If you do not A SMOKING need this guide, kindly pass it on. CESSATION Guide KALEIDA HEALTH Language assistance services are available free of charge for anyone who has a need for an interpreter. Tenemos servicios de ayuda en Español, para cualquiera que necesita un intérprete.
contact/registration Information: Buffalo General Hospital 100 High Street Buffalo, New York 14203 (716) 859-1890
DeGraff Memorial Hospital 445 Tremont Street North Tonawanda, NY 14120 (716) 690-2074
New York State Smoker’s Quitline 1-866-NYQUITS (1-866-697-8487) www.nysmokefree.com
The quitline is sponsored by Roswell Park Cancer Institute and has trained specialists to help with quit plans and see if you are elibible for free supply of medications.
page 12 INTRODUCTION
This booklet guides you from thinking about stopping smoking through actually doing it. You will find a variety of tips and helpful hints on how to contest your smoking habits, no matter at what point you are in the quitting process. Take some time to look over each of the suggestions in this booklet. Pick those you feel comfortable with and decide today that you’re going to use them to quit. Just remember, don’t get discouraged – it may take a number of times for you to quit for good, but you can do it.
THREE COMPONENTS OF SMOKING 1. Physical addiction to the nicotine Nicotine levels in your blood are like waves - they peak after you smoke and drop when you have cravings for another cigarette. If you’re quitting “cold turkey,” it would take 5-7 days to get the nicotine out of your system. There are methods to help with nicotine cravings if “cold turkey” does not work for you. (See the “Methods” section of this booklet.)
2. Psychological Stress and anxiety often trigger people to smoke. The smoker feels calm after having a cigarette due to the deep breathing done when inhaling. Urges to smoke are also psychologically associated with triggers such as alcohol, caffeine, and preventing weight gain.
3. Habit It takes time to break any kind of habit. The hand-to-mouth association with smoking is a habit from the amount of times you do it during the day, sometimes lighting up before you even realize that you did. Even when using nicotine replacement therapy or other aides that help with the physical addiction to nicotine, you still have to change your routine so you do not smoke out of habit.
page 1 children and The Effects of Second Hand Smoke
Most people understand the negative effects that smoking can have on their own health, including an increased risk of heart attacks and lung cancer, but they often still need some extra motivation to quit smoking. Understanding the effects of second hand smoke on your children may help you give up smoking. Fortunately, most mothers understand the negative effects that smoking while they are pregnant can have on their unborn baby. These effects can include having a small or underweight baby or having a baby with abnormal lung function. Mothers who smoke are also more likely to have a premature baby and, according to the American Academy of Pediatrics, “long-term cognitive and behavioral problems including lower intelligence and attention deficit disorder with or without hyperactivity.”1 Although they may stop smoking during their pregnancy, many of these mothers do start smoking again after their baby is born.
This postnatal exposure to smoke by their children is also bad. Being exposed to someone that smokes, even if they just smoke outside the home, is thought to increase a child’s chance of having ear infections, allergies, asthma, wheezing, pneumonia and frequent upper respiratory infections. Smoke can also trigger asthma attacks in many children and they are often worse than in children who aren’t exposed to someone that smokes. Infants who are exposed to second hand smoke from their mother, father, or caregiver or whose mother smoked while she was pregnant, are up to 4 times more likely to die of Sudden Infant Death Syndrome (SIDS).
1 American Academy of Pediatrics: Tobacco’s toll: Implications for the pediatrician. -Pediatrics- 01-Apr-2001; 107(4): 794-8
page 2 MARKING PROGRESS
- Periodically, write down new reasons you are glad you quit and post these reasons where you will be sure to see them. - Cross off each day you quit on a calendar and indicate the money you saved by not smoking. Reward yourself! - Don’t think of never smoking again. Think of quitting in terms of one day at a time. - Keep positive thoughts!
SMOKING CESSATION PROGRAMS
Kaleida Health offers programs designed to help you quit smoking. Each program consists of small group sessions and includes group support, tips, motivational films and handouts. Check your insurance to find out if you are eligible for coverage of class fee and reimbursement for smoking cessation medications after completing the program.
page 11 5. Drink lots of water Water has no calories and will help you feel more full. If you are dehydrated, your body feels sluggish and you’ll have no energy. Drink water before, during, and after exercise too. 6. Get up from the table! Do something else after dinner so you don’t want to smoke. Brush your teeth to change the taste in your mouth. Get your mind on something else and keep your hands busy. Wash the dishes! Wait one hour after eating to exercise.
IMMEDIATE BENEFITS OF SMOKING CESSATION
• 20 MINUTES = Blood Pressure and Pulse Rate return to normal
• 8 HOURS = Oxygen level in blood increases. Carbon Monoxide in your blood returns to normal.
• 24 HOURS = Mucus in the airways breaks up and clears out of your lungs.
• 48 HOURS = Senses of smell and taste improve.
• 72 HOURS = Bronchial tubes relax, making breathing easier; energy level increases.
• 5-7 DAYS = Nicotine is out of your system (if not using nicotine replacement therapy).
• 2-12 WEEKS = Circulation improves; the body’s immune system is enhanced.
• 3-9 MONTHS = Respiratory symptoms such as sinus congestion, wheezing, shortness of breath, and sputum production decrease. Lung function improves.
page 10 So improve your own and your child’s health by getting some help to quit smoking. If you need another reason, remember that children whose mother or father smokes are more likely to start smoking themselves when they get older. Do you want your children to have an increased risk of lung cancer or heart attacks because they learned to smoke from you? If you can’t quit for yourself, quit for your children. If you can’t quit, at least don’t smoke inside your home or your car or other places that your children will be directly exposed to the smoke. But remember, this doesn’t totally protect your children from the effects of second hand smoke. medications TO AID SMOKING CESSATION
Nicotine Replacement Therapy Check with your doctor to see if nicotine replacement is right for you. The purpose of it is to provide an even level of nicotine in the bloodstream to prevent physical withdrawal symptoms. Nicotine replacement can not be used if you plan to continue to smoke or use another tobacco product, as the combined dose of nicotine can be dangerous to your health. You may be eligible to get a free supply through the NYState Smoker’s Quitline (see last page), your insurance company or smoking cessation programs.
page 3 The following are some types of nicotine replacement therapy available. Refer to the package inserts for instructions and information. 1. Nicotine Patches (Nicoderm) (Habitrol) (Nicotrol) These provide a measured dose of nicotine through the skin. The nicotine doses are lowered over a course of 6-12 weeks, weaning the smoker away from nicotine gradually.
2. Nicotine Gum (Nocotrol gum) Nicotine is absorbed quickly through the mucous membrane of the mouth. When you get a craving to smoke, chew the gum and then “park” it in your cheek. It comes in 2 mg and 4 mg strengths.
3. Nicotine Lozenge(Commit) Nasal Spray (by prescription only) gives immediate relief of withdrawal symptoms and offers the smoker a sense of control over nicotine cravings. Generally it is weaned down within 3 months.
4. Nicotine Nasal Spray (Nicotrol NS)-by prescription only The inhaler (by prescription only) delivers nicotine through a plastic tube when you inhale. The nicotine is absorbed though the membranes in the mouth. Each puff of the inhaler contains 8 to 10 times less nicotine than a puff of a cigarette – and none of the tar and other toxins cigarettes deliver.
5. Nicotine Inhaler (Nicotrol) – by prescription only
page 4 SMOKING CESSATION & WEIGHT CONTROL TIPS
1. Make not-smoking your #1 priority Tackle one thing at a time. Quitting is the most important thing you can do for yourself.
2. Don’t obsess about the scale! Its O.K. to monitor your weight, but don’t do it every day. You would have to gain 80-100 lbs. to equal the health risk of smoking one pack a day. Not everyone will gain weight when quitting. Be prepared for a temporary decrease in metabolism and be careful not to increase calorie consumption by substituting food in place of smoking.
3. Exercise! Regular cardiovascular exercise (walking, biking, stair climbing, etc.) will make you feel and look better. It can raise your metabolism to help you maintain your weight. Exercise can also raise HDL, “good” cholesterol, which is usually low in smokers.
4. Eat Well-Balanced Meals Do not skip meals to try to lose weight. It is better to eat smaller meals more frequently during the day to keep metabolism up. Start off with a good, healthy breakfast! Snack on nutritious food. Avoid high calorie sweets. Do not try to diet at this time to lose weight. Just try to maintain weight.
page 9 - If you miss the sensation of having a cigarette in your hand, play with something else, such as a pencil, a paper clip, or a marble. - Keep busy. - For the first few weeks, avoid or reduce situations you strongly associate with smoking, such as watching TV, drinking alcohol and coffee, and stressful situations. - Keep oral substitutes handy. Try carrots, pickles, sunflower seeds, apples, celery sticks, raisins, toothpicks, or sugarless gum instead of a cigarette. (Just watch your calories.) - Get plenty of sleep so you don’t have to deal with fatigue along with withdrawal symptoms. - Never allow yourself to think, “one won’t hurt”- it will! - Tell yourself the urges will pass and with time they will lessen. - Do things that require you to use your hands. Try crossword puzzles, needlework, gardening, or household chores. Go bike riding or take the dog for a walk; give yourself a manicure; write letters.
page 8 Non-Nicotine Medications (by prescription only) Zyban Zyban is a nicotine-free pill that can help you stop smoking. Zyban (generic name, Buproprion) inhibits the brain neurochemicals that make you have urges to smoke. It was first marketed as an anti-depressant (Wellbutrin) and was discovered to help people quit smoking. When you start taking Zyban, you should set a quit date about 2 weeks afterwards so your blood level of medication reaches appropriate levels. There are starter kits with instructions and help lines available.
Chantix Chantix is a pill that blocks the nicotine receptors in your brain, reducing the urge to smoke. TIPS FOR QUITTING SMOKING
- You have to want to quit smoking! - List your reasons for quitting and refer to them often. - Plan a quit date and prepare yourself to quit. - Ask your doctor if nicotine replacement therapy (i.e.: patch, gum, inhaler) or Zyban is right for you. - Join a smoking cessation program. Join a smoking cessation program (see last page). Check your insurance to see if the class fee is covered and if you can get reimbursement for smoking cessation medications by taking the classes. - Make not smoking #1 priority over barriers (i.e.: weight gain). - Anticipate triggers and prepare to deal with them (i.e.: coffee, alcohol, stress).
page 5 - Use relaxation techniques (deep breathing, meditation, music). - Get social support (family and friends). - Use the 4 D’s: • Delay (the urge will pass whether you smoke or not) • Drink Water (flushes nicotine out of your system and makes you feel full) • Do something else (keep mind off smoking) • Deep Breathe (slow, deep breaths; exhale slowly) - Use positive thoughts - you can do it!
PREPARING TO QUIT
- Set a quit date. - Cut down the number of cigarettes you smoke and smoke only half of each one. - Each day, postpone the lighting of your first cigarette by ½ hour. - Eat healthier and end meals or snacks with something that won’t lead to a cigarette. - Change your daily routine. - Exercise (see “Weight Control” section). - Smoke only those cigarettes you “really” want. Catch yourself before you light up a cigarette out of pure habit.
page 6 - Stop buying cigarettes by the carton. Wait until one pack is empty before you buy another. - Stop carrying cigarettes with you at home or at work. Make them difficult to access. - Collect all your cigarette butts in one large glass container as a visual reminder. - Clean your clothes to rid them of the cigarette smell, which can linger for a long time.
ON THE DAY YOU QUIT
- Throw away all your cigarettes and matches. Hide your lighters and ash trays. - Visit the dentist and have your teeth cleaned to get rid of tobacco stains. - Keep busy on the “big” quit day. Go to the movies, exercise, take long walks, go bike riding. - Remind your family and friends that this is your quit date and ask them for their support during the first couple of days and weeks. - Buy yourself a treat or do something special to celebrate.
MAINTAIN BEING SMOKE FREE
- Develop a clean, fresh, nonsmoking environment at work and at home. - The first few days after you quit, spend as much free time as possible in places where smoking isn’t allowed, such as libraries, museums, theaters, department stores, and churches.
page 7 Buffalo General Hospital • DeGraff Memorial Hospital • Millard Fillmore Gates Circle Hospital Millard Fillmore Suburban Hospital • Women & Children’s Hospital of Buffalo
DMH-012 Rev. 03/09