In many countries quitting smoking services are being funded by the government who realise that it is more economical to stop people smoking rather than treat them or pay sick pay.

    How much difference do you think the smoking ban in Spain has made?
    The fundamental difference is that it is now no longer "normal" to smoke, and those smokers who used to use the excuse that if it was that bad for you it would be banned now have to find another one. Only 13% less people are going to bars since the new ban here in Spain and in other countries where it has been going on longer, the hospitality industry has actually seen sales increased.

    Approximately how many of those who suffer smoking-related diseases are passive smokers?
    Passive smoking causes one in 100 deaths worldwide. It is a scary figure and is the reasoning behind a lot of the smoking bans.

    How can passive smoking affect a child’s health?
    Children who are exposed to smoke are more prone to asthma, ear nose and throat infections. Higher rates of cot deaths are also recorded in smoky homes. Now there is talk of third hand smoke exposure which suggests that the residues of smoke on clothes and walls may also be toxic. Just think of the yellowing walls of a smoker´s living room. So saying you only smoke on the balcony is not valid. That goes for smoking in cars too, a recent study showed that the message about having smoke-free cars isn´t getting through. Something else parents often don´t think about is that children in a smoky home do less well at reading and reasoning skills compared to children in smoke-free homes, even at low levels of smoke exposure. And of course, every parent knows children do as they see and not as they are told, children of smokers grow up to become smokers themselves. This is especially important when it comes to teenage years as children of smokers are also more likely to use other drugs too. However, parents who do quit are giving a doubly important message, that smoking is not good for you and that as an addiction it has to be taken seriously in order to quit. Responding to their childrens´repeated requests for them to quit smoking is often a motivation cited by my patients and having their childrens´ support makes it a very positive experience.

    What services does the Stop Smoking Doctor offer?
    As a GP specialized in smoking cessation I offer a personalised treatment plan which combines medication and cognitive behaviour therapy which has been proved to give the best results in all the clinical trials comparing different methods including hypnosis and acupuncture. The medication means you no longer have to go through the anxiety and ill tempered moments traditinoally associated with quitting smoking. However, as the emphasis is on the personalised aspect not everyone will need medication. What everyone does need is a behaviour change and long-term follow-up. In addition to the face to face visits, I offer extra virtual support by phone, email and sms. This is something I started doing in Barcelona and it has given very good results as unexpected situations can crop up at any moment. My patients know they can ring me anytime including weekends and I often ring them at weekends myself as this can be one of the harder times for people quitting. Stopping smoking is a very positive experience as people take back control over this aspect of their life and physically feel better within a couple of days. In the first hour-long session I really to get to know the smokers habits, motivations and, very importantly, their fears about the quitting process. Then I prepare a treatment plan which makes sure they are prepared for the different situations they will come across. Forewarned is forearmed.

    Have most of the smokers who visit you tried to give up smoking before?
    All of my patients have tried to quit before, often spending vast amounts on quick-fix solutions. I always insist on the long-term follow-up as changing a habit which has been part of your life 10-20-30 times a day for many years will be consolidated over night. Your reactions to situations at work, of stress and happiness whether with family or friends have all involved your “friend” the cigarette.

    What are the main reasons why they have failed to give up smoking for good?
    The quitting process has well documented stages of initial euphoria then a sense of loss followed by normalization and consolidation of the behaviour. Classically smokers go back during the stage of loss as they are not prepared for it or a few months later when they think they can allow themselves “just one drag”. Lack of preparation and lack of support are the main reasons. Often they come to me quite despondent with a feeling of failure that they are still smoking. I always remind them that even if they were only one day without smoking that they were capable of resisting 10 or 20 cigarettes. I have yet to meet someone motivated who has not been able to quit, it may take more time but the end result is always a positive one.

    How can you help someone who has recently given up smoking to resist a cigarette in moments of temptation?
    If you have recently quit, you should always make sure that you have in your pocket or bag a subsitute for the cigarette packet so that you are not caught out unprepared. The physical craving itself lasts only 3-5 minutes, the length of a song, the time to drink a bottle of water or the the time walk up and down a couple of flights of stairs. Smokers do have one good habit, which is to make time for mini-breaks. If they weren´t filling themselves with carbon monoxide which stops the oxygen getting to their brain they would feel refreshed after their break. So ex-smokers should keep their breaks.

    What kind of situations should people who have just stopped smoking avoid?
    Instead of avoiding situations I prefer to think of making positive choices. Meet up with non-smoking friends or at least in smoke-free locations which is now very easy. Start walking or running as you will notice how much quicker you are after just a few days. Do avoid alcohol though, at least for the first 2 weeks, as your more likely to find it harder to resist in social situations. With medication the withdrawal syndrome and cravings are much less but as mentioned before changing your behaviour is the most important part.

    Do you think smoking should be banned in all public spaces?
    Smoking should be banned in all places where others are exposed to second-hand smoke. I do believe that everyone is free to do whatever they wish with their life as long as they take on the consequences for themselves and their family, however as a mother to a child with respiratory problems I am especially sensitive to not being exposed to other people´s smoke in public places.

    What are they key benefits for people when they have successfully given up smoking?
    The health benefits are well-known including reduced risk of lung cancer and heart attacks. But what I most enjoy about this job is that people quitting are spurred on by the immediate benefits. At the end of your first day your clothes and body no longer smell of smoke, as anyone who lives with a smoker knows that it is often a bone of contention. After a few days you notice your food tastes and smells better as your taste buds start to recover. Even going up stairs or running will become significantly easier after only a few days.

    How can people find out about you and can you offer your services to smokers in all areas of Spain?
    There is more information on my website www.stop-smoking-doctor.com and I continuously try to add more content. I do insist on a face to face visit as a GP I do a full health and life-style check in the first visit which is in Jerez de la Frontera. After that depending on the each individual the follow-up can be more by phone or skype. I am always open to answering queries from people in other areas struggling to quit smoking, you can ring me on 669 256 257 or email info@stop-smoking-doctor.com. As a GP and mother I think that is one of the most important decisions people can take to improve their mental and physical health both in the short and long-term so am happy to help anyone thinking about quitting.

    (June 2011)