Shahab, L;
Kenyon, J;
(2013)
The ‘Not-a-Puff’ rule.
(NHS Centre for Smoking Cessation and Training Briefings
11
).
NHS Centre for Smoking Cessation and Training (NCSCT): London.
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Abstract
The ‘not-a-puff’ rule involves assisting smokers to stop smoking abruptly, commit to not smoking any further cigarettes after the quit date and also to promise to not taking even a single puff on a cigarette from that day forwards. This briefing provides the rationale and the theoretical and empirical evidence behind this clinical intervention. The traditional definition of a four-week quit used for stop smoking service returns to the Department of Health is ‘continuous abstinence from smoking from day 14 to the four-week follow-up point’. This means that occasional smoking is permitted in the first two weeks of the quit attempt but should NOT be interpreted clinically that this is a strategy that is encouraged. Better long-term results are obtained from abrupt cessation and adoption of the ‘not-a-puff’ rule. Continued smoking following the quit date prevents resolution of the neuroadaptive changes in the brain that take place upon quitting and leads to prolonged withdrawal symptoms. The ‘habit’ element of smoking is not broken whilst a smoker continues to have occasional puffs. Smoking following the quit date reduces the client’s self-efficacy, which only increases through continued abstinence. Self-control, also valuable in quitting, is similarly related to the length of time a client abstains and will not build up if the client continues to smoke. Empirical studies have shown that lapses are commonly followed by relapses, in up to 95% of cases. The ‘not-a-puff’ rule is associated with better outcomes than gradual cessation, in both supported and unsupported quit attempts. Harm reduction, where continued smoking is permitted with concomitant use of pharmacotherapy (i.e. nicotine replacement therapy; NRT) to reduce consumption, can be recommended for smokers who are unwilling or unable to stop.
| Type: | Report |
|---|---|
| Title: | The ‘Not-a-Puff’ rule |
| Open access status: | An open access version is available from UCL Discovery |
| Publisher version: | http://www.ncsct.co.uk/usr/pub/not_a_puff_rule.pdf |
| Language: | English |
| Additional information: | © 2013 National Centre for Smoking Cessation and Training (NCSCT) |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1450801 |
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