The five stages of grief are said to be denial, anger, bargaining, depression and acceptance.

Quitting smoking has its equivalent stages.

Delusion

This is the feeling that all will be well. At this point, smoking is engrained in your life. You are coping with it and can quit at any time.  It’s easy to think of all of the smokers who don’t have any health issues. We’ve all heard of someone who was a heavy smoker and lived to over 100.

All of the above just need to be challenged with evidence and common sense.

It’s true that not all COPD sufferers smoked, but smoking does drastically increase your chances of developing COPD. Try breathing in and out through a straw for two minutes – that’s how COPD feels.

Frustration

This is the start of something good – you know that you should do something about smoking, but you’re not sure how to make the change. You know for sure that it takes so much willpower, which is something your stressful job won’t allow for.

Modern lifestyles and busy schedules mean we’re getting less ‘me time’. When will you get enough time to do something for yourself?

Those feelings of frustration are a direct response to closed thinking. It’s similar to looking at a magnificent vista and only seeing the farm gate. Set a goal, make a plan and stick to it.

Gambling

‘What if’ - two great words to start a bargaining session.

“What if I cut down to just five a day?”

“What if I only smoke at work?“

”What if I change to roll-ups?”

This is like a bad episode of Deal or No Deal – there’s no winner in this game. All of the boxes have something nasty inside and there is no banker trying to outsmart you. Your only option is to wait until the last box opens, and that may not be the one you bargained on.

Isolation

“All of my friends smoke.”

“The boss smokes and that’s when the best decisions are made.”

"That last fag means I will never smoke again, and I quite liked it really.”

“Giving up would be really hard and nobody knows what this feels like for me.”

The feeling of loss is quite natural. You have given up one of the things you thought defined you. The fag shed was the place where you’d have casual conversation while smoking. It was a comfortable space - away from the desk or the machine – and it was a place to relax.

Think again. This is Britain. Most of the time it’s raining or it’s freezing, usually both.

Look around the next time you’re standing in your cold and damp fag shed, wrapped up in your coat which you constantly drape over the radiator trying to get it dry enough before your next cig break. You’re missing out on conversations with all of your non-smoking friends who don’t have to stand outside shivering from the cold.

You are never alone in this. Smoking does not define you, and it never has. You are now part of the non-smoking majority. Only a fool would trade health for five minutes outside in the rain.

The majority of society are non-smokers; they’ve either never smoked, or they’ve given up. These are your people now. You are amongst friends.

Elation

This is defined as great happiness and exhilaration. It’s a feeling of joy that’s matched only by the relief felt when achieving a goal.

People who quit can’t wait to tell you about it - about how it feels to be free and how glad they are that they took the first step. You too will be like them.

Remember your cravings for what they were: disruptive.

 Remember the smell for what it was: disgusting.

 Remember the taste for what it was: dreadful.

Come over to the sunny side of the street and feel the weight lift from your shoulders. Alright, I may have gone metaphor happy, but in reality you will be glad you got here.

There you have it - five stages of quitting smoking. If any of them resonate with you, remember that we all experienced them to some extent when we quit.

Don’t be afraid of them. Know them for what they are - just paving stones on the path to a smoke-free life.

-          Les Jackson, ex-smoker.

Puffell is an evidence-based solution to create and deliver a lifestyles-based ecosystem that offers a targeted and universalistic approach for building greater wellbeing and resilience for society.

What matters to you?

Puffell supports people at their point of need by understanding what’s important to each of us and building behaviourally-focused activation. Puffell then uses both technology and peers to maintain that choice until it is habit formed.

We leverage the evidence and disciplines from behavioural science, cutting edge digital solutions and strategy from the 9 wider social determinants of health. We empower people by engaging the power of the 5 ways to wellbeing - connect, get active, be positive, learn new things and enjoy the power of giving.

Why we do this is simple. At the heart of everything we do, we believe in making better happen. We want to build a society that is resilient, well and HAPPY; we do this by making what we do simple to use, beautifully designed and user friendly. Want to join us?

Before beginning on our journey, we conducted a piece of insight that told us 7 things:

1. People don’t understand/recognise their health and implications of poor health long term
2. People want to do more for some themselves but don’t know where to start
3. People feel ‘frustrated’ ‘abandoned’ –  health system misses key opportunities to engage with the right tools
4. Want to be treated as the ‘whole person’
5. A plea - use channels that we use
6. Lack of trust in government
7. They have great aspiration -  they want better, although struggle to define what better is for themselves, yet can almost always describe it for others important to them.

By building Puffell based on insight, we are able to collect meaningful hard and soft data for individual areas:

1. Clinical measures - that evidence that a patient or citizen has made positive progress

2. People-centred outcome measures (PCOMs and PROMs) - a relatively new concept which involves putting patients, people, and their families and carers at the heart of deciding which goals are most valuable for individuals with a range of health conditions, rather than clinicians deciding what is best

The data we are collecting is now evidencing outcomes, including: 

1. Increased patient self care
2. Better citizen self-management
3. Reduced and redirected service demand
4. Reduced health and social care costs

                                                              i.      via prevention and better managed conditions

We strive to demonstrate positive behaviour change; over the last 12 months we can demonstrate the following outcomes on Puffell.

The above image demonstrates the behaviour change we are starting to see - over an average of 127 days, an average of 4.3 less units were consumed every day; over an average of 158 days, there has been an average reduction in cigarettes smoked per day by 7.4 and over an average of 168 days, an average reduction of 3.1kg (that’s half a stone!) has been made.

Puffell doesn’t just offer lifestyle support; we offer long-term condition management. Combining this with the lifestyle support means we can support reducing cost out of the system.

Asthma and Viral Wheeze:

We recently launched a number of new spaces on Puffell for you all to use. The first of these was the launch of the asthma and viral wheeze space for adults and the asthma and viral wheeze space for children. Both of the spaces contain information, advice and tips about asthma and viral wheeze. It is there to help you manage your asthma and viral wheeze, allowing you to do more of what you want, when you want to do it.  

COPD:

The chronic obstructive pulmonary disease (COPD) deck was our second addition in the last 12 months, offering a space for anyone with COPD to manage their long-term condition and to help keep it under control.

Both the asthma and viral wheeze and COPD spaces offer the ability to create a digital diary, as well as allowing for cross reference with air pollution and humidity levels. This means that you can recognise and keep track of any trends or patterns.

CAMHS:

Our pilot for Child and Adolescent Mental Health Services (CAMHS) is now live in the Slough region. This space has been developed because young people have been waiting for long periods of time to access support. Puffell is designed to support young people whom can self manage, and we are working with the CAMHS team to refer any young people who need service-based intervention.

Health Checks:

We have also had a great opportunity through the development of our digital health checks space. We are in the process of launching a dedicated health checks space where you can get your heart age and then see the impact of your day-to-day life on your heart age. We have been involved in helping to map the national strategy for health checks with Public Health England (PHE), which Puffell will support by offering a digital platform for health checks.

Diabetes:

Our bespoke diabetes space is also in development and will be launched later this year. This is a great place for anyone with diabetes to track their condition, as well as writing down what their personal aspirations and goals to determine how best to achieve them.

To find out more about Puffell and how it can support you and your citizens, contact Richard Forshaw-Smith on 0151 647 4700 or at richard@icecreates.com

Young people are a notoriously difficult audience to engage with, but the benefits of doing so are overwhelming across health and social care and society as a whole. So, the challenge many of us face is how do you go about future-proofing the under 25s - a group that lives for today with little consequence for tomorrow?

Our experience from working with young people across the country tells us that the answer lies in delving underneath the bed, into the cupboards and through the ear buds to find out what really matters to them; to uncover the real reasons why they behave the way they do and to hardwire our services directly into their world. We know, for example, that as many as one in five young people are still smoking and over 80% of adults started smoking before they were 20 years old.

Here are our top three tips for setting up stop smoking service for young people - ‘on their turf and in their style’:

• Engage with young people in places they already visit. By creating a network of venues such as colleges, universities, training centres and youth offender locations, services are fully integrated into everyday lives
• Take a holistic approach – interventions need to uncover and manage the wider motivations for smoking such as lifestyle, confidence and social pressure
• Think digital – this savvy group don’t read ‘information-based’ websites; they interact, share and learn from others. An at scale behavioural ‘nudge’ like our Puffell platform is essential

One of our key insights from working with young people is that they are often not heavy smokers and can be influenced before they fall further into addiction. Their quit journey will also influence others around them - their families, friends or partner - thereby reducing the strain on services while also making communities healthier.

ICE is an experienced healthy lifestyle provider, operating a holistic service that resonates with the needs and wants of our audiences to produce measurable outcomes. We are also adept at working in a consultancy service capacity.

If you would like to create a bespoke stop smoking or lifestyle improvement service for young people or would like us to co-create designs with your service providers, talk to Graeme Morgan on 0797 357 8337 or at graeme.morgan@icecreates.com

Today is national No Smoking Day; I was around for the first one all those years ago when it was treated as a mildly amusing joke.

The tobacco culture had a real grip on society, and being a non-smoker was quite an oddball thing -unless you were of the sporting variety. Health for health’s sake hadn’t taken off just yet, while the only nods to general fitness were “The Green Goddess” and “Mad Lizzie” on Breakfast TV - just for the girls, you understand.

There was no information about men’s health at all. 70% of men smoked, as well as “keeping fit” with football and rugby which was often followed by several pints and a pack of fags in the evening. Sporting events were routinely sponsored by tobacco giants. Meanwhile, women were targeted with chic cigarettes which were often slim and liquorice paper wrapped, giving a look of elegance when held in a certain way. This aesthetic was advertised everywhere from magazines, billboards and newspapers to TV and cinema advertising. Women’s sport still hadn’t caught on with the advertisers.

I was working in despatch at a very large factory employing vastly more women than men, mostly in repetitive routine manual work. It was the stuff that 1970s robots couldn’t do. Most of these women smoked and their lives revolved around the break bell, and of course the cigarette that accompanied the tea. Men would be under the same influence of time but their machines kept the clock ticking. You would be relieved to have a break as the machines kept going. It was repetitive, manual and controlled. It wasn’t a break - it was a fag break seen as part of the working day.

Thankfully, those days have gone and more often than not, we now tend to look to a healthier option. Smoking prevalence has plummeted since those far off tobacco filtered days. However, when we look at the data we find that routine manual workers still have the highest proportion of smokers today. Women have by and large quit or taken up the habit less quickly than men, but in the under 30s it is still stubbornly higher than average. Women in lower income employment and the unwaged are the higher proportion of that group.

We still have a long way to go and today it couldn’t be easier. Getting help to quit is only a matter of asking. The internet will give you all of the stop smoking services in your area. Stop4Life operates in workplaces, colleges and community venues, ensuring that the help you need is readily available in your busy lifestyle. Nicotine replacement therapy and all of the support you need comes from our advisors. With a solid support system, you are four times more likely to quit than going it alone. Our own Puffell.com will guide you and help with tracking your success. It is just a matter of taking the first step.

We have come a long way from the 70s and 80s; your smoking habit could well be history if you take one step more.

-        Les

For more information contact Les Jackson via les@icecreates.com or 0151 647 4700

NHS Health Check Case Study

How to increase NHS Health Check uptake in your area 

Read more... NHS Health Check Case Study

To take advantage of our successful model and the support we can provide please see our case study or contact Graeme Morgan on 0797 357 8337 or at graeme.morgan@icecreates.com