Kristi Copple, CRT 

Smoking Cessation Information

You are not Alone

• In 2005, 45.1 million adults (20.9 percent) in the United States were current smokers---23.9 percent of men and 18.1 percent of women.  An estimated 70 percent of these smokers said they wanted to quit.

• Nicotine dependence is the most common form of chemical dependence in the United States.  In 1987 the Surgeon General reported that smoking is the leading cause of preventable death in our nation.

What is in a cigarette?

• Cigarette tobacco is blended from two main leaf varieties: Virginia tobacco, which contains about 3% nicotine and burley tobacco which has up to 4% nicotine content.  U.S. blends also contain up to 10% of imported oriental tobacco, which is aromatic and has 2% nicotine.
• Cigarettes also contain ‘fillers’ which are made from the stems and bits of tobacco that would be waste products.  These are mixed with water and various flavoring and additives.
• Sugars are added to make the smoke seem milder and easier to inhale.
• High levels of ‘free’ nicotine are added to increase the ‘kick’ of the nicotine.
• Chocolate and vanilla are also used to improve the taste of the smoke.
• Menthol additives numb the throat so the smoker cannot feel the smoke’s irritating effects.
• Cocoa may also be used to open the airway,.  This allows the smoke to go deeper into the lungs so the body can get more nicotine and higher levels of tar.

What effects does smoking have on the body?

Your risk of heart disease, lung disease and cancer increases directly with the number of cigarettes you have smoked over a lifetime.  Smoking is linked to lung cancer and emphysema.  If you have a history of heart disease, lung disease or cancers, smoking as few as two cigarettes a day will make it worse.

Nicotine makes the heart work harder.  It increases the heart rate, blood pressure and constricts the arteries.  Smoking reduces oxygen in the blood and tobacco smoke makes blood clot faster.  Smokers also have more fatty deposits in their arteries.  This increases the risk for heart attack and stroke as much as 20%

Smoking is the biggest risk factor for sudden cardiac arrest—in which the heart stops beating.

After a heart attack, research has shown that by not smoking there will be a 50% lower chance of having a second heart attack and/or blocked vessels.

Secondhand smoke also produces the same harmful poisons as smoking.  Secondhand smoke is a mixture of the smoke given off by the burning end and the smoke exhaled from the lungs of the smoker.  Secondhand smoke is dangerous.   Over 4000 different chemicals have been identified in secondhand smoke and at least 40 of these chemicals cause cancers.

Children who breathe secondhand smoke are more likely to suffer from bronchitis, pneumonia, childhood asthma, ear infections, sudden infant death syndrome (SIDS), low birth weight, and behavior and thinking problems.  Exposure to second hand smoke can cause the eye, nose and throat to be irritated.  It can also irritate the lungs, leading to cough and trouble breathing.

Consider Quitting

Smoking is a powerful addiction.  It is as strong as drug or alcohol addiction.  Taking steps toward quitting is a positive move, it is very hard to quit smoking because of the discomfort one may have.

Why should I quit?

• What do you want to gain from quitting?
• What are the most important reasons for wanting to quit?
• Have you been concerned about getting cancer or having a heart attack?
• Have you had more colds or flu in the last year?
• Have you had shortness of breath when you walk or climb stair?
• Have you had shortness of breath when doing daily activities such as getting dressed?
• Do you have a cough in the morning and/or throughout the day?
• Have you noticed an increase in the number of coughs, colds and earaches in the young children that live in your home?
• Has anyone complained about the smell of your clothes, hair, breath, home and car?
• Would you like to have more money to spend on other things?

What steps should be taken to quit?

When you are in the hospital, your doctor may request or insist that you quit smoking.  Smoking may slow your recovery from surgery and illness.  It may also slow bone and wound healing.  This is a chance to make this your “Quit Day.”  These are the steps to take when you decide to quit:

• Make your home a non-smoking zone.
• Make your car or truck a non-smoking zone.
• Do not buy any more cigarettes (packs or Cartons).
• Do not carry cigarettes, matches or lighters on your person (pockets, purses).
• Place cigarettes, matches or lighters outside your home in a place that would cause you to have to make an effort to get to these items,  You would then have to make a decision to smoke rather than to smoke out of habit.
• Tell everyone you know that you have quit.
• Drink water or fruit juice instead of coffee – if you were prone to having a cigarette with your coffee.
• Substitute healthy activities/foods in place of the cigarette.
• Avoid temptation by staying away from situations you associate with pleasurable smoking.

What Should I expect when I stop smoking?

When you stop smoking your body may go through withdrawal.  This can be the toughest part of quitting.  Remind yourself that it is a sign that your body is starting to heal.  Symptoms last from 2-3 weeks and include:

Should I consider Nicotine Replacement Therapy?

 Nicotine replacement products help to relieve some of the withdrawal symptoms people have when they quit smoking.  Talk with your doctor to help decide what is best for you.  Always use these products only as prescribed.

 The goal of using nicotine medications is to quit smoking.  If you plan to use nicotine replacement, begin using them on the day you quit.  If you continue to have strong urges to smoke or are struggling to stop smoking completely ask you healthcare provider about additional help.

What options are available for Nicotine Replacement Therapy?

Nicotine Patch

The nicotine patch releases a constant amount of nicotine in the body.  The nicotine is absorbed through the skin and into the bloodstream.  Less nicotine is taken in through the patch than when smoking.  The patch does not have all the tars and poisonous gases that are in cigarette smoke.

 Most nicotine patch products are changed once every 24 hours.  The nicotine level in the body stays fairly constant day after day.  Always inform your physician that you are using nicotine replacement.

 Wearing the nicotine patch lessens withdrawal symptoms such as tenseness, irritability, drowsiness, and lack of concentration,.  Some side effects from wearing the patch can include:

·         Upset stomach

·         Weakness

·         Blurred vision

·         Vivid dreams

·         Mild itching and burning on the skin

·         Diarrhea

Nicotine Gum

The term ‘gum’ is misleading.  It is a gum-like substance with enough nicotine to reduce the urge to smoke. However, the gum is not chewed like regular gum.  Instead, it is chewed briefly and then “parked” between the cheek and gum.  The nicotine is absorbed through the lining of the mouth.  The gum helps take the edge off cravings without the tars and gases in cigarettes.

Nicotine gum must be used properly in order to work.

Steps to follow include:

• Stop all smoking when beginning the nicotine gum therapy.
• Do not eat or drink (especially carbonated or acidic drinks) for 15 minutes before using the gum.
• Chew the gum slowly on and off for 30 minutes to release most of the nicotine then ‘park’ it between the cheek and gum to allow the absorption of nicotine into the lining of the cheek.
• Chew enough gum every day for a month, and then start to reduce the number of pieces used each day.  Chew only what is needed to reduce cravings.  Most people need 10-12 pieces per day.
• Stop using the gum after three months.

Nicotine Inhaler

A doctor must prescribe a nicotine inhaler.  Although it looks like a cigarette, the inhaler delivers nicotine into the mouth, not the lung.  The nicotine enters the body much more slowly compared to smoking.

Puffing must be done frequently, far more often than with a cigarette.  Each cartridge lasts for 80 puffs or approximately 20 minute.  A minimum of six cartridges per day is needed for three to six weeks, then start tapering off.  You do not need to inhale deeply to achieve and effect.  Small doses of nicotine provide a sensation in the back of the throat similar to cigarette smoke.

The nicotine inhale mimics the hand-to-mouth behavior of smoking.  It may cause throat irritation and coughing.

Nicotine Nasal Spray

A doctor must prescribe a nicotine nasal spray.  The nasal spray is designed to deliver nicotine to the nasal membranes and reaches the bloodstream faster than any other nicotine replacement therapy product.

This can be used in response to stress or urges to smoke and to help reduce cravings within minutes. Frequent use during the day is required to obtain adequate nicotine levels.  It can cause nose and eye irritation, but these symptoms usually go away within the first week of use.

Nicotine Lozenges

The Commit Nicotine Lozenge is a form nicotine replacement.  It can be brought without a prescription by anyone 18 or older.  As the lozenge dissolves over 2-30 minutes, it releases nicotine.  The nicotine helps reduce cravings and withdrawal symptoms.

Commit is designed as a 12-week program.  Patients using Commit lozenges should not smoke while on the program, and should stop using the lozenges after 12 weeks.

Non-Nicotine Medication

Bupropion is a pill that must be prescribed by a doctor.  It helps with a depression and aids in quitting smoking.  Brand names include Wellbutrin and Zyban.

This can be taken 1-2 weeks before you stop smoking and is usually continued for 7-12 weeks.  Do not use a nicotine patch with Wellbutrin unless your physician tells you to.  Do not drink alcohol with this medication.

This medication may make you dizzy; avoid using machines or doing anything else that could be harmful if you are not alert.  Call your doctor right away if you have severe headaches, increased agitation, confusion, hallucination or other unusual thoughts/feelings.  Allergic reactions to this medication include itching or hives, swelling in face or hands, swelling or tingling in the mouth or throat, tightness in chest or trouble breathing.

Chantix is the newest, by prescription, non-nicotine medication.  It works by both stopping nicotine withdrawal symptoms and by blocking the reward sensation smokers get from the nicotine.  Smokers are also eligible to enroll in a support program to help identify individual smoking triggers and to manage smoking cravings.  Recommended therapy is for 12 weeks.  The smoker starts Chantix 7 days before his quit date, then needs to stop smoking and continue the Chantix twice a day.

The most frequent side-effects are nausea (so take after a meal with plenty of water), headache, and insomnia.

Smoking Cessation Programs available in the Concordia area:

1)                  Salina Tobacco Prevention Coalition “Freedom From Smoking”  Contact Central Kansas Foundation 785-309-0918

2)                  Kansas Tobacco Quit Line:  1-866-Kan Stop or www.kanstop.org

3)                  National Cancer Institute Smoking Quit line: 1-877-44U-QUIT

Recommended websites:

www.lungusa.org – Freedom from Smoking online

www.nlhep.org – National Lung Health Education Program

www.surgeongeneral.gov/tobacco

www.smokefree.gov