1. Session #3 Cravings, withdrawal and coping strategies

2. Outline Session #3 Welcome and introductions Group guidelines
How smoking impacts Mental Health
How smoking impacts Physical Health
How smoking affects non-smokers
Costs of smoking
Withdrawal symptoms
Registration forms
PACT - MHG

3. Group Expectations Review…
Review flipchart or insert slide from week 1 for review
Ask for a volunteer to read out loud
PACT - MHG

4. Why is nicotine so addicting?
In brain in 7-10 seconds from inhaling
Binds to receptor – releases dopamine
Dopamine
increases pleasure, relaxation, alertness
Decreases fatigue, anxiety, stress
PACT - MHG

5. Why is smoking harmful? Exposure to more than 4000 chemicals
50 chemicals known to cause cancer
Smoking reduces lifespan
Smoking reduces lifespan, quality of life
Increased risk of suicide
Causes 80% of addiction related deaths
PACT - MHG

6. Smoking reduces lifespan
Every cigarette smoked reduces your life by 8 minutes
A pack a day smoked loses:
3 hours per day
~ 1 day per week
~ 48 days per year
PACT - MHG

7. Smoking reduces quality of life
Heart disease
Lung disease
Cancers
Ulcers
Skin, eyes, teeth, mouth, throat…
PACT - MHG

8. Smoking affects non-smokers
Heart disease
Lung disease
Cancers
Fetus/infants/children
Pets
2nd & 3rd hand smoke
PACT - MHG

9. Smoking is expensive A pack-a-day costs more than $84/week $360/month
$4380/year
(based on average $12/pack)
What could YOU do with that extra money? Easier to pay rent/groceries, buy clothes, personal items, occasional movie or eating out, …….
Can generate some interesting discussion!
One paatient saved enough money to buy contact lenses!!
PACT - MHG

10. Symptoms caused by smoking
Cough
Trouble breathing
Bad breath
Stained fingers
Dental problems
Cold hands/feet
PACT - MHG

11. Diseases caused by smoking
Lung disease
Heart disease
Cancer
Ulcers
Poor circulation
PACT - MHG

12. Benefits of reducing/quitting
Within 20 minutes – heart rate slows
Within 48 hours - ↓ risk of heart attack
After 1 year - risk of heart attack ↓ 50%
Reduce blood pressure, reduce risk of complications of diabetes
Less stress and anxiety
Some medication doses can be decreased
The very best thing you can do for your health
MORE money for food, rent, clothes….
PACT - MHG

13. Wiggle Break!!
PACT - MHG

14. Does smoking reduce stress?
NO!
Initially seems to ↓ stress and ↑ relaxation
BUT…
The effect is very brief
Withdrawal between cigarettes ↑ stress and anxiety
PACT - MHG

15. Afraid to reduce/quit because………
Record ideas from group discussion
PACT - MHG

16. Withdrawal Symptoms Cough Headache Irritable, grumpy
Tired, can’t sleep
Restless, can’t concentrate
Hungry
PACT - MHG

17. Cough
WHY:
lungs work better and clear mucous which has blocked airways
TIME:
a few days
DO:
drink lots of fluids, hot water with lemon/honey
Sugarless cough drops or hard candies
PACT - MHG

18. Headache WHY: TIME: DO: more oxygen, less carbon monoxide in body
1-2 weeks
DO:
drink lots of water, take pain reliever, relaxation exercise, warm bath
PACT - MHG

19. Irritable, Grumpy WHY: TIME: DO:
body craves nicotine, missing pleasure feeling
TIME:
2-4 weeks
DO:
reduce caffeine, walk or other exercise, deep breathing, hot bath, relaxing music
(Let family & friends know this might happen – ask for their help)
PACT - MHG

20. Tired, can’t sleep WHY: TIME: DO:
Brain is adjusting to lack of nicotine
TIME:
2-4 weeks
DO:
reduce caffeine, avoid caffeine in afternoon/evening, exercise, deep breathing, bedtime routine, hot bath/shower, relaxing music
PACT - MHG

21. Restless, can’t concentrate
WHY:
Brain is adjusting to lack of nicotine stimulation
TIME:
Less than 2 weeks
DO:
Make to-do lists, allow extra time for tasks, exercise, deep breathing
PACT - MHG

22. Hungry WHY: TIME: DO: Hand-mouth habit Food smells and tastes better
10-12 weeks
DO:
Drink lots of water, low-calorie, healthy snacks, keep hands busy (crafts, puzzles, hobbies) exercise
PACT - MHG

23. Common strategy?
EXERCISE!
PACT - MHG

24. Remember…
Withdrawal symptoms are normal – they are positive signs that your body is starting to heal!!
PACT - MHG

25. Some advise is not helpful!
PACT - MHG

26. Try using the 4 Ds Drink plenty of water Delay for 5-7 minutes
Do something else
Deep breathing
PACT - MHG

27. Are you thinking about reducing or quitting?
Yes No
Not sure
PACT - MHG

28. Weekly Activity
PACT - MHG

29. Forms For any new attendees Program registration Consent form
Tobacco/health history
Fagerstrom/Why
Registration and consent forms facilitate
- de-identified research
- billing by the presenter’s pharmacy to a fund which is administered by the drug plan
- the program is NOT “free” – there is a cost, but the participants are not required to pay that cost
- the money is a pharmacy fund, not government funds
- advise doctors/dentists re quit attempt, encourage their support
- some medication doses may need to be adjusted, pharmacist will discuss with prescriber for those who quit or significantly reduce use – pharmacist may check provincial drug records (PIP)
Forms take a fair amount of time, most participants will need assistance to complete.
Helpful to have a second person available for this part of the process.
PACT - MHG

30. See you next week!
PACT - MHG