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Tobacco Road:How to Navigate the

Tricky Corners, Detours and Pot Holes of

Tobacco Cessation Presented By: Bill Byron Presented By: Bill Byron

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Workshop Agenda

• Tobacco Use Dependency

• Consequences to Smoking

• Quit Tips

• Local and National Resources

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Did You Know…

• Tobacco kills more than 430,000 U.S. citizens each year-more than alcohol, cocaine, heroin, homicide, suicide, car accidents, fire, and AIDS combined.

• Tobacco use is the leading preventable cause of death in the United States.

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Tobacco Use Dependency

Tobacco Addiction:

•Physical

•Psychological

•Emotional

American Lung Association

www.lungusa.org

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Physical Dependency to Tobacco

• Nicotine is the addictive product that acts on the brain

• Addiction is characterized by compulsive drug-seeking and use, even in the face of negative health consequences

National Institute on Drug Abuse

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Physical Dependency to Tobacco

After exposure to nicotine…– a “kick” is experienced– adrenal glands react and

release epinephrine (adrenaline)

– the body then releases glucose, blood pressure, respiration and heart rate increases

National Institute on Drug Abuse

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• Nicotine also stimulates the pleasure center of the brain and affects dopamine levels

• Makes you feel good

• Increases nicotine receptors in the brain which increases tolerance for the drug

Physical Dependency to Tobacco

Interesting Fact:

Nicotine reaches the brain in 7-10 seconds

National Institute on Drug Abuse

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Physical Dependency to Tobacco

Questions to Ask Yourself or Someone You Know Who Smokes?

1. Do you have your 1st cigarette within 30 minutes after waking?

2. Do you smoke when you are sick?

3. Do you find it difficult to refrain from smoking for a few hours?

4. Do you physically feel bad when you don’t smoke?

American Lung Association

www.lungusa.org

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Psychological Dependency to Tobacco

This is the mind’s response to smoking

• Learned Behavior

• Triggered Behavior

• Automatic Behavior

American Lung Association

www.lungusa.org

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Psychological Dependency to Tobacco

Automatic Behavior by the Numbers!

10 X 20 = 200Inhalations Per Cig. Cigs. Per Day Inhalations Per Day

20 X 365 = 7,300Years Days Per Year Day in 20 Years

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Psychological Dependency to Tobacco

7, 300 X 200 =Days Inhalations Per Day

1,460,000

Inhalations for a 20 year smoking history

American Lung Association

www.lungusa.org

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Emotional Dependency to Tobacco

• This is the connection one feels towards their tobacco product

“It’s for me!”

“Cigarettes are my friends”

“Cigarettes are always there for me”

American Lung Association

www.lungusa.org

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Consequences to Smoking

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Tobacco Use in NH

• Cigarette smoking rate in NH:– Adults – 20.5%

– High School Students – 20.5%

• Annual deaths in NH:– Adults – 1,800

– Kids under the age of 18 who will die prematurely – 31,000

Campaign for Tobacco Free Kids, 2007

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16 American Lung Association, 2007

What’s in Cigarettes?

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Consequences to Smoking

American Lung Association

www.lungusa.org

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Consequences to Using Spit Tobacco

What’s in Spit Tobacco?

NicotineCarcinogensSugarSodium

National Spit Tobacco Education Program – www.nstep.org

Centers for Disease Control

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Quit Tips

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Make the Decision to Quit

• Determine what your quit date will be– Make it for a few weeks out– Record it on your calendar– Tell your family and friends

• Prepare for your quit date• Make a list of why you want to quit

American Lung Association

American Cancer Society

Quit Tips

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• 20 minutes after quitting: Your heart rate and blood pressure drop.

• 12 hours after quitting: The carbon monoxide level in your blood drops to normal.

• 2 weeks to 3 months after quitting: Your circulation improves and your lung function increases.

• 1 to 9 months after quitting: Coughing and shortness of breath decrease, regain normal function in the lungs, increasing the ability to handle mucus, clean the lungs, and reduce the risk of infection.

• 1 year after quitting: The excess risk of coronary heart disease is half that of a smokers.

• 5 to 15 years after quitting: Your stroke risk is reduced to that of a non-smoker.

• 10 years after quitting: The lung cancer death rate is about half that of a person who continues smoking. The risk of cancer of the mouth, throat, esophagus, bladder, cervix, and pancreas decreases.

• 15 years after quitting: The risk of coronary heart disease is the same as a non-smoker’s.

American Cancer Society

When smokers quit – what are the benefits over time?

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Learn About Your Smoking Habit

• Determine your smoking pattern– Track when you have each cigarette/dip/chew– Track need and mood for each cigarette/dip/chew

• Determine why you smoke– Stimulation– Handling– Pleasurable Relaxation – Crutch: Tension Reduction– Craving (physical/psychological)– Habit

American Lung Association

American Cancer Society

Quit Tips

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Talk To Your Providers

• Discuss your smoking habit with your physician• Ask about your options for over-the-counter nicotine

replacement therapies and prescribed smoking cessation medication

• Learn about the medical and wellness benefits that are available to assist you through the quitting process

American Lung Association

American Cancer Society

Quit Tips

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Set up a support system

American Lung Association

American Cancer Society

Quit Tips

• Surround yourself with positive people• Don’t put yourself into a situation that will make you

want to smoke

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Prepare for Urges & Cravings• Behavioral Tips

– Avoid triggers

– Change habits

– Use alternatives

– Practice deep breathing

– Delay

– Remember: The urge will pass whether you smoke or not

– Reward yourself

American Lung Association

American Cancer Society

Quit Tips

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Prepare for Your Quit Date• Practice saying “No thank you, I don’t smoke” or

“I can quit smoking”• Reflect on past quit attempts• Get rid of all cigarettes and smoking paraphernalia• Reward yourself

American Lung Association

American Cancer Society

Quit Tips

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Pharmacy Benefit Program Enhancements – Effective 10/1/2010

• New Coverage for Physician-Prescribed Tobacco Treatment Medications and Over-the-Counter (OTC) Medications

• You may purchase tobacco treatment prescriptions and over-the counter medications to help you quit using tobacco products – Nicotine Replacement Therapy Patches, Gum, and Lozenge – Bupropion – Zyban– Nicotrol Nasal Spray– Nicotrol Inhaler– Varenicline – Chantix

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Pharmacy Benefit Program Enhancements – Effective 10/1/2010

Ask your doctor if a prescription or OTC medications would help you with your quit attempt – A prescription is also required for all OTC

medicationsPresent your CVS Caremark prescription ID card

with your prescription at the local retail pharmacy, or you can fill through the mail order program

The same copays apply to tobacco treatment medications and OTC medications as all other prescription copays

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Pharmacy Benefit Program Enhancements – Effective

10/1/2010• Dependence counseling programs available

Your Employee Assistance Program – Call 800.852.3345, ext. 4336

NH Smokers’ Helpline 800-Try-To-STOP (800.879.8678)

Other group counseling programs are also offered in your local community, hospital and workplace setting

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Smoking Cessation Resources

• In NH– QuitWorks™- NH– 1-800-TRY-TO-STOP, Department of Health &

Human Services – Community-based programs, Center for Health

Promotion, local hospitals, non-profit organizations, etc.

• National– QuitNet - www.quitnet.org– Freedom From Smoking® Online program –

www.lungusa.org

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Smoking Cessation Resources

• Breathe New Hampshire www.breathenh.org

• NH Department of Health and Human Services www.dhhs.nh.gov

• Centers for Disease Control www.cdc.gov

• American Lung Association www.lungusa.org

• American Cancer Society www.cancer.org

• MayoClinic www.MayoClinic.com

• National Spit Education Program www.nstep.org

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Questions?