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Stop Smoking Workbook UCSF MEDICAL CENTER FONTANA TOBAccO TREATMENT CENTER Stop Smoking Workbook Paul Brunetta, MD Suzanne Harris, RN, CTTS Dianne Derby, MS Lisa Kroon, PHARM D Robin Corelli, PHARM D Stop Smoking Workbook 1 © 1999–2012 The Regents of the University of California. All rights reserved. Credits Neal Benowitz, MD: Neurochemical and Related Effects of Nicotine, page 54 Paul Brunetta, MD: Small-Cell Lung Cancer, pages 82–84 True Emotions, pages 88–92 Smoking Cessation: Advice to Clinicians and Patients, pages 97–101 Karl Fagerström:, PhD Fagerström Scale, page 25 John Harding photographs: Clarence Brown, page 10 Roger Sako, page 80 Barbara Vos, page 86 Suzanne Harris, RN, CTTS: Clarence Brown, page 11 Roger Sako, pages 81, 82 Barbara Vos, pages 87, 88 Contents About This Workbook .......................................................................................................... 6 Lesson One ................................................................................................ 9 Clarence Brown ................................................................................................................10 Lung Health ......................................................................................................................12 Tobacco-Related Disease ................................................................................................13 What’s in Cigarette Smoke? ............................................................................................16 Tobacco Facts ...................................................................................................................17 Carbon Monoxide ............................................................................................................18 The Power of Denial .......................................................................................................19 What Is Motivation? ........................................................................................................20 My “Want to” Motivation ...............................................................................................22 Smoking Behavior Awareness ........................................................................................23 Rating Your Addiction to Nicotine: Fagerström Questionnaire ..............................25 Setting Your Stop Date ...................................................................................................26 Practice and Exercises .....................................................................................................27 Sample from a Smoking Journal ....................................................................................28 Smoking Awareness Journal ...........................................................................................29 Lesson Two .............................................................................................. 31 Medicines for Smoking Cessation .................................................................................32 Readiness for Change ......................................................................................................42 Introduction to the Journey of Change ......................................................................43 The Journey of Change ..................................................................................................44 Courage = Desire + Doubt + Action ..........................................................................45 Practice and Exercises .....................................................................................................46 Smoking Awareness Journal ...........................................................................................47 Lesson Three ........................................................................................... 50 Understanding Dependence ...........................................................................................51 Nicotine Addiction Cycle ...............................................................................................52 Withdrawal Symptoms ....................................................................................................53 Neurochemical and Related Effects of Nicotine........................................................54 Understanding the Thought Process ............................................................................55 Using Language ................................................................................................................58 Trying .................................................................................................................................59 “Entitlement”—Another Language Trap ....................................................................60 Triggers ..............................................................................................................................60 Commit to Quit Agreement ...........................................................................................61 Quit Date Tips .................................................................................................................62 Dealing With Urges .........................................................................................................63 Rewards and Celebrations ..............................................................................................64 My Quit Plan ....................................................................................................................65 Practice and Exercises .....................................................................................................67 Smoking Awareness Journal ...........................................................................................69 Lesson Four ............................................................................................. 72 Benefits of Quitting .......................................................................................................73 Preventing Relapse ...........................................................................................................74 Setting New Goals ...........................................................................................................75 Quit Bonus Calculation ...................................................................................................76 Practice and Exercises .....................................................................................................77 Smoking Awareness Journal ...........................................................................................78 Roger Sako ...................................................................................................................81 Small-Cell Lung Cancer..............................................................................................82 Barbara Vos ..................................................................................................................87 True Emotions ............................................................................................................88 Breathing, Smoking, and the Stress Response ........................................................94 Breathing Exercises ....................................................................................................96 Smoking Cessation: Advice for Clinicians and Patients ........................................97 About the Fontana Tobacco Treatment Center (FTTC) .....................................................102 Biographies .........................................................................................................................104 Resources ............................................................................................................................105 Course Evaluation and Feedback ........................................................................................106 4 Stop Smoking Workbook For a smoker, quitting smoking is the single most important thing you’ll ever do for your health. Stop Smoking Workbook 5 About This Workbook You may be reading this introduction as a member of one of our Stop Smoking Groups. Perhaps you are considering using this workbook to assist you in overcoming smoking on your own. Or you may be a nonsmoker seeking information about tobacco dependence and how you could support a friend or loved one who is trying to achieve freedom from smoking. Regardless of your motivation, we hope you will find content in this workbook that will be of use to you. The Fontana Tobacco Treatment Center (FTTC) at the UCSF Medical Center was founded by a physician and a nurse who are former smokers and have witnessed im- mensely debilitating effects of prolonged tobacco use. Recognizing that stopping smok- ing is the single most important thing a smoker can do to improve health, they created the FTTC as a resource for smokers and their friends and family, and also for medical personnel. The FTTC offers group and individual support for smokers, and it serves as an educational resource for health-care providers and the public. This workbook is structured into four weekly lessons. Because each lesson builds on the previous ones, the sequence is important. Information in each lesson is organized into three sections: medical implications of tobacco dependence, understanding and building motivation, and planning skills to help you reach your goals. Weekly homework concludes each
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