1. Smoking

2. Why people smoke and find it difficult to stop Smoking is an addictive habit. It is associated with strong cravings, dependency, tolerance, and withdrawal symptoms that can last for weeks Smoking habits are reinforced by social ‘rituals’. Craving is only partially relieved by administration of pure nicotine 70% want to give up, a third try each year, but less than 3% are successful. Most make multiple attempts Most smokers start smoking in adolescence Children smoking habits are strongly influenced by smoking habits of their family and friends, and by advertising

3. How does smoking affect the health of smokers? “Smoking remains the leading cause of preventable morbidity and premature death in the UK….”

4. Harms of smoking Tobacco smoke is carcinogenic and highly toxic Smoking is the leading cause of preventable morbidity and premature death in the UK— lifelong smokers can expect to die about 10 years younger than never-smokers Smoking increases the risk of cancer, heart disease, respiratory diseases, reproductive disorders, and many other diseases Increasing levels of smoking increase the risk The only safe cigarette is the one that is not smoked

5. Benefits of quitting AFTER 20 mins Heart rate drops 12 hoursCarbon monoxide level in your blood drops to normal 2 wks to 3 months Heart attack risk begins to drop. Lung function begins to improve 1 to 9 months Coughing and shortness of breath decrease 1 year Added risk of CHD is half that of a smoker’s 5 yearsStroke risk is reduced to that of a nonsmoker’s 5-15 years after quitting 10 years Lung cancer death rate is about half that of a smoker’s Risk of cancers of the mouth, throat, oesophagus, bladder, kidney, and pancreas decreases 15 yearsRisk of CHD is back to that of a nonsmoker’s

6. The 5 basic ways to help smokers quit 1.Increase the price of cigarettes 2.Prohibit smoking in public places 3.Create and disseminate effective counter marketing messages about smoking (media, pack displays) 4.Ban tobacco advertising and promotion 5.Provide cessation aids – Counselling / Behavioural therapy – Pharmacotherapy NRT Bupropion Varenicline Nortriptyline, Clonidine Individual measures (NHS Stop Smoking Services) Population measures (Government initiatives)

7. Steps to quitting 1.Get ready 2.Get support 3.Learn new skills and behaviors 4.Get medication – if recommended by your doctor – and use it correctly 5.Be prepared for cravings and withdrawal symptoms

8. Steps to quitting Step 1: Get Ready Set a quit date Get rid of all cigarettes and ashtrays at home, work, and in your car Keep a diary of when and why you smoke Tell friends and family you’re going to stop

9. Steps to quitting Step 2: Get Support Your chances of success increase if you have a support network Ask friends, family, and co-workers for their support in helping you quit Ask others not to smoke around you or leave cigarettes out in the open Talk to your doctor/ pharmacist about tobacco’s effects on the body, choosing a quit plan, and dealing with withdrawal Get individual, group, or telephone counselling

10. Steps to quitting Step 3: Learn New Skills & Behaviours Distract yourself from urges to smoke – Talk to someone – Go for a walk – Get busy with a task – Go somewhere you’re not allowed to smoke Change your routine – Take a different route to work – Drink tea instead of coffee – Eat breakfast in a different place

11. Steps to quitting Step 3: Learn New Skills & Behaviours Reduce stress – take a hot bath, exercise, or read a book Plan something enjoyable to do every day Drink a lot of water and other fluids

12. Steps to quitting Step 4: Get Medication Your GP or pharmacist may recommend one of these to help you quit: – Bupropion SR (Zyban) – Nicotine gum – Nicotine inhaler – Nicotine nasal spray – Nicotine patch – Varenicline (Champix)

13. Steps to quitting Step 5: Avoid Relapse Most relapses occur within the first three months Avoid drinking alcohol – drinking lowers your chances of success Avoid being around other smokers – can make you want to smoke Expect a small weight gain (usually less than 10 pounds) Eat a healthy diet Stay active Look for ways to improve your mood other than smoking

14. Nicotine Replacement Therapy (NRT) Gives a dose of nicotine to reduce cravings which is reduced over time Patch, gum, lozenge, sublingual tablet, nasal spray, inhalator, oral spray Available on prescription, over the counter and on general sale and Smoking Cessation service in pharmacy

15. Zyban®and Champix® Non-nicotine tablets Start whilst smoking and set quit date for second week Reduces cravings (and the feel good effect of smoking) Prescription only medicines Not for under 18’s, in pregnancy, those with seizure risk, some drug interactions etc

16. Managing withdrawal If you crave a cigarette Wait out the craving (usually less than five minutes) Try deep breathing Use distractions Call someone in your support network Chew gum Brush your teeth

17. Changing behaviour "Giving up smoking is easy: I've done it a hundred times” Mark Twain

18. Renew your dedication Review your reasons for stopping Reward yourself for resisting urges to smoke Remind yourself often how well you’re doing

19. You can do it!! Tobacco addiction is a chronic disease – seek advice, support, and care from your GP/ Pharmacist to increase your chance of success Quitting smoking can reduce illness, prevent death, and increase your quality of life Quitting can be difficult – remember to ask for help You can do it!