Working in smoking research: Alix Covenant
Alix Covenant is a health trainer at the University of Oxford who works on The Trial of physical Activity and Reduction of Smoking (TARS) study, which is looking at whether giving smokers one-to-one support can help them cut down or quit. Participants were recruited from their GP practices and randomly allocated to receive either this support or a single appointment to discuss stopping smoking, to compare the two.
What do you do in your role as a health trainer?
“Our aim is to help people achieve what they want, whatever their overall goal is we discuss strategies and work out steps together to allow them to succeed. In the case of the TARS study, this is focused on helping people with smoking, either to reduce or quit. We meet people out in community areas in places convenient to them.”
What made you want to work in research?
“I was a health trainer for three years before I took the job on the TARS project. I wanted to affect policy rather than be part of the policy that was already formed. I wanted to try and push public health policies in the right direction and the way to do that is through research.”
What does the TARS study involve?
“We’re trying to show that supporting people and giving them one-to-one help means that more people reduce or quit smoking. It’s all based on what they want to do. Quite often what they want to do changes throughout the study. For example, some people begin saying they don’t want to quit and just want to reduce and then by the end of it are saying ‘yeah, I think I’m going to quit eventually’. It helps them focus and understand that it’s not about completely cutting out cigarettes instantly on a set day, they can drop steadily and work out the issues in their head. They can also use that time to look at each issue separately. For example, some people smoke when they’re stressed or when they drink or when they’re bored and most people do a combination of all three. It’s about trying to find the best strategy for them to deal with each situation.Also, a lot of smoking is triggered by routine and habit and if you change those you can often change your smoking behaviour too.”
What strategies have you used with patients?
"Generally it’s a combination of what they think and what we think. I’ve got one lady, for example, who really struggled with telling herself that she couldn’t have a cigarette so we talked about distractions instead. I advised that every time she wanted a cigarette she should distract herself for 10 minutes before having one and she’s now able to distract herself for hours. We do ask people to rate cigarettes too, for example people will rate their first cigarette in the morning highly and they’ll rate them lower throughout the day. It makes people realise they don’t want them as much. Even analysing what you’re doing is enough to make you change what you’re doing. A lot of smoking habits are unconscious and when you take them into consciousness, you’re able to change them because you become aware of them.”
How can physical activity help smokers cut down?
“Physical activity was brought into the study because research has shown that it can help fight cravings for cigarettes. I found that those who take to it really enjoy it and say that it helps them, not just with dealing with cravings, but it also makes them feel healthier.”
What activities do people go for?
“Mostly walking. It’s easy, it’s free and it’s outside everyone’s back door. I’ve also had people swim, run and ride their bicycles. It all depends on what people enjoy because it’s easiest to build healthy habits if you are having fun.”
Have patients responded positively to the study?
“Yes. Almost everybody I’ve seen has reduced how much they smoke and most people reduce significantly with a few stopping completely. Even if you cut down by half, it makes a significant difference to your health. It’s also good for you on a psychological level because you realise that you can cut down, which is something a lot of people don’t believe they can do. It’s also helped them to leave the study with the tools to either continue to cut down or stop completely.”
What do you enjoy most about your job?
“When people walk away having made a significant difference to their lives, whether they’ve cut down or quit, I know they’re happier.”
