Age at interview: 40
Brief Outline: Raf, 40, gave up smoking three months ago. He is British Pakistani, currently unemployed and lives with his wife and four children. Raf started smoking on a trip to Pakistan when he was a teenager. He ended up smoking up to 30 cigarettes a day before he started trying to quit. Raf has now quit for 3 months with the help of varenicline and hasn’t wanted a cigarette since.
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Raf started smoking at the age of 16 when he went to Pakistan with his family. His friends were surprised that he had started as he used to try and convince them to stop. He went from having the ‘odd few’ to later smoking 10 a day, then 20, then 30. Raf tried smoking Silk Cut as he thought it would help him stop, but he said that he just ended up smoking more. At first he didn’t tell his family that he smoked, out of ‘respect and fear’. Later he felt that ‘more responsibilities kicked in’ and said that he felt the impact of smoking on his wallet. Raf’s wife used to nag him about smoking and saying that it smelt around the house. Raf used to work as a taxi driver and said that, even though he wasn’t allowed to smoke in the cab, he used to find lots of opportunities to smoke when he was waiting around. At the time, he thought that the smoking ban was a ‘waste of time’, but now he sees it differently. He has stopped twice: once for two months and the second time around three months ago. However, the first time he ‘fell back into it’ because of tragedies in the family.
Raf has been diabetic since the age of nine and has Type I insulin-dependent diabetes. At the hospital he would always be urged to give up smoking by his consultant, but he never paid any attention. Then eventually he started thinking about quitting ‘a lot more’.
The first time he quit, he relied on ‘willpower’ and every time he felt like smoking he would chew some chewing gum and keep himself ‘occupied’. However, towards the end of a three-month period, his grandfather passed away and the ‘easiest thing’ to ‘fall back on’ was a cigarette. Then he said he was back to ‘square one’.
Raf had tried nicotine replacement patches and gum before, but found they didn’t really help. He registered with a ‘stop smoking’ clinic as there was a seven-month waiting list at his surgery. Raf phoned the NHS ‘stop smoking’ line and found a support group through which he could be prescribed varenicline (Champix). Now he says that smoking is the ‘last thing on his mind’ and he has only smoked three cigarettes since stopping smoking. He finds that smoking now makes him feel sick, and thinks that taking Varenicline may help a lot of other people. Now he has saved an average of £60 a week and he has put that money elsewhere, such as for gifts for his kids. He says that there have been only positives to giving up, and there haven’t been any negatives.
Raf would compensate for not smoking in daylight hours during Ramadan by smoking intensively during the evening.
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Would there be any other times that you couldn’t smoke for a longer period of time? Did you ever stop smoking in Ramadan or anything like that?
No, I didn’t, because, because of my illness I can’t actually fast. And so it never really came to a point of actually even trying to stop smoking during then, even when I was fasting, I’d spend the majority of the day in bed, and I’d wake up or get out of bed a couple of hours before the fast was actually open, and I’d like stick it out for them two hours and then as soon as the fast was open I’d have the bare minimum to eat, and I’d get up and I’d walk outside and light a cigarette up and smoke a cigarette. And between the fast opening and keeping the fast the following morning, I’d smoke 20 cigarettes in the space of like six, maybe seven hours. So I’d like basically make up for the time of not smoking in them few hours in between.
Raf’s wife and mother wanted him to give up smoking, but he tried to block it out as he wanted to continue.
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Well my wife, she would always nag me that it smells of cigarette smoke around the house, but apart from that, my Mum occasionally would give me a lecture. But apart from the two of them, no nobody else really.
And what went through your head whenever your Mum was giving you a lecture or your wife was complaining about the smell in the house?
I’d basically just blank it out, in through one ear straight out of the other, not let it register with me. ‘Cause I, basically I just didn’t want to stop, or I couldn’t stop. I think it was more a case of I didn’t want to stop, and I’d never really think much about it.
And why was it that you didn’t want to stop? What is it about it that you really liked?
I don’t know to be honest with you. It was just a case of like, if you’re ever feeling down or anything it was just the most easiest thing to fall back on, just for that comfort fact kind of thing, and I think that was the main reason, but it could be something else, but I’d personally say that that was actually the main reason; if I ever felt down, light a cigarette up, cheer me up straight away. Alright, if not cheer me up, it would take my mind off things.
Raf was very anti-smoking before he went on a trip to Pakistan. His friends were surprised when he came back a smoker.
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And how old were you?
I was about sixteen and a half years old at the time. And, basically it was friends that I made out there, they were all smokers and I think that may have played a big, big part in the fact that I actually tried it for the first time, and from there, as I say it just, it became an everyday thing.
And was that when you came back to England or…?
Yes. So I can remember when I came back to England, a lot of my friends here, they were all already smoking before I actually went to Pakistan, and I used to always fight with them, as to try to stop them from smoking, but it was a case of them doing what they wanted to do, and not paying any attention to what I was saying. But when I actually started smoking, they used to look at me, they used to say, “You’re the same person that used to try to stop us. How come you’ve started smoking?” And I don’t know, I don’t know how I really explained it to them. But [coughs] it was just... foolishness more than anything else I think, that actually made me carry on smoking. Because in the beginning obviously one cigarette, two cigarettes, it wasn’t a great big deal, but as time went by, I just started smoking more regularly. It became a permanent way of life if you like.
Raf felt on edge without a cigarette and had a constant urge to smoke. This may be why he smoked for so long.
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Not, not really. I mean they all, to me they felt the same. Apart from Silk Cut because they have little holes in the filter and it were just a case of the thought of them helping me stop smoking, was the reason why I actually started smoking them, but, whereas I’d smoke one cigarette, with Silk Cut I’d end up smoking two, one straight after the other, just to get that same kind of fix.
And then eventually I just changed brands again, and it went back to how it was prior to going onto Silk Cut.
So what was the fix like that you wanted out of cigarettes?
It was just, I don’t know really how to explain it, but it was just, it was like an urge but, with some urges, after a little while the urge goes away, but with this it was just constantly there, until I didn’t actually light a cigarette and smoking it, I didn’t feel no different. But once I’d actually had a smoke I’d be a lot more calm, and I’d be able to concentrate better. And basically I think that’s just what kept me smoking.
It was like well not like, it actually it was addiction, but I mean I don’t know because, I’ve never done drugs or anything, so I wouldn’t know what that kind of addiction would be, but to me, I mean this was like the next best thing, and until I’d have a cigarette, I would be, I wouldn’t really be myself, I’d always be slightly jumpy, on edge, that kind of thing.
Now that he has stopped smoking Raf thinks that the ban is a good thing, but when it first came in he used to smoke between jobs as a taxi driver.
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Yes, yes I can.
Tell me what you can remember about that and how you felt about it and…?
When it actually started at the time, I was working as a taxi driver and it became law that you can’t actually smoke in your car because it’s a public place in a sense, and but it never actually stopped me. I’d have the window fully down and I’d light a cigarette up in between jobs and I’d smoke it, and working on weekends, in picking customers and dropping them in town and vice versa, you’d see people standing outside clubs smoking and complaining, ever since this ban’s come in we can’t smoke inside, whereas normally they’d be enjoying a drink and a cigarette inside a club, but ever since this basically happened. It has affected I’d say every smoker in the sense that they’re limited to where they can and where they can’t smoke.
And what do you think about that?
I think it’s good now that, now that obviously that I have obviously stopped, but at the time, right up to when I hadn’t stopped, I thought it was just a waste of time, bringing that ban in and stopping people from smoking where they’re more comfortable, and but now obviously I see it all different. If not completely different, a lot more different than what I actually did prior to that.
Raf couldn’t afford to smoke once he had more family responsibilities, and now he has quit he has saved around £60 a week.
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So what were the responsibilities that kicked in?
Just family, family responsibilities, you know, like having to pay your own way at home and that kind of thing, and then when I got married and as time’s gone by, obviously responsibilities they just increase. They never decrease and it’s just been getting harder and harder and harder as time’s been going by. And I mean no matter how much money you’re actually earning, you still do feel what’s going out of your pocket, and especially to things like cigarettes and what have you.
So have you noticed the difference in the last nine weeks at all?
Yes. I’m saving on average I’d say about £60 a week. And whereas before, that £60 a week, no matter what I’d need it for, it’d go on cigarettes. Whereas now obviously I can put that money elsewhere, and get something for the kids, or whatever else I need to go out and buy, I’ve got that spare money there, sat there waiting to be used. Whereas before it would just be cigarettes only.
And are you keeping it sort of separate or does it just get absorbed?
No, not separate as such. But it’s just the fact that knowing that I’ve got that extra money there, I can actually go out and whatever else I need to get, I can comfortably go out and get it. Whereas before, no matter how urgently I needed something, I wouldn’t buy it for the sake of that money being spent on the cigarettes.
Raf was told that he couldn’t get the prescription he wanted unless he attended a support group. He found his GP’s surgery had a long waiting list, but he had quicker support via a NHS Stop Smoking phone line.
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So what happened this time, when you went to the group, what was that like?
Well this time round I went, I had, I was at an appointment at my GP’s, and I mentioned it to my GP again and he told me the same thing. When I inquired at the reception desk they told me there was a seven month waiting list and it was a lady behind the reception counter that actually gave me the NHS stop smoking number. So I rung that number up and they give me an appointment for three days later. I went down, it was only a ten minute chat initially, and the person that I saw there, he gave me a letter to give to my GP’s. I went and gave that to, in at the reception at the GP’s practice. The lady behind the reception counter, she told me to come back the following day and pick the prescription up. Which I went, or no sorry, I didn’t go up, I phoned them to ask if the prescription was ready, and they told me that the doctors wanted to speak to me before they actually prescribed it for me. So, another week and a half went by. I got an appointment, went to the doctors’ and they just basically wanted to explain the side effects to the tablets to me. And I was happy with that, and then the doctor prescribed the tablets for me, and I started taking them that same day then.
And was the sort of going to the smoking support, was that sort of just a way of getting the tablets or did they come up with anything useful at the time?
Well I’ll be honest with you, for me it was just a way of actually getting the tablets, because the doctor will not prescribe them without a letter from the stop smoking clinic. And everything else that really they used to say to me, I didn’t really pay much attention to. I just wanted to try the tablets to, if you like, try and prove the tablets wrong. But I can’t. They’ve worked brilliantly.