One of my favourite episodes of the exquisite British sitcom The Smoking Room is “Quitters”, where the disparate habitants of the eponymous workplace smoking room have to sit through a patronizing anti-smoking lecture led by a man dressed as a giant cigarette.
The product of gay writer Brian Dooley, and starring a host of British comic talent, it showed at its heart that smoking brings people together: even if they all hate each other.
At GMFA in London, there’s a different kind of smoking room: one in which guys who want to quit can gather for a weekly support session.
The sessions run for two hours on either Tuesday or Thursday evenings, and the whole course runs for seven weeks.
“The most recent data we have showed that 25% of the general male population in Britain smoke,” says Barry Dwyer, one of the facilitators. “For gay men, that goes up to 36%, and for HIV positive men 47%. The only group that even comes close to that last number is Bangladeshi men in one small area of London, Tower Hamlet.”
Dwyer is particularly concerned about the disproportionate effect that smoking has on HIV positive men.
“If you have a compromised immune system, whether you’re on meds or not, there has already been damage to your system. Add smoking to that mix, it adds to the risk of lung cancer, anal cancer, and dementia.”
The first few weeks of the course consist of information-gathering. Men are asked about other ongoing health issues, such as HIV status and presence of mental illness. This is important to know for two reasons: both practical (some anti-smoking treatments will interfere with HIV or antidepressant meds) and supportive.
Dwyer remembers one man with bipolar disorder who took the course. “During an episode of mania, sometimes everything goes out the window, and your only focus is getting through that time.
“This particular man found that it would creep up on him slowly, and manifest itself in different ways each time so he found it difficult to see when it was coming on, and then it would peak. In the group, we were able to talk about what cigarettes were doing for him during those times so he could find something to replace it with.”
An environment of trust is created within the group so men can feel comfortable sharing personal information.
“It’s one of the things I’m proudest about with the group. People turn up on a course where they’ve probably never met anyone before, and they talk about their most intimate details and secrets. We have group agreements that what’s said here remains here, so you’re not going to be walking through a supermarket one day and having someone point the finger at you.”
Information is also given out during the first two weeks of the course, including helpful details that aren’t always known about anti-smoking remedies – for example, nicotine gum.
“When you chew ordinary gum, you just chew it. But with nicotine gum, you’re supposed to chew it a couple of times to break it down, then park it between your teeth and gums, so the nicotine gets absorbed through the mucus membrane on the inside of your cheek. When people chew the gum in the ordinary way, you end up with a lot of nicotine going into your stomach, which makes people nauseous.”
People are encouraged to start using the quit remedies, be it gum, patches or the two pills available – Zyban (originally developed as an antidepressant) and Champix (which covers the receptors in the brain that cause pleasure from smoking) – before they quit.
“It takes away the pressure that you’ve moved straight from smoking to the replacement product. There’s also time for us to talk about whether that particular product is working for you.”
Week 3 is quit week, but Dwyer says it’s important to be realistic about this. Some anti-smoking courses will banish members if they fall off the wagon, but GMFA’s course doesn’t take this approach.
“We would prefer guys to come back and have the conversation about why they’ve tripped up rather than think, ‘I’m so bad that I can’t even give up smoking.’ We can talk that through and set a new quit date, or find out if the person genuinely isn’t ready to stop yet.”
Many who come to the group have attempted to quit smoking before.
“Coming to a group can help you identify those times when you may have gone back to smoking in the past. You don’t know you’re going to have an issue with something until it presents itself. For example, I got a call from one guy nine weeks after finishing our course and he said, ‘You’ll never guess what happened, I started smoking again – I went to my brother’s wedding.’”
Motivation is the most important factor in quitting, Dwyer says.
“We talk about this, and that surprises a lot of guys. If you’re doing this because your boyfriend or your doctor wants you to stop, but you don’t, then it’s not going to work. So part of this course asks the question, is this the right time for you to quit smoking? But we will be here to support you when you’re ready.
“There’s nothing worse than trying to give up smoking, failing, then continuing the behaviour because you feel so guilty about not giving up the behaviour!”
The remaining four weeks of the course are geared around dealing with cravings, and how to recognize the difference between smoking as an addictive pattern and smoking simply out of habit: helping people say no when cigarettes are offered, helping them deal with quitting if their partner is still smoking, or if the majority of their social circle still smokes, and what people can sometimes do to undermine your quitting choices.
GMFA operates on limited funding, so the course is advertised mainly through social media, volunteers (who run the courses), and word of mouth.
“The best recommendation is word of mouth. People get really passionate about the help we’ve given them. We get people who did the course ten years ago that want to help out – they’ll send us donations out of the money they’ve saved.
“It’s peer to peer, non-judgmental, and we don’t treat people as if they’re sick or addicts. They’re people with an ability to stop something that they want to stop doing and we support them in doing that.”
For more information about GMFA’s quit smoking course, click here.