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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?