Age at interview: 53
Brief Outline: Caroline, 53, lives with her husband, has 5 grown-up children, and has quit smoking recently with an online programme. Caroline smoked 20 a day for much of her adult life. About three years ago she experienced a ‘rattling’ in her chest and tried many different methods of giving up. She finally stopped with the help of an online support programme and now feels much better, and even goes running with her dog.

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Caroline started smoking when she was about 12 and used to get her sister to buy cigarettes for her. They used to hide in a phone box and smoke on the way to school. Both her parents used to smoke so she says she used to be able to hide the smell in the house quite easily. She thinks that by the age of 16 she smoked about 20 a day. She remembers that it was cool to smoke in clubs and thinks that it was a lot easier to get hold of cigarettes when she was young. She felt that smoking gave her a bit more ‘confidence’, gave her a ‘boost’, and made her feel better. She worked in a bank where she felt it was the ‘norm to smoke’. When she was pregnant she became a ‘secret smoker’. After this time she was on maternity pay so she says she couldn’t afford as many cigarettes. She smoked through all five pregnancies and smoked in front of her children, which she knows now ‘wasn’t a very sensible thing to do’. She and her husband used to smoke only in the garden when their children were teenagers. Her children had had it ‘drummed into them’ at school that smoking was harmful, and she can remember trying to talk over anti-smoking adverts on the television. She said that two of her children have smoked in the past but mostly they were ‘anti-smoking’. She remembers smoking menthol cigarettes that she bought from Holland and Barratt, thinking they were healthier. She wanted to give up because of her children and also for financial reasons, as she realised the money she was spending on cigarettes could be spent on her kids instead. Caroline says that the smoking ban in public places ‘didn’t bother her too much’.

About three years ago Caroline started to ‘feel the effects of smoking’ as when she lay in bed she could ‘hear her chest rattling’. She tried to give up but again became a ‘secret smoker’. Later she heard that there was a smoking cessation group and she used to go there to get nicotine replacement patches, even though she still used to smoke. In March 2009 she had a ‘serious attempt’ to give up which lasted about four months. Then she started smoking herbal cigarettes again, and later started putting the odd ‘normal’ cigarette into her herbal packet. She started smoking ‘normal’ cigarettes again whilst on holiday. She then had another attempt to give up which lasted about six months, then just started having the ‘odd one’ when she went out.

Caroline tried a number of different methods to quit, including patches, and lozenges. However the patches irritated her and she found that she had a ‘funny sort of pain’ when she put them on. Caroline joined an online forum to help her stop and got advice about stopping, but started smoking more and more when she went out. She found it useful not knowing the people on the forum, but she said she never knew whether they were ‘still having the odd cigarette’ or not. However later she joined the ‘Nicorette Active Stop’ programme, a scheme in which she received text messages and emails every day to support her. The programme gave her tips such as remembering to compare how she fared running up the stairs when she first stopped with the same activity a week later. She feels this programme was successful because she really wanted to give up, and not because she felt that she should. She experienced cravings but learnt to ‘almost enjoy them’ as she felt it was one less craving she was going to experience in her life. She hasn’t smoked since and now doesn’t know why she smoked before. She says she feels much better, and can now run with her dog; the ‘rattling’ in her chest has gone, and she says it’s nice to be able to play with her grandchildren without having to eat lots of mints beforehand. She says that the only downside is that she has gained 10 pounds but asserts that she would rather have to lose weight than not be able to breathe properly.

Now she can’t see what pleasure people get from smoking, but says she doesn’t want to preach to people. She thinks that cutting down doesn’t work, as it made her enjoy smoking more. Now she finds it a relief that she can go all day without worrying when she can have a cigarette. As a non-smoker, the smoking ban annoys her as she has to wait inside whilst her friends have a cigarette outside. She is proud of herself for stopping and shows her friends, via the app on her phone, how long it is that she hasn’t smoked.

Caroline didn’t feel the ‘rattling’ in her chest at night, and had a heightened sense of smell. She has noticed the smell of other people smoking much more since quitting.

You said you felt so much better. What have you noticed?

First of all when I’m laying in bed, there’s none of the rattling on my chest. I’m sure I almost used to feel my blood pressure, I presume it was really high from smoking, you lay in bed and you could almost feel your heart pounding in your ears, so all of that’s gone. When I walk my dog, I can now run [laughs]. Not sort of miles, but before hand, I mean I’d just be puffing and panting after sort of few steps, but now I can run quite a long way with the dog.

It’s, I’ve got grandchildren, so it’s quite nice. I haven’t got to worry about having a full load of mints before they come, and I can cuddle then knowing that I’m not making them smell of smoke. Which is actually quite important to me, although I didn’t realise how much I smelt until I stopped smoking, and I now smell it on other people. I can go in a room where someone who’s had a cigarette, if they go into a room and then I follow them into the room, I can still smell it, even though they smoked outside.

My husband smokes and I can, if I’m coming down the path and he’s in the back garden having a cigarette, I can actually smell the stale smell. I can smell it in the toilet [laughs] wherever he’s been in a small space, I can smell it. Which as I say I didn’t notice before. You can be walking along the road, and you know that somebody has been standing there having a cigarette a minute beforehand.

So it’s nice to know that I can have the children near me, and not worry about me smelling for them really. I can smell the shampoo on my hair still. So when I wash my hair it sort of still smells of shampoo a few days later, whereas beforehand I couldn’t smell anything.

Caroline thought people should try to understand why they smoke; she found giving up easier than she had thought.

Well my message definitely is to learn as much as you can about why you smoke, but not learn it in one great, big, long blob. You just need to kind of little bite sized bits, every now and then. First of all, about why you smoke and then what the benefits would be if you didn’t smoke, you know, so what damage you’re doing to your health through smoking. But the smaller, the better. So great big chunks of information to read, it puts you into information overload and as a smoker you actually switch off. You know that they’re right but you choose not to listen to it. So just small little bits is the best thing and to go for it. It’s easier [laughs]. It’s easier than you think. I think the hardest bit is thinking right I’m going to do it, and then once you’ve done it you suddenly think oh that actually wasn’t that bad.

Smoking gave Caroline a confidence ‘boost’ when she was in unfamiliar social situations out, but also found it inconvenient when she needed to smoke at work

It kind of gives you confidence, I mean if you go to somewhere where you don’t make very many people for instance, somehow at the time to stand there smoking kind of gave me a bit more confidence, especially if you were with other smokers. It, somehow it just gave me a boost and I can’t really explain the boost what it was, but it made me feel better. It kind of, at the time I thought it relaxed me, although I realise now it actually stresses you more, because you’re then wondering when your next cigarette was going to be. I mean there’d, there’d be days when I’d come into work and I know that we had a meeting that might go on over lunch time. And my boss didn’t know I smoked, well he did originally, but when I first gave up he never knew I went back to smoking.

So then I’d be in the morning thinking oh I won’t be able to have a cigarette until he goes out. You know, and I’d be thinking counting out the hours until I could have that cigarette, and I think when I stopped smoking I suddenly realised I can go all day and not worry.

Caroline was offered support through a smoking cessation clinic and pretended she had stopped. She said she wasn’t offered much practical advice.

It was when they offered this smoking cessation programme that was with the nurse, and I spoke to other people that were doing it, on this forum I told you I used and they all had their, is it your CO meters or whatever, so they couldn’t cheat at all. Whereas I went she never measured anything, so when she said have you smoked, I was like, “No.” [laughs] And because she believed me, I was like, I, I believed myself, I wasn’t smoking even though I was smoking. So I was never given any advice on how to quit. I did with the nurse talk through which was the best course of NRT if you like, and we decided on the patches with her. So I think she offered me, there was like a nose spray or something, patches, or lozenges and we went for patches. But there was never any sort of real advice I was given.

I did have somebody phone me up once from the NHS, they do a Hertfordshire Smoke Free Zone or something and she did find me up and ask me how I was doing, and I think that day I hadn’t really smoke so I was just like oh fine, you know, but she didn’t sound very sincere so, we didn’t really keep the conversation going for very long.

So I guess kind of they’re busy, they haven’t got time to really help each individual anyway, so I didn’t get that much help from them. Though that’s not say other people don’t, just because it didn’t for me [laughs].

Caroline used nicotine lozenges and patches, but disliked the taste of the lozenges and reacted badly to the patches.

I’m cold turkey. I just I missed it too much, or I thought I missed it too much. The lozenges which I do use now actually, but when I first gave up they really taste disgusting and they, they always get, they seemed to give me the hiccups and I couldn’t kind of quite swallow properly, but now if I’m honest, I think I’m quite addicted to them like, oh I really, really fancy a lozenge and I do always have some in my bag. Down to the lowest strength, but the way I see it, if I ever really needed a cigarette I’ve just had a lozenge instead.

Patches I wore for a while, but I found them so irritating. They’re itching, plus you kind of, every now and then you get this funny sort of pain, wherever you put them on. Really hard to explain and I did try talking to the chemist about it. He thought I was totally mad, but it was, I suppose it was as the nicotine is released from them I could kind of, I either had it had my arm, or on my hip and I’d get this almost sort crampy pain. So the chemist was just like I think you’re imagining it, and I wasn’t imagining it, so I stopped using them.

Caroline read the Allen Carr book but “it was too much information”; she preferred her advice in “bite-size chunks”.

So you were saying that you had had the Allen Carr book?

I did read it. Yes. It didn’t do a lot for me if I’m honest. I didn’t, well I say I didn’t agree with his way of thinking. It’s not that I didn’t agree it, just reading a book, and so reading too much it almost just goes over your head, which is why these very little interactive sort of chunks that they send you through, bite size pieces should I say, they’re so much better. There’s just too much information from him.

Caroline joined an online forum that she liked, but she started smoking again in secret. Later she used an online support programme called ‘Active Quit’ that helped her quit smoking for good.

The forum that I used, I say that, that was really good, but I found that, I don’t know not talking to real people in some ways was nice. But you never even knew whether they really were not smoking or whether they were like me and a slight secret smoker and even though they weren’t smoking, they were still having the odd cigarette. I did make a couple of friends on there which is really nice. And I still I keep in touch with them now.

So what forum was it?

It was No Smoking Day Forum. They’re a charity and they have like a forum on there. Which is really good. I mean there’s hints and tips on there, and sort of, you can kind of look ahead to people that have been quit for longer than you and see what to expect. But then when you have a cigarette, you think right do I admit it on there, or do I just pretend that I’ve still not smoked for six months or whatever, and eventually I just stopped using it.

And then as I say I joined up with this Active Stop Programme. And you have a week preparing with them and all through that week they don’t tell you that smoking is bad for you, because they say you already know it’s bad for you, but you don’t want to admit it’s bad for you, but they just send you little tips like if you didn’t smoke for a week you could buy such and such, just kind of gives you an idea of how much money you’re saving and when your quit day comes and mine was the 7th February, they, you’ve already previous to that, kind of logged all the cigarette that you smoke, so I guess they know what time you smoke your first cigarette of the day, and they send you, obviously it’s automated, but it seems personal, because it has your name on it. They send you a text message around that time, just telling you how well you’re doing, this, that and the other and there was like an interactive programme on the internet that you do each day and then you have to fill in a diary and it would tell you to run up the stairs and then run up them again after you’d not smoked for a week and see what the difference is.

And even though you could easily cheat every day they would text me and say, ‘Have you smoked today?’ You could easily say no when you hadn’t. I suddenly thought cheating is just sort cheating me. It doesn’t really matter what other people think. So one time when I did have what they call a blip I did say, yes, but other than that I was truthful all the time, and since then there’s been no looking back. So very proud of myself [laughs].
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