1. Freshstart Facilitator Training
This PowerPoint is a tool available to assist you in facilitating the four Freshstart sessions.
The information in this PowerPoint is presented in the same order as the information in the Participant Guide.
There are notes for you as a facilitator in the notes section, but you will need to refer to the Participant Guide and corresponding Lesson Plan to prepare for each session.
Session 3: Your Quit Day

2. Session 3 – Objectives Understanding and managing nicotine withdrawal
Handling rationalizations
Stress management
Session 3 – Your Quit Day – focuses on a participant’s Quit Day and provides information about how to deal with nicotine withdrawal and rationalizations. Stress management, including relaxation techniques and working through negative thoughts, is also discussed. At the end of this session, participants should feel prepared to get through – and beyond – the first few days of quitting.

3. Session 3 – Progress Share & Review
Individual Attention and Review
Share progress or struggles since Session 2
Discuss homework
Begin session 3 with the Individual Attention and Review (10-15 minutes). Your goal is to see if any participants have stories or struggles to share since the second session. This could be related to completed homework or anything related to tobacco use.

4. Suggestions For Your Quit Day
Session 3 – Your Quit Day
Suggestions For Your Quit Day
Don’t smoke at all. Not even a puff.
Keep active.
Drink water.
Use NRT.
Attend a stop smoking class (like Freshstart!)
Avoid situations where your smoking urge is strong.
Avoid alcohol.
Think about changing your routine, at least temporarily.

5. Session 3 – Withdrawal Symptoms
Dizziness
Depression
Frustration
Anxiety
Irritability
Sleep disturbances
Headaches
Increased appetite
When smokers cut back or quit, the lack of nicotine leads to physical and mental withdrawal symptoms.
Physically, the body reacts to the absence of nicotine and mentally one has to handle the habits related to smoking.
Withdrawal symptoms start within 1-2 hours of the last cigarette and peak about 2-3 days later when most of the nicotine and by-products are out of the body.
Withdrawal symptoms can lead a person back to smoking in their attempt to alleviate the symptoms.
Call a pharmacist or see a doctor if your withdrawal symptoms get severe.

6. Session 3 – Rationalizations
“I’ll just have one to get me through this.”
“Today is not a good day. I’ll start tomorrow.”
You can probably add more rationalizations to the few that are listed.
As you go through the first few days of not smoking, write down any rationalizations that come up and recognize them for what they are: messages that can trick you to going back to smoking.
Be prepared for these, have an action plan and strategies to get your mind back on track.
To help stay committed to quitting, you can avoid temptation by avoiding people and places where you are tempted to smoke.
Change your habit by taking a different route to work or using a substitute in your mouth like sugarless hard candy or straws.
Use the 4 D’s (which we will talk about on the next slide) and reward yourself. Put the money you would have spent on cigarettes towards something else. What you are doing is not easy so pick a reward and look forward to it!

7. Session 3 – 4 D’s Do something else Drink water Deep breathing Delay
Do something else – Do something to relieve stress or keep your hands busy. This will distract you when you have the urge to smoke.
Drink water – During a craving drink cold water, slowly.
Deep breathing – When you smoked, you took deep breaths of a cigarette. Now take slow deep breaths of clean, fresh air. Remind yourself of your reasons for quitting.
Delay - If you feel you are about to slip, tell yourself to wait 10 minutes. This trick can get you past the strong urge.

8. Session 3 – Stress Management
Relaxation Techniques
Exercise 1: Deep-breathing
Exercise 2: Muscle relaxation
Other techniques
Think positively
Finding a way to manage stress and relax is important while quitting smoking.
Exercise 1: Sitting or standing. Place feet flat on the floor and close your eyes. Relax and let your head go to your chest. Slowly inhale through your nose, drawing your breath deep through your abdomen, feeling your stomach expand. Hold breath and slowly exhale through your nose. Repeat four times, if you get dizzy stop. When you are ready to complete exercise, open your eyes.
Exercise 2: Stand with feet planted on the floor and eyes closed. Begin by tensing your feet as if you were grabbing the floor with your toes. Stay in this position and tighten your grip, now move the tension up your body starting with your ankles, calves, and thighs, tightening as much as you can. Now move the tension through your stomach, chest and shoulders, and clench your fists. Now move the tension to your neck, face, mouth, eyes and scalp. Hold this tension for 5 seconds. 4, 3, 2, 1. Now slowly release the tension and open your eyes.
Other techniques - take a warm bath, listen to music, walk or meditate.
Think positive – some stressful situations cannot be taken away. You may have urges to smoke in these situations. If you are stressed and begin to have unpleasant, negative thoughts, think about how you will respond to the thoughts without smoking.
For example. When stressed, you think “I can’t handle this situation without a cigarette.”
Positive thought, “I am going to take these cravings one day at a time.”
If your thoughts are constructive you will have fewer moments of stress. Negative thinking can undermine your goals of health.

9. Session 3 – Positive & Negative Responses
List areas of stress in your life that you cannot change
Write a positive and negative way of thinking about the issue
Positive and negative stress responses (page 25 of participant guide)
Goal – Think about stressful situations in your life and how to act and think positively instead of negatively to such events. Being able to change negative thoughts around is crucial when trying to stay quit.
List areas of stress in your life that you cannot change. Write a positive and negative way of thinking about the issue.

10. Session 3 – Summary Managing stress will help you quit successfully
Focus on the fact that this time is unique. This time you are quitting for good!

11. Session 4 –Stay Quit Recover from slips
Practice for tough situations in the future
Discuss special concerns related to quitting
Review health benefits over time
Learn tips to stay tobacco-free
Overview & Purpose
This session of the American Cancer Society® Freshstart program looks at relapse prevention. At the end of this session, participants should have tools to deal with quit attempt slips and future tough situations where they might be tempted to smoke.