1. Tobacco products control amendment bill 2006 A nurse,s point of view Xandra van Biljon Xandra van Biljon

2. An emosional issue Tobacco companies – protect their investments Tobacco companies – protect their investments Anti-smoker – protect rights for own health Anti-smoker – protect rights for own health Smoker – wants protect rights of freedom Smoker – wants protect rights of freedom Patient – lost all rights to healthy life Patient – lost all rights to healthy life Nurse – sort out emosional issue Nurse – sort out emosional issue

3. Nurse as Rolemodel We stand for caring and healing We stand for caring and healing We should also prevent illness and disease We should also prevent illness and disease Smoking is a deadly disease Smoking is a deadly disease Smoking is PREVENTABLE Smoking is PREVENTABLE Do we have the training to deal with the tobacco epidemic? Do we have the training to deal with the tobacco epidemic? Do we have the skills to deal with smokers? Do we have the skills to deal with smokers?

4. in the end, it is the nurse Parliament Lobbies for and against smoker

5. Smoking Cessation Clinic Started July 1999 Started July 1999 Conducting scientific studies Conducting scientific studies Also offer counseling on private basis Also offer counseling on private basis Experience the devastating effects of cigarettes on daily basis Experience the devastating effects of cigarettes on daily basis How can we not speak out? How can we not speak out?

6. Smoke-free Public Places From my praxis perception: A large percentage of smokers prefer to eat in a non-smoking environment From my praxis perception: A large percentage of smokers prefer to eat in a non-smoking environment They have since learned how to eat out without smoking They have since learned how to eat out without smoking Children must be banned from smoking sections Children must be banned from smoking sections If we continue to make smoking an „effort“, cigarette consumption will decrease If we continue to make smoking an „effort“, cigarette consumption will decrease

7. Smokers work less hours Employers will get pressure from non- smoking employees because they work more hours for the same pay. Employers will get pressure from non- smoking employees because they work more hours for the same pay. A smoker (or employer!)loses at least 10 min of time for every smoke-break A smoker (or employer!)loses at least 10 min of time for every smoke-break Limit the smoke breaks to the tea-time and lunch-time Limit the smoke breaks to the tea-time and lunch-time

8. Big fat „Light“ lie Over 90% of our clients changed at one or other stage to a so-called „Light“ cigarette Over 90% of our clients changed at one or other stage to a so-called „Light“ cigarette Created the false impression – they smoke „healthier“ Created the false impression – they smoke „healthier“ Remove „Light“ from all cigarette packs Remove „Light“ from all cigarette packs BAN!! Buying singles BAN!! Buying singles

9. „Light“ in the pocket too! Smokers usually and gradually increase their tobacco consumption: instead of 10 „unhealthy cigarettes“, they smoke 20 „healthy“ cigarettes, but do not realise that they are spending double the amount of money! Smokers usually and gradually increase their tobacco consumption: instead of 10 „unhealthy cigarettes“, they smoke 20 „healthy“ cigarettes, but do not realise that they are spending double the amount of money! How many teenagers plan to become full blown smokers? How many teenagers plan to become full blown smokers?

10. What is available in SA today? No programs for nurses in their Curriculum for tobacco behaviour related issues No programs for nurses in their Curriculum for tobacco behaviour related issues No training of special skills for nurses in this field No training of special skills for nurses in this field Certain areas of nursing should be identified for instance Midwives, Clinics in the Communities, industrial nurses Certain areas of nursing should be identified for instance Midwives, Clinics in the Communities, industrial nurses

11. Smoke-free homes? Nurses encourage smokers to keep homes smoke-free, to protect non- smokers…..specially children, they cannot protect themselves Nurses encourage smokers to keep homes smoke-free, to protect non- smokers…..specially children, they cannot protect themselves If they are unwilling to stop, they can limit themselves to a certain area or better smoke outside If they are unwilling to stop, they can limit themselves to a certain area or better smoke outside

12. Smoke-free cars? Smallest confined smoke is in a car – how can we protect the non-smoker? Smallest confined smoke is in a car – how can we protect the non-smoker? How do we protect children in the same car? How do we protect children in the same car? What about taxi,s – complaints alone do not change behaviour, should the passengers just refuse to pay? What about taxi,s – complaints alone do not change behaviour, should the passengers just refuse to pay? Suggestion: inform parent – encourage parents to change their behaviour (national adds) Suggestion: inform parent – encourage parents to change their behaviour (national adds)

13. Effects of tobacco use Cancer Emphysema (long and slow death) COPD (chronic cough) Nurses should at all times make negative statemants about ill-effects of smoking Also the direct costs involved Also the direct costs involved Plus minus R37 000 over 7 years!! Plus minus R37 000 over 7 years!!

14. Regulation of tobacco products Very frustrating topic – we wait many months for nicotine studies to be approved Very frustrating topic – we wait many months for nicotine studies to be approved We wait up to 3 years to get safe and proven drugs (to help people quit) registered We wait up to 3 years to get safe and proven drugs (to help people quit) registered In contrast, how can the deadly product called „cigarette“ be so easily available? In contrast, how can the deadly product called „cigarette“ be so easily available? By-products of cigarettes are deadly, how come we allow this on the market? By-products of cigarettes are deadly, how come we allow this on the market?

15. Suggestions from a nurse Basic training ( 1 full day)for nurses of all clinics Basic training ( 1 full day)for nurses of all clinics Measure CO (breath test) like Bp Measure CO (breath test) like Bp Support the Help-line (011-720 31 45) Support the Help-line (011-720 31 45) Expose the truth about tobacco Expose the truth about tobacco Support the New Ammendmend Bill Support the New Ammendmend Bill Make more funds available for prevention Make more funds available for prevention

16. What do we need? Nurses best practice guidelines can be successfully implemented only: Nurses best practice guidelines can be successfully implemented only: Adequate planning Adequate planning Resources Resources Organizational support Organizational support

17. My plight? My motivation: to support the smoker in their quest to free themselves from this deadly addiction My motivation: to support the smoker in their quest to free themselves from this deadly addiction Protect the non-smoker, specially children, from the harmful effects of tobacco consumption Protect the non-smoker, specially children, from the harmful effects of tobacco consumption PREVENT anyone from taking the first cigarette!!!! PREVENT anyone from taking the first cigarette!!!!

19. Thank you