• Smoking
  • Alcohol
  • Diet
  • Safe Sun
  • Health Promotion Room

We offer support to patients who wish to stop smoking. We can arrange for patients to meet with a smoking cessation advisor or you can contact Resolution (The Stop Smoking Service) yourself on 0845 045 2828.

We provide nicotine replacement therapy, and organise prescriptions for alternative therapies, such as tablets to reduce cravings etc.

The programme is client centred and emphasis is on ways of helping quitters.

Some topics covered include:

  • Coping with cravings.

  • Ways of breaking very old ingrained habits

  • Coping with stress without smoking

  • Relaxation Techniques

  • Prevention or limitation of weight gain.

  • We focus on changing the way smokers think about tobacco, aiming for lifelong non smokers.

Some tips which may help you to stop smoking

  • Set a date for stopping, and stop completely. (Some people prefer the idea of cutting down gradually. However, research has shown that if you smoke less cigarettes than usual, you are likely to smoke more of each cigarette, and nicotine levels remain nearly the same. Therefore, it is usually best to stop once and for all from a set date.)

  • Tell everyone that you are stopping. Friends and family often give support.

  • Get rid of ashtrays, lighters, and all cigarettes.

  • Be prepared for some withdrawal symptoms. When you stop smoking, you are likely to get symptoms such as: feeling sick, headaches, anxiety, being irritable, craving, and just feeling awful. These symptoms are caused by the lack of nicotine that your body has been used to. They tend to peak after 12-24 hours, and then gradually ease over 2-4 weeks.

  • Be aware of situations in which you are most likely to want to smoke (for example, the pub). Try changing your routine for the first few weeks.

  • Take one day at a time. Mark off each successful day on a calendar. Look at it when you feel tempted to smoke, and tell yourself you don't want to start all over again.

  • Be positive. Tell people that you don't smoke. You will smell better. After a few weeks you should feel better, taste your food more, and cough less. You will have more money.

  • Food. Some people worry about gaining weight when they give up smoking as the appetite may improve. Be prepared for an increase in appetite, and try not to increase fatty or sugary foods as snacks. Try sugar-free gum and fruit instead.

  • Don't despair if you fail and have a cigarette. You don't have to start smoking again. Examine the reasons why you felt it was more difficult at that particular time, and try again. On average, people who eventually stop smoking have made 3 or 4 previous attempts.

  • Stop smoking clinics are available on the NHS. They have a good success in helping people to stop smoking. Your doctor may refer you to one if you are keen to stop smoking but are finding it difficult to do so.

  • Various medicines can increase your chance of quitting. These include Nicotine Replacement Therapy (NRT) which comes as gums, sprays, patches, tablets, lozenges, and inhalers. You can buy NRT without a prescription. Also, medicines called bupropion (trade name 'Zyban') and varenicline (trade name 'Champix) can help. These are available on prescription.

Further help and information

Quit - a charity that helps people to stop smoking.
Quitline: 0800 00 22 00 Web: www.quit.org.uk

Smokefree - information from the NHS
Free smoking helpline 0800 022 4 332 Web: www.smokefree.nhs.uk
For help and advice on stopping smoking, and for details of your local NHS Stop Smoking Service.

What are the safe limits of alcohol drinking?

  • Men - no more than 21 units per week (and no more than 4 units in any one day).

  • Women - no more than 14 units per week (and no more than 3 units in any one day).

  • Pregnant women, and women trying to get pregnant, should not drink alcohol at all.

In general, the more you drink above these limits, the more harmful alcohol is likely to be. Also, binge drinking (for example, 10 units twice a week) can be harmful even though the weekly total may not seem too high.

One unit of alcohol is 10ml (1cl) by volume, or 8g by weight, of pure alcohol. For example:

  • One unit of alcohol is about equal to:

    • half a pint of ordinary strength beer, lager, or cider (3-4% alcohol by volume), or

    • a standard pub measure (50ml) of fortified wine such as sherry or port (20% alcohol by volume).

  • There are one and a half units of alcohol in:

    • a small glass (125ml) of ordinary strength wine (12% alcohol by volume), or

    • a standard pub measure (35ml) of spirits (40% alcohol by volume).

  • Note: many wines and beers are stronger than 'ordinary' standard strength.

What problems can develop if I drink too much alcohol?

You have an increased risk of developing illnesses

For example:

  • Serious liver disease (cirrhosis or hepatitis).

  • Stomach and pancreas disorders.

  • Depression and anxiety.

  • Sexual difficulties.

  • Muscle and heart muscle disease.

  • High blood pressure.

  • Damage to nervous tissue.

  • Accidents - in particular injury and death from fire and car crashes.

  • Some cancers (mouth, gullet, liver, colon and breast).

  • Obesity (alcohol has many calories).

You may become alcohol dependent

This means that if you stop drinking alcohol for a day or so, you suffer unpleasant withdrawal symptoms. For example: feeling sick, trembling, sweating, craving for alcohol. So, you end up drinking alcohol every day to avoid these symptoms.

You can damage others

Many families have become severely affected by one member becoming a problem drinker. Emotional, financial, and psychological distress often occur in such families. Often the problem drinker denies or refuses to accept that the root cause is alcohol.

Tackling the problem of heavy drinking

Many people can quite easily cut down on heavy drinking. Try drinking low alcohol beers, pacing the rate of drinking, or drinking on fewer days of the week. For some people it is more difficult.

  • Accepting that you may have a problem can be the biggest step to returning to sensible drinking. Counselling and support from a doctor, nurse, or counsellor often helps.

  • A 'detoxification' treatment may be advised for some people.

  • Referral for specialist help is needed in some cases.

Further resources and sources of help

Drinkline - National Alcohol Helpline Tel: 0800 917 8282
Offers help to callers worried about their own drinking and support to the family and friends of people who are drinking. Advice to callers on where to go for help.

Alcoholics Anonymous PO Box 1 10 Toft Green, York, YO1 7ND
Helpline: 0845 769 7555 Web: www.alcoholics-anonymous.org.uk
There are over 3000 meetings held in the UK each week with over 40,000 members. The only requirement for membership is a desire to stop drinking.

AL-Anon Family Groups 61 Great Dover Street, London, SE1 4YF
Tel: 020 7403 0888 Web: www.al-anonuk.org.uk
Offers support for families and friends of alcoholics whether the drinker is still drinking or not.

Know Your Units campaign From the NHS
Web: www.units.nhs.uk
Aims to tell drinkers how many units are in their drinks and help them stick to their limits.

Department of Health - Their alcohol misuse page
Web: www.dh.gov.uk/en/Publichealth/Healthimprovement/Alcoholmisuse/index.htm
Includes information on the National Alcohol Strategy, and policy and advice on sensible drinking and the prevention of alcohol misuse.

Basic principles of a healthy diet

Eat plenty of starchy foods (complex carbohydrates)
The main part of most meals should be starchy foods such as bread, cereals, potatoes, rice, and pasta, together with fruit and vegetables. Some people wrongly think that starchy foods are 'fattening'. In fact, they contain about half the calories than the same weight of fat.

Eat at least five portions of a variety of fruit and vegetables each day
One portion is: one large fruit such as an apple, pear, banana, orange, or a large slice of melon or pineapple, OR; two smaller fruits such as plums, satsumas, etc, OR; one cup of small fruits such as grapes, strawberries, raspberries, cherries, etc, OR; two large tablespoons of fruit salad, stewed or canned fruit, OR; one tablespoon of dried fruit, OR; one glass of fresh fruit juice (150ml), OR; a normal portion of any vegetable (about two tablespoons), OR; one dessert bowl of salad.

Eat protein foods in moderation
Meat, fish, nuts, pulses, chicken, and similar foods are high in protein. You need some protein to keep healthy. However, most people eat more protein than is needed. Choose poultry such as chicken, or lean meat. Oily fish is thought to help protect against heart disease. For example, herring, sardines, mackerel, salmon, kippers, pilchards, and fresh tuna (not tinned tuna). Aim to eat at least two portions of fish per week, at least one of which should be oily.

Don't eat too much fat

  • Try not to fry much food. It is better to grill, bake, poach, barbecue, or boil food. If you do fry, use unsaturated oil such as corn, sunflower or olive oil. Drain off the oil before eating.

  • Choose lean cuts of meat, and cut off any excess fat.

  • Try not to add unnecessary fat to food. For example, use low fat spreads, spread less butter or margarine on bread, measure out small portions of oil for cooking, etc.

  • Watch out for hidden fats that are in pastries, chocolate, cakes, and biscuits.

  • Have low-fat milk, cheeses, yoghurts, and other dairy foods rather than full-fat varieties.

  • Avoid cream. Use low fat salad cream, or low-fat yoghurt as a cream substitute.

Don't have too many sugary foods and drinks
These are high in calories, and too much may cause weight gain (and they are bad for your teeth).

Try not to eat too much salt
Use small amounts of salt with cooking, and don't add more salt at the table.

Don't drink too much alcohol
A small amount of alcohol (1-2 units per day) may help to protect you from heart disease. One unit is about half a pint of normal strength beer, or two thirds of a glass of wine, or one pub measure of spirits. However, too much can be harmful. Men should drink no more than 21 units per week (and no more than four units in any one day). Women should drink no more than 14 units per week (and no more than three units in any one day).

Understanding sunlight

Too much sunlight is harmful and can damage the skin. There are two main types of damaging ultraviolet (UV) sunlight, UVA and UVB. UVA has an effect of ageing the skin and causing wrinkles and other damage to deeper layers of skin. UVB causes sun tanning but also burning. It can also cause other damage to the skin.

Who is at risk from the sun?

All people are at risk if exposed to too much sun. People most at risk are those with fair skin, freckles, red or ginger hair. It is not just people who sunbathe who are at risk. Outdoor workers and people simply being outdoors who do not protect their skin are also at risk.

What are the possible problems from the sun?

Sunburn and sunstroke
Short term overexposure to sun can cause burning. The skin becomes red, hot and painful. After a few days the burnt skin may peel. A cool shower or bath will help. Soothing creams such as calamine lotion will help. Paracetamol will help with pain. A mild steroid cream may be advised by a pharmacist or doctor to reduce inflammation in the skin.

If vomiting, fever and headaches occur this may be due to sunstroke. If this occurs make sure you have plenty to drink to prevent dehydration. Paracetamol or ibuprofen will help to ease headaches and fever. Consult your doctor if it does not quickly settle.

Skin damage
Repeated exposure to too much sun over a number of years can cause damage to skin. The effects of sun damage include: premature skin aging and wrinkling, brown spots, actinic keratoses (benign warty growths on the skin), and skin cancer.

Skin cancer
About 9 in 10 non-melanoma skin cancers, and about 6 in 10 melanoma skin cancers (the most serious form of skin cancer) are thought to be caused by excessive exposure to the sun. In particular, episodes of sunburn greatly increase the risk. Skin cells that are damaged are at greater risk of becoming abnormal and cancerous.

All people of all ages should protect their skin, but it it is even more vital to protect children. Although skin cancer is rare in children, the amount of sun exposure during childhood is thought to increase the risk of developing skin cancer in adult life. Therefore, take extra care with children, and keep babies out of the sun completely.

How can I protect skin from the sun?

Avoid the sun as much as possible when the sun is strong
In the UK, stay in the shade or indoors as much as possible between 11 am and 3 pm in the summer months (May to September). This applies all year round in hotter countries nearer to the equator. This middle time of the day is when the sun's ray's are the strongest. Trees, umbrellas, canopies, etc, provide good shade.

Cover up
Cover up the body as much as possible when you are out in the sunshine.

  • Wear wide brimmed hats with a brim that goes all around the hat to protect the face and neck. These are the areas most commonly affected by sun damage. Baseball caps are not so good as they shade the face but not the neck, lower face and ears. Young children should wear hats with neck protectors too.

  • Wear loose baggy T-shirts (or even better - long sleeve tops) and baggy shorts. The material should be tightly woven which blocks sunlight.

  • Wear wrap around sunglasses (your eyes can get sun damage too). Make sure the sunglasses are ones which protect against UV light.

Use factor 15+ sunscreen (sunblock) liberally
You should apply sunscreen with an SPF (Sun Protection Factor) of at least 15. Be sure to cover areas which are sometimes missed such as the lips, ears, around eyes, neck, scalp if hair is thinning, hands, and feet. You should not think of sunscreen as an alternative to avoiding the sun or covering up. It is used in addition. No sunscreen is 100% effective and so it provides less protection than clothes or shade. Ideally:

  • Apply 20-30 minutes before going out into the sun (it takes a short time to work).

  • Re-apply frequently, at least every two hours, and always after swimming or towelling (even those that say they are waterproof).

  • Reapply to children even more often.

  • Use a 'broad spectrum' sunscreen to protect against UVA and UVB.

Some things that you might not realise

  • Sunscreens less than factor 15 do not give much protection. Always use factor 15 or above.

  • Sunscreens can 'go-off' and not work after a time. Therefore, do not use out of date sunscreen (see the 'use by' date on the packet). Most have a shelf-life of 2-3 years.

  • Some experts think that the increased use of sunscreen lotions and creams may give a false sense of security. This may encourage people to go into the sun more, and as a result, cause an increase in your risk of developing skin cancers. It has to be emphasized that sunscreen only partially protects your skin. Using sunscreen does not mean that you can sunbathe for long periods without harm. If you tan - you have done some damage to your skin.

  • Reflected light can damage too. On sunny days, even if you are in the shade, sun can reflect onto your skin. Sand, water, concrete, and snow are good reflectors of sunlight.

  • Wet clothes let through more UV light than dry clothes. Take spare clothes with you if you expect to get wet.

  • Clouds may give a false sense of security. Most of the UV radiation from sunshine still comes through thin cloud. Thick cloud provides some protection, but you still need protection when there is thin cloud.

  • Many clothes worn in hot weather (thin T-shirts etc) actually allow a lot of sunlight through. You need to wear tightly-woven clothes to protect from the suns rays. If you can see light through a fabric, damaging UV rays can get through too.

  • The suns rays are more powerful at higher altitudes. It may be cooler up a mountain but you will need more skin protection.

  • Fair-skinned people who sunburn easily are at particularly high risk of developing skin cancer and should be most careful about protecting their skin.

  • There is no such thing as a healthy tan. A tan is the skin's response to the sun's damaging rays.

  • Artificial tanning from sun-ray lamps and 'tanning parlours' are probably just as damaging as sunshine - so avoid them.

  • It's not the heat that does the damage but the UV radiation in sunlight which is present all year. You can get a lot of exposure to UV doing winter sports such as skiing as it is often done in sunny weather and at high altitudes. In particular, when out in ice and snow which reflects a lot of sunlight, wear a hat, sunscreen, lip balm, and sunglasses.

The UV index

The met office provide information called the 'Solar UV index' with their weather forecasts. The index is given as a figure in a triangle over the maps they use when giving forecasts. Basically, the higher the index (from 1 to 10), the greater the risk from the sun, the more care you should take of your skin when outside. See their website (given below) for details.

Further help and information

SunSmart - www.cancerresearchuk.org/sunsmart/
The UK's national skin cancer prevention campaign. Run by Cancer Research UK.

Solar UV index forecast - www.met-office.gov.uk/weather/uv/
From the met office

During Surgery Hours you can visit the Health Promotion Room. You can get leaflets on various topics including stopping smoking, alcohol, diet and contraception.

You can also -

  • Check your blood pressure

  • Check your pulse

  • Measure you height and weight