Building a Better Health Service

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Miriam’s support vital for smokers quitting

Quitting is something most of us are trying to avoid right now – holding firm and hanging on is where we are all aiming to be.  Yet, for the thousands of smokers who annually embrace the New Year as the right time, quitting is very much something they want to do right now.

The success of the HSE Quit programme over the past decade has meant there are now more quitters than smokers in our midst and while the pandemic has brought such devastating consequences and impacted on every aspect of our lives, hundreds of individuals and many HSE staff are positively looking to make the break and quit smoking for good.

Having someone as empathetic, knowledgeable and positive as Cork based Smoking Cessation Officer Miriam O’Shea there to provide assistance is a welcome bonus.  Offering tailored support to both HSE staff as well as the general public, Miriam says the last 12 months have seen continuing referrals to the service.

“It has been constant.  Obviously, at the start of the pandemic we had to cease physical face to face interactions, so we had to re-organise how we deliver our service.  But we were already well placed to do that and so now we are offering virtual appointments through Attend Anywhere, the secure platform video link.   We offer telephone support as well – for a lot of people, that phone access is sufficient.  And so the reality for us is that we are actually reaching more people at the moment because of the new way of working.


(l to r) Priscilla Lynch,  Head of Service, Health & Wellbeing, Cork Kerry Community Healthcare,  Miriam O’Shea, Smoking Cessation Officer Cork Kerry Community Healthcare and Clr Tony Fitzgerald, Cork City Council and Manager of the Knocknaheeny Youth Centre

“Some people are particularly delighted that in the middle of the pandemic they can have this service brought right into their living room.  I have one client whom I ring at 11.30am every week for her follow up appointment.   That’s the time her baby has gone to sleep. She can chat, we talk through everything and most importantly it means she doesn’t have to take her baby out of the house, or find a sitter.  It means I am working around her and her daily routine which suits her best.”

Miriam’s referrals come from a variety of sources; “They come from across the spectrum – self referral, GP referral, hospitals, community based health professionals like dieticians.  Self referrals are more likely to be coming through the National Quit team but they can re-direct people back into the local services for clients who are looking for face to face support or group support (whenever that starts up again). It’s never quiet!

The focus on encouraging people to quit for 28 days is based on international research and evidence.  The process of supporting them in person and with products like Nicotine Replacement Therapy provides increases their chances of success.

“When you get support in quitting, you are doubling your chances of succeeding. When you use products such as NRT (under advisement) you are also doubling your chances.  So, all taken together, you are four times more like to succeed if you have support and use products including NRT.”

The support that Miriam provides is vital: “The value for us is that our clients commit to not having a puff of a cigarette, for them to know that they are not trying to stop smoking, they are either smoking or not smoking.  We trying to tease out critical dangerous times, trigger situations, and help them work through those so that they come at it and they have thought those times through and are prepared for them.   Preparation is the key to success.  The value of spending time planning and preparing before they reach their quit date is critical.”

Although Miriam stresses that Quit is not a reduction programme, they do take a client centred approach and work with people: “While our focus is on smoking, you do get to know the person really well. Of course it’s a stop smoking programme, we are very clear on that but our clients will have been smoking for loads of different reasons and it is an addiction so we meet them where they are at and support them as best and in as holistic a way as possible. 

“Any positive change any client makes we affirm it, we build them up.   I had a client who had gone from 30 to six cigarettes a day and we worked out how many minutes a day she was gaining back by reducing in that way.  I would point out that there are lots of the times of the day that she would have smoked that she isn’t now, so her confidence around quitting is greater.”

The Quit plan allows for Miriam to work with the client and prepare for their quit date and aiming to get to 28 days smoke free: “Looking four weeks in advance can seem a very far away and I know they are just trying to get through the here and now.  So we try to break it down to each day, to where they are at - get through the morning, then get through the day.  But if they do find they can get through the day and not have one puff of a cigarette for four weeks then they are five times more likely to not smoke again.

The impact of the service is often not just specific to quitting: “It can act as a catalyst.  If the person succeeds in quitting, then they often think there are loads of other things they can now do in their lives.  It can be anything from learning to drive or maybe using the positive experience to reach out further and maybe address other issues or challenges in their lives.

“Its re-assuring for people to know that when they come to me, they probably have several attempts behind them, and so their chances of success now are greater because they have learned what works and what doesn’t work. “

“I had a girl with MS who came into the group one day.  She had been referred on to me through her MS Support Group.  She came into our group here and on the very first day she said “I’m here now but I am not going to quit smoking.”  She said she just wanted to see what it was all about.  By the end of the six week programme, the other group members were looking to her because of how good a client she was.  She quit smoking and has been smoke free for two years now. 

“When she arrived there was no pressure, no expectation,   I often say to people, let’s just see what happens, let’s do the assessment and by the end of the assessment, they know more about their smoking.  We weigh up the pros and cons of smoking versus quitting.”

The support is very personalised for each individual.  “Each person is coming with their own background and story.  One client I am supporting is now a guardian for her grandchild.  She had a heart attack this past Christmas but is doing well.  But for her, the big motivator is that as a his guardian she does not want to smoke around her grandchild and equally she wants to ensure she can live a long life to be able to look after him.”

A recent client Miriam supported was spending €120 a week on cigarettes and once she quit, she calculated that she would be saving about €6700 a year.  While the financial element wasn’t the sole reason for quitting for her, it was one of the very real benefits that would accrue.  Another individual who was receiving ongoing medical care had told Miriam she was due back for a consultant appointment mid-February.   Miriam asked her what would it be like to go back to the consultant and be able to tell them they are three weeks smoke free. “It had an impact.”

Ultimately Miriam stresses that “Its about giving people hope, then giving them a plan and supporting them to implement it. Lots of people have come back over the years and said ‘you never gave up hope on me’, ‘you always believed I could do it’.”

It’s easy to see how the support Miriam provides impacts on lives and improves them. 

For more information on quitting smoking visit