An invitation to talk about tobacco — whether or not you are ready to stop.
You do not have to have decided anything to come in. A conversation about what you use, how much, and what has happened when you have tried before is useful on its own, and it costs you nothing to have it.
Why this is hard
Nicotine dependence is a medical condition, not a failure of character. It changes receptor density in the brain, and withdrawal from it produces irritability, poor concentration, disturbed sleep and a craving that is genuinely physiological. People who describe themselves as weak-willed are usually describing a well-treated-elsewhere illness that nobody has offered them treatment for.
Most people who stop for good have stopped several times before. Previous attempts are not failures — they are data. What happened, when it happened, and what you were doing at the time tells us a great deal about what will work this time.
This programme covers every form of tobacco used here, not only cigarettes: beedi, gutkha, khaini, zarda, paan masala with tobacco, snuff, hookah and vaping included. Smokeless tobacco is the form most often left out of quit services, and it is the form most used in this country.
What it includes
- Step 01
Assessment
What you use and how much, a dependence score, previous attempts and what happened, a carbon monoxide breath test, and spirometry where the chest is involved — so we know where your lungs are starting from.
- Step 02
A quit date, chosen by you
Set far enough out to prepare and close enough to be real. Preparation matters more than willpower: what changes at home, what you tell people, what you do at the times you would normally smoke.
- Step 03
Medication
Nicotine replacement — patches, gum and lozenges, often in combination — and where appropriate prescription medicines such as varenicline or bupropion. Each is explained: what it does, how long you take it, what it commonly causes, and who should not have it.
- Step 04
Behavioural support
Mapping the triggers that are specific to you, managing cravings in the moment, handling stress, alcohol, and the people around you who still smoke. Weight gain is discussed openly rather than waved away, because it is a real reason people restart.
- Step 05
Follow-up, with a number that moves
Carbon monoxide is measured at every visit. It falls within a day or two of stopping — which makes an invisible process visible, and is the most encouraging number in medicine.
| When | What happens |
|---|---|
| Week 0 | Assessment, CO breath test, quit date agreed, medication started |
| Weeks 1 and 2 | The hardest fortnight. Short reviews, CO measured, dose adjusted |
| Week 4 | Review and CO — the four-week mark is the strongest single predictor of long-term success |
| Weeks 8 and 12 | Review, CO, and a plan for tapering medication |
| 6 and 12 months | Follow-up, relapse prevention, and lung function repeated where relevant |
If you slip
A relapse is part of quitting, not the end of it
If you smoke one cigarette three weeks in, you have not undone three weeks. Come back and say so. The plan gets adjusted — usually the medication, sometimes the circumstances — and you carry on from where you are.
The single most damaging thing that happens after a slip is that people stop coming to appointments out of embarrassment. Nobody here is keeping score. Quitting takes time, and it is fair to take it one day at a time.
What changes, and how fast
Your body starts almost immediately
- Within 24–48 hours — carbon monoxide clears from your blood and oxygen carriage returns to normal. This is the number we measure.
- Within weeks — cough and breathlessness begin to ease; the airways become less irritable.
- Within months — lung function improves measurably, and the rate at which it declines with age slows to that of a person who never smoked.
- Over years — cardiovascular risk falls substantially, and cancer risk declines steadily.
It is never too late for this to be worth doing. Quitting helps at seventy as well as at thirty — the benefits are different, but they are real at every age.
For families
How to help without nagging
If you are reading this for someone else: pressure rarely helps and reminders almost never do. What does help is removing the friction — not smoking in front of them, changing the routine that surrounds their cigarette, being patient about irritability in the first fortnight, and treating a slip as a normal event rather than a betrayal.
You are welcome to come to the first appointment with them, if they want you there.
You can book just to talk about it
No quit date, no commitment, no lecture. If you use tobacco in any form and want to know where your lungs stand and what the options would be, that is a reasonable thing to come in for.