Ms Claire Gordon:

One of the tragedies for us is that 42% of people try to quit cigarettes by willpower. There are many alternatives, such as the HSE Quit programme which provides support, groups and face-to-face cessation counselling. There is gum, there are patches, and there are medications like varenicline that will literally suppress the nicotine urge. Those are all available, but by and large most people try to do it on willpower, and that is why it is so difficult and the numbers are so low. I understand perfectly someone who does not want to medicalise it. He or she is a smoker who wants to get off smoking but who does not feel it is something to see the GP about. It would be great if more people would look at the services that exist and take advantage of them. At the moment, clinical guidelines are being developed by the HSE for GPs and others about how to deal with people who are smokers, as in what advice to give them, where to point them and what to discuss.

One of the terrible things for us is that many services and alternatives are available but there is the attitude, "Just have a backbone", or, "Just give up; what is your problem?", and there is always this example of Jimmy who gave up without any help. However, everybody is different, neurologically and biochemically, so the addiction is different for different people, and I do not need to tell the Deputy that. For us the view is, why would someone not get the help that is out there? Why do people try to hard-nose it and do it all by themselves? They do not see it as something medical but as a lifestyle issue, like eating less or exercising more.

We need to recognise the power of the addiction - the absolute power of nicotine addiction, so much so that a colleague of ours who is a public health doctor was on a ward, exactly as the Chair said, where four men had limb amputations because of their smoking and one of them would get into the wheelchair five or ten times a day to go out and have a smoke. That is the power of the addiction. It is such a tragedy then when people think, "Oh I failed. I did not quit. I tried and gave up. I had to go back", as if it is some kind of character failing or lack of moral spine when it is not that at all. It is a massive biochemical addiction such that someone who has already suffered something like a lost limb will continue to smoke. There needs to be more recognition of that, no more than harm reduction with other drugs as well, because it is the same thing. It would be brilliant if we were all doing everything right and off everything, but if some in-between stage can assist in quitting cigarettes, such as gum, e-cigarettes, the drugs or talking to the GP, it is a sufficiently serious problem that needs all the help that is available. Definitely one of the things for us is that 42% of people try to go it alone, and it is really hard.