IT IS barely over a month since new year resolutions were made and already they are being broken as fast as children’s Christmas toys. Seventy per cent of smokers say that they want to stop smoking and it is a safe bet that many resolved to do this, and equally certain that most will lapse. There is good news for those who succumb to the temptation year after year. By the time these hardened smokers find themselves barred from Wetherspoons pubs it is likely that Varenicline, a new preparation that removes much of the desire to smoke, will be available to strengthen their will.

Although 21 per cent of women and 27 per cent of men are ex-smokers there is evidence that shows that most people succeed in giving up only once they grow older and infirmity caused partly or entirely by tobacco has provided the spur. As the chronic chest diseases of bronchitis and emphysema, now known as COPD, and coronary arterial disease start so insidiously, and cancer of the lung kills so rapidly, none of these diseases is the ideal deterrent to smoking. Even the disturbing statistic that about half of all regular smokers will eventually be killed by their habit, and that in 50 per cent of these cases death occurs in middle age, is rarely enough to stop a hardened smoker.

Gender differences affect the motivation to give up smoking. Women are more emotionally dependent on cigarettes than men and fear that they would be unable to cope without them. Nearly half of the women who smoke do so to give themselves social confidence, while 44 per cent of the women in a Health Education Authority survey said that they also regarded smoking as their main source of pleasure (the figure for men was 38 per cent). Women also suggest that they need cigarettes to ease the stress of their lives. Conversely men who want to give up cigarettes are motivated by the intention to improve their health and physical fitness.

Although an increased risk of chest and heart disease doesn't act as an effective deterrent, it would be expected that early ageing, a reduction in fertility, an increased chance of developing cancer of the cervix and an unflattering effect on appearance would succeed when breathlessness and a productive cough have failed.

A woman’s fertility — when assessed by the time it takes to conceive — is on average halved in light or moderate smokers. Heavier smokers when trying for their first baby are at a grave disadvantage: the time it takes for a heavy smoker to become pregnant is 70 per cent greater than it is for a non-smoker.

Smoking appears to have a directly damaging effect on the unfertilised egg. The adverse effect of smoking on reproduction is confirmed by its influence on the menopause, which is two years earlier than in non-smokers.

One would think that even in those in whom the maternal instinct is not strongly developed the potential of cigarettes to cause early ageing would have a decisive impact. Women who smoke age earlier and these changes can be seen from the twenties onwards. They develop thickened skins that give them deeply lined and furrowed faces that become increasingly obvious after the mid-thirties. Another effect, rather more intimate, is apparent in their twenties. Women who smoke, even if thin and well exercised, have soft, potentially saggy, bottoms; the face is not the only part of the body to lose its elasticity and tone.

Men’s fertility and potency is not helped by smoking either. Smoking so affects the blood vessels leading to the penis that it is an important cause of impotency. Fertility is also affected, the sperm count falls and there are more abnormal sperm in the specimen. With each year, the likelihood of a male smoker’s sperm being able to fertilise an egg that is implanted and capable of surviving until the twelfth week of pregnancy drops by 2.5 per cent.

The evidence is that no existing aid to stopping smoking is dramatically effective, but without nicotine patches or other nicotine preparations or Zyban, the likelihood of giving up is small. Pfizers, the pharmaceutical giant, has now introduced an anti-smoking pill that works in a different way from all other preparations. In trials of the new tablet Varenicline, which is not yet available to patients, half all the smokers taking it not only stopped smoking but lost their addiction to cigarettes.

Varenicline affects the nicotine receptors in the brain so that it kids a smoker's brain that the person has already had a cigarette and dulls or abolishes the craving to light up. If the smoker is tempted to smoke because their addiction, despite the Varenicline tablet, hasn’t been quite satisfied, he, or she, is in for a disappointment.

Having had the tablet, the next cigarette doesn’t give the same sense of relief as it normally would.

www.timesonline.co.uk/health
Email Dr Thomas Stuttaford your questions on giving up smoking