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Help and advice on quitting smoking

Medication Compliance

Over half the medicines prescribed by doctors are either never taken or taken only very briefly. This may sound surprising, but it is in fact true. Even people who are gravely ill or facing imminent death show a tendency to not take their medicines, or to reduce the dosage in a way that is very dangerous for their health.

Let’s look at some statistics:

  • Around 15% of boxes containing medication are never opened, and a further 25% are barely opened

  • 20% of people with heart conditions do not take their anti-cholesterol drugs

  • 36% of diabetics take insufficient doses of their medication, and 9% do not take anything at all

  • 79% of teenagers with HIV have stopped their treatment at least once

It is easy to see why Medication Compliance has become a subject of study in its own right over the past few years. Nowadays, we try to sweeten the pill – patients no longer have to follow the doctor’s orders without having any say. On the contrary, the doctor and the patient may discuss the situation as equals in order to come to an agreement via the “therapeutic education” of the patient.

If the behaviour described above seems surprising, it is not necessarily rational. Scientists now know that certain treatments have a greater chance of being followed than others. Specifically:

  • Compliance depends on the number of pills to be taken daily. It averages 88% for 1 pill a day but only 39% for 4 pills a day.

  • Compliance increases if the treatment produces good effects at an early stage

  • Compliance decreases if side effects immediately occur

  • Compliance improves if the patient has a good self-image and good self-esteem

  • Compliance improves if the patient’s friends and family are understanding and supportive

  • If patients think their condition is serious and that their medicine is working, their compliance will be better

  • So-called "silent diseases" requiring major changes in behaviour are linked to bad compliance

  • Even when patients start off taking their medicine properly, they may be tempted to suddenly stop taking it when they feel better

Most studies on medication compliance focus on diabetes, cardio-vascular diseases and psychiatric disorders. Compliance in the field of smoking cessation has been little studied, despite the potential interest for public health. All the same, we know that relatively few people who want to stop smoking try nicotine replacements, and if they do, they often take doses which are too weak for periods which are too short for the treatment to be effective.

As for the cigarette, it has never known such problems. It can be fascinating to observe how “compliant” people are when it comes to this product – not a day goes by (or in some cases, not an hour) when they do not smoke. Of course, nicotine dependency is a large part of this, but it does not explain everything. The same people who smoke religiously tend to shun nicotine replacement products when they try to stop smoking, even though these products are proven to be effective and less dangerous than cigarettes. From our point of view at, better informing the public is undoubtedly part of the solution.