Smoking – Dangers and Steps to Help You Quit

Ann Morin, RN, BSN

George Sargent, RRT

One Weapon That Kills From Both Ends

FACTS

• An estimated 47 million Americans smoke.

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

• Cigarette smoking and exposure to secondhand smoke causes 443,000—or 1 in 5 deaths.

• Smoking-caused diseases result in $96 billion in health care costs annually.

Enticing Advertising

• Using ANY tobacco products has been shown to cause cancer.

• In fact, smoking tobacco, using smokeless tobacco, and being exposed regularly to second-hand tobacco smoke are responsible for a large number of cancer deaths in the U.S. Each year.

Carl Wilson, 51, musician (Beach Boys) lung cancer, deceased

Duke Ellington, 75, lung cancer, deceased

News Related to Smoking

• State courts have held that it is appropriate to consider whether a parent smokes around a child in determining who should be awarded custody.

• These states are: California, Florida, Illinois, Louisiana, Maryland, Massachusetts, Michigan, Missouri, New York, New Jersey, Texas, Oregon, Pennsylvania, South Carolina, and Tennessee.

• Smoke-Free Workplace Laws Linked to Lower Incidence of Heart Attacks

• Smoking is being banned in more public places.

Yearly Cost for an Average Smoker

• Adult smokers consume an average of 1.3 packs of cigarettes a day, or 472 packs a year per smoker

• Total cost $ 3,776 per year at $8.00 pack • If someone starts at age 18 (now) and smokes

till they are 70 it will cost them $196,352. (Not adjusted for increase in price)

• Cigarette taxes can increase the cost per pack to $10 a pack in some places.

Costs People Don’t Think Of

• Teeth Cleaning – get rid of yellow stains $75. avg. per cleaning

• Extra Doctors visits for smoking related illnesses $80. or more per visit

• Life insurance- Smokers can pay up to 3 times as much!

• Hospital bills- for lung cancer, surgery, etc $50,000 or more

• Funeral costs- Cigarettes kill 1 out of 3 long term users $3,000 to $10,000

What could you do with an extra $3,776 a year????

Types of Tobacco • Cigarettes

• Pipe

• Cigar

• Chew/Spit

Absorption of Nicotine

• Rate of Absorption

–Cigarette : fastest route

–Cigar : slower than cigarettes

–Spit/Chew : slowest rate

Enticing Advertising

WAYS TOBACCO HARMS

• First hand Smoke (actually smoking yourself)

• Second hand Smoke ( Smoke from you that others breathe in)

• Third hand Smoke (Smoke particles that stay on your clothing, skin and hair)

Conditions Caused by or Aggravated by Smoking

• Lung Cancer and other forms of cancer • Emphysema • Heart disease • Chronic bronchitis • Sinusitis • Amblyopia(a condition involving loss of vision) • Premature aging of the skin • And MORE…………

Lung Cancer Awareness

What Are The Risks?

1 In 10 Men Who Smoke Will Develop Lung Cancer 1 In 5 Women Who Smoke Will Develop Lung Cancer

Peter Jennings, 66, ABC News Anchor, lung cancer, deceased

Physiological Effects of Smoking

• Carbon Monoxide prevents oxygen from reaching tissues in all parts of body

• Brain activity slows down

• Lack of oxygen can cause heart disease

• Nicotine is also a stimulant and can cause increased nervousness in predisposed smokers.

• Tars from smoking may stimulate the growth of cancer.

• Over 100 different poisons in tobacco smoke that have harmful effects.

• Lung cancer is the leading cause of cancer death in men and women in the United States.

• It occurs most often between the ages of 55 and 65, but can also occur as young as age 25.

Wayne McLaren, 51, "Marlboro Cowboy"

lung cancer

John Wayne, 72, lung cancer,

deceased

Non Smokers Lungs

Cilia that line the airways and lungs

Mucus in Cilia

Smokers Lung

Second Hand Smoke

• Secondhand smoke (SHS) is also known as environmental tobacco smoke (ETS). SHS is a mixture of 2 forms of smoke that come from burning tobacco:

• Side stream smoke – smoke from the lighted end of a cigarette, pipe, or cigar

• Mainstream smoke – the smoke exhaled by a smoker

• Even though we think of these as the same, they aren’t. Side stream smoke has higher concentrations of cancer-causing agents (carcinogens) than mainstream smoke. And, it has smaller particles than mainstream smoke, which make their way into the lungs and the body’s cells more easily.

Secondhand smoke can cause harm in many ways. Each year in the United States alone, it is

responsible for:

• An estimated 46,000 deaths from heart disease in people who are current non-smokers

• About 3,400 lung cancer deaths in non-smoking adults

• Worse asthma and asthma-related problems in up to 1 million asthmatic children

• Between 150,000 and 300,000 lower respiratory tract infections (lung and bronchus) in children under 18 months of age, with 7,500 to 15,000 hospitalizations each year

• Children exposed to secondhand smoke are much more likely to be put into intensive care when they have the flu, they are in the hospital longer, and are more likely to need breathing tubes than kids who aren’t exposed to SHS

• In the United States, the costs of extra medical care, illness, and death caused by SHS are over $10 billion per year

Third hand Smoke

• Third-hand smoke is a term used to describe the particles and gases that are left over after a cigarette is extinguished. These particles land and remain on virtually any surface in an area where someone has smoked -- on clothes, in hair, on furniture and on flooring.

• Chemicals that are left over after smoking land on any surface in an area where smoking has taken place. Studies have found that of chemicals in third-hand smoke, 11 are carcinogens (substances capable of causing cancer.

• A second way that toxins can be of concern with third-hand smoke is through a process called “off-gassing". Off-gassing occurs when substances from smoke that have been deposited on surfaces, such as nicotine, are released back into the air as gases. Through this process , tobacco residue that has built up on surfaces continues to emit toxins long after smoking has occurred.

Why It Is So Addictive

• Nicotine provides a bigger boost than chocolate or a cup of coffee. Perhaps most importantly, nicotine passes into our brains much more quickly than most other substances.

• Nicotine enters your brain within 10 seconds of taking a puff on a cigarette. This rapid delivery of nicotine means that we develop a strong association between using tobacco and the feelings it brings.

• Nicotine is also highly addictive because it causes changes in your brain. Fortunately, most of these changes will be reversed once you quit smoking.

• However, some changes may last for long periods of time and may explain why some people get cravings to smoke many months or years after quitting.

• Smoking is also a learned behavior. For example, over a one year period, a one-pack a day smoker will take a puff more than 70,000 times.

• We begin to learn or associate things such as the way we hold or light a cigarette or take it out of the package with the pleasant feelings or sense of relief that it brings us.

• We also learn to associate having a cigarette with other things we do immediately before or after smoking such as drinking coffee or alcohol, and enjoying a good meal.

• Because smoking often requires us to take a break from our daily duties, we may also learn to associate smoking with the temporary relief of worry, tension, boredom or fatigue.

Psychological Effects

• In large part, the psychological effects of smoking are directly linked to how nicotine physically affects the brain.

• Early cigarette use can cause improvement in reaction and processing times because nicotine is a psychomotor stimulant.

• Even though this improved skill does not last long, smokers notice it enough to continue to claim the enhancement from cigarettes.

• Smokers also claim that cigarettes are mood enhancing or have a calming effect.

• There is research that shows smoking may indeed have a calming, rather than stimulating, effect depending on the amount of nicotine in the bloodstream.

• In fact, it has been shown that smokers alter the way they smoke (for example, longer or shorter puffs) to achieve the desired effect.

• It has also been shown that the impression of mood change can be due to short-term nicotine withdrawal.

• Withdrawal can happen any time a smoker goes without cigarettes longer than they are used to, such as when they sleep.

• The first cigarette of the day stops the withdrawal symptoms, thereby causing the smoker to feel calmer.

• The feelings of euphoria and calm coupled with the perceptions of performance enhancement are at the root of psychological addiction to cigarettes.

• When a person tries to quit smoking, the physical addiction is usually overcome within fourteen days

• However, the psychological desire for cigarettes can last for years, and is especially prevalent in situations where reaching for a cigarette was previously the normal reaction.

• Smokers often see cigarettes as a cure-all.

• When under stress, inhalation of nicotine would enable the smoker to feel calm. When tired, cigarettes would act as a stimulant to wake the smoker up. When a smoker was bored, they would light up a cigarette as well.

• This attitude that smoking fixes everything makes times of mental distress very difficult on the person trying to quit.

• In addition, these people are faced with attempting to do things without the ritual of lighting up.

• Human beings like rituals and order. Our brains are wired in such a manner that we tend to do things in the same way all the time.

• When a step of that process is removed, people tend to get confused and have difficulty performing the task.

• When a smoker quits smoking, this problem occurs every time they try to do something where they would have normally lit a cigarette, from getting ready in the morning to winding down at night.

• Because of the combined effect of these psychological factors, smokers who try to quit often find that even after they have overcome the physical addiction they still need help.

.

• Many people turn to acupuncture, hypnotherapy, or support groups for assistance in dealing with the psychological dependency for cigarettes that could very well plague them for life.

When is it Addiction? Three or more of the following: Preoccupation with getting tobacco Compulsive use Difficulty with controlling intake Persistent, even with health problems Relapse Tolerance Withdrawal

References: World Health Organization Diagnostic and Statistical Manual - IV (DSM-IV) How long does it take to become dependent? Can be after the first cigarette!

Pre-Contemplation Stage

Not ready to quit Not interested in

changing Are defensive “I can’t quit” “It will not happen to me” “I enjoy it to much”

Stages of Change

Contemplation & Determination Stages

Seriously thinking about changing

Aware of the need to quit Taking small steps to quit “I know I need to quit” “You know, I should quit” “I want to quit within the

next 30 days”

Stages of Change

Action Stage Ready for change Prepared mentally to

change “I am going to quit

smoking” “I want to live to see my

grandchildren” Attends class or calls a

quit line Quits smoking Last approximately 6

months

Stages of Change

Maintenance Stage Has quit smoking Prepares for stress Handles temptation Reminds themselves

of what they have accomplished

Continues to be smoke-free

Stages of Change

Relapse Stage Most experience Sees oneself as a

failure A normal event A person may go

through the stages of change several times before complete cessation.

Stages of Change

Benefits of Quitting

• Improved Health

• Better Taste

• Good Role Model

• Enhanced Self-Esteem

• Improved Stamina

• More Money!

• Stopping smoking greatly reduces your risk for developing lung cancer. After you stop, your risk levels off.

• Ten years after the last cigarette, the risk of dying from lung cancer drops by 50 percent -- which does not mean, however, that risk is eliminated.

Roger Miller, 56, singer/songwriter, lung/throat cancer, deceased

Eddie Kendricks, 52, singer (Temptations), lung cancer,

deceased

Smoking cessation timeline – the health benefits over time

• In 20 minutes, your blood pressure and pulse

rate decrease, and the body temperature of your hands and feet increase.

• Carbon monoxide in cigarette smoke reduces the blood’s ability to carry oxygen. At 8 hours, the carbon monoxide level in your blood decreases to normal. With the decrease in carbon monoxide, your blood oxygen level increases to normal.

• At 24 hours, your risk of having a heart attack decreases.

• At 48 hours, nerve endings start to regrow and the ability to smell and taste is enhanced.

• Between 2 weeks and 3 months, your circulation improves, walking becomes easier and you don’t cough or wheeze as often. Phlegm production decreases. Within several months, you have significant improvement in lung function.

• In 1 to 9 months, coughs, sinus congestion, fatigue and shortness of breath decrease as you continue to see significant improvement in lung function. Cilia, tiny hair-like structures that move mucus out of the lungs, regain normal function.

• In 1 year, risk of coronary heart disease and heart attack is reduced to half that of a smoker.

• Between 5 and 15 years after quitting, your risk of having a stroke returns to that of a non-smoker.

• In 10 years, your risk of lung cancer drops. Additionally, your risk of cancer of the mouth, throat, esophagus, bladder, kidney and pancreas decrease. Even after a decade of not smoking however, your risk of lung cancer remains higher than in people who have never smoked. Your risk of ulcer also decreases.

• In 15 years, your risk of coronary heart disease and heart attack in similar to that of people who have never smoked. The risk of death returns to nearly the level of a non-smoker.

QUITTING

• Plan a Day & Date To Quit

• Go “Cold Turkey” or..

• Pick a method to quit

• Enlist Support From Others

• Plan For & Be Prepared For Potential Difficulties

• Make Sure Your Surroundings Are Non-Tobacco Friendly

• Congratulate Yourself For Your Progress & Success!

Nicotine Replacement Options

• Nicotine Gum • Nicotine Patches • LOZENGE or MINI-LOZENGE • Nasal Spray • Inhaler • VARENICLINE (Chantix®) • BUPROPION SR (Zyban®/ Wellbutrin SR®) May

be combined with a Nicotine replacement

Other Options

• Acupuncture

• Hypnosis

• Biofeedback

• Support groups

• Tapering/ Gradual Approach to quitting

• Cold Turkey

Options For Quitting Assistance

•NH Quit Works • 1-800-784-8669 (1-800-QUITNOW)

• Offers brief counseling

• Tips, follow up calls, ongoing support

• Reports to your practitioner

• Assistance with the cost of Patches

NH Tobacco Helpline

1. 1-800-QUIT-NOW

2. www.trytostopnh.org

3. Text ‘CALL ME’ to 22122

Tips to Remember

• Smokers visiting those with lung disease can aggravate their condition. Be careful visiting sick people or those with respiratory disease.

• ASK FOR HELP • Offer encouragement to smokers, but don’t

“force” them to quit. It only breeds resentment and hard feelings.

• If you smoke be respectful of the effects it has on others.

We Must Break The Cycle

Not a

Thank you