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and , Cloves and Brown Health Services Patient Education Series

Why are and nicotine have a nicotine content that is 3-5 times products dangerous? that of a cigarette. Cigarette smoking is a known cause of many , as well as lung disease, heart disease, What about ? ulcer disease and osteoporosis. Cigarette Chewing tobacco and are associated with smoking also can cause pregnancy substantial risks for gum and mouth cancers, complications, premature aging/wrinkling of stained teeth, bad breath and loss of taste. your skin and can contribute to sexual , a of moist snuff, has a nicotine problems. Nicotine is the major contributing content 2-6 times that of a cigarette. factor to the dependence-forming properties of tobacco use. The effects of nicotine include What about e-? increased blood pressure, headaches, sleep Electronic cigarettes are battery operated ​ disturbances, increased blood clotting, pain in devices that provide doses of nicotine for joints, diarrhea, problems with blood sugar inhalation. A nicotine-containing liquid available metabolism and most importantly, ADDICTION. in a variety of is put in the device. While In fact, research suggests that nicotine may be e-cigarette manufacturers promote their as addictive as heroin, cocaine and . products as a path to , there What about smoking clove cigarettes, , is no research that supports this. The Centers hookah and bidi? for Disease Control and Prevention (CDC), U.S. ● Clove cigarettes () also contain Food and Drug Administration (FDA), state, and ​ nicotine. In fact blood levels of nicotine local health agencies are investigating a and carbon monoxide from smokers multistate outbreak of severe pulmonary were tested after smoking kreteks and disease associated with e-cigarette product use. were found to be similar to non-clove Hundreds of cases of lung illness including brands of cigarettes, such as . deaths have been associated with the use of ● Cigars may have up to 4 times the e-cigarette products nationwide. Seek ​ ​ nicotine of a cigarette. immediate medical assistance should you ● Hookah uses black “air-cured” tobacco experience shortness of breath. To reduce this ​ ​ which has a higher risk of esophageal risk do not use THC/nicotine pods from . The filtering effect of water unregulated sellers. Inform your healthcare ​ ​ does NOT make it less dangerous. provider if you have been using an e-cigarette ● Bidi, hand-rolled leaf-wrapped product so you can be thoroughly assessed. ​ cigarettes, often offered with sweet Additional concern has been raised over other flavors such as chocolate and cherry, ingredients identified in e-cigarettes such as

Brown Health Services Patient Education Series: Tobacco and Nicotine www.brown.edu/health 401-863-3953 ​ (last updated 9/19) volatile organic compounds and ultra- fine ● OTC Nicotine replacement , including . methods-gum, lozenges, patches are Is it worth quitting? designed to reduce the intensity of ● Within 20 minutes of your last nicotine cravings (difficulty falling cigarette, blood-pressure and pulse asleep, irritability, anxiety, difficulty return to normal concentrating) but will not prevent ● Within 8 hours of your last cigarette symptoms fully. Tapering of the carbon monoxide levels drop to normal nicotine dose helps wean off cigarettes. and oxygen levels increase to normal ● Vareniciline (Chantix ) is a prescription ● Within 2 days of quitting, nerve endings medication that works in the brain to start to regrow and your ability to smell reduce symptoms and taste improve and cravings. ● Within 3 months, circulation improves ● Buproprion (Wellbutrin) is a and lung function increases up to 30% prescription medication that helps you Lowered risk for and heart stop smoking. disease within 1-2 years of quitting Other Modalities to help you Quit: ● Reduced risk of developing chronic ● Acupuncture, hypnotherapy, yoga obstructive pulmonary disease ● Behavioral programs available through ● Reduced risk of infertility and the RI Department of Health impotence “QuitworksRI”. Your Health Services provider can help with the referral. Getting Ready to Quit ● Miriam Hospital Behavioral Medicine ● Set a start date (also sponsors a paid research study ● Tell co-workers, friends and family of [email protected]) 401-793- ​ your intent to stop smoking 8770 ● Anticipate foods, activities and ● Quitline Services sponsored by the CDC situations that are associated with 1-800-QUIT-NOW smoking, and have oral substitutes Combining medications with behavioral and available such as carrot/celery sticks, other modalities may offer the best results for gum, mints, hard candies, sunflower tobacco cessation, possibly doubling the chance seeds, etc of success. Talk to your provider to discuss ● Remove all tobacco products from options that work best for you. home, car, work, and even your car ! What happens if I relapse? ● Talk to your provider about getting help Don’t get discouraged; smokers may need to stop smoking several attempts to quit. Discuss with your provider or program what happened that derailed the attempt. On average it can take 4-5 attempts before achieving success staying tobacco . Resources to Help you Quit Medications:

Brown Health Services Patient Education Series: Tobacco and Nicotine www.brown.edu/health 401-863-3953 ​ (last updated 9/19)