CESSATION
University of North Carolina at Chapel Hill Center for Functional GI & Motility Disorders
Smoking Cessation is designed by Nicolette DeGroot All content is borrowed from the Stop Smoking Program of Miami VA Medical Center
Contents
Health Effects of Tobacco
Good News from the ACS
Hints to Help You Stop
Ideas and Strategies
Post-Smoking Weight Gain
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Effects of Tobacco on Your Health Tobacco smoking is the leading preventable cause of death in the United States. In 1990, smoking contributed to 417,000 deaths in this country. When a smoker dies “prematurely� (that is, before age 69 years), he/she loses an average of between 20 and 25 years off life expectancy. Tobacco use is one of the main causes of cardiovascular disease. This disease involves blockage in blood vessels. Blockages in blood vessels of the heart are the reason for pain from the heart (called angina) and for heart attacks. Cardiovascular disease is the most frequent cause of death in the United States. It is the reason for half the deaths in this country. Tobacco use is also a cause of many types of cancers. Cancer is the second most common reason for death in this country. Nearly one-third of the deaths from cancer are related to smoking. The leading cause of death due to cancer for both men and woman is from lung cancer. Nearly all cases of lung cancer (87 percent) are related to smoking. If you smoke and are male, you re 23 times more likely to die from lung cancer than if you do not smoke. If you smoke and are female, you are 24 more times more likely,. Last, cigarette smoking is a major cause of chronic obstructive pulmonary (lung) disease or COPD. COPD includes chronic bronchitis and emphysema. The rate at which males die from COPD has nearly doubled since 1960. For females, the death rate from COPD has more than tripled
Some Good News from The American Cancer Society As soon as you snuff out that last cigarette, your body will begin a series of physiological changes: Within 20 minutes Blood pressure, body temperature and pulse rate to drop to normal. Within 8 hours Smokers’ breath disappears. Carbon monoxide level in blood drops and oxygen level rises to normal. Within 24 hours Chance of heart attack decreases. Within 48 hours Nerve endings start to regroup. Ability to taste and smell improves. Within 3 days Breathing is easier. Within two to three months Circulation improves. Walking becomes easier. Lung capacity increased up to 30 percent. Within one to nine months Sinus congestion and shortness of breath decrease. Cilia that sweep debris from your lungs grow back. Energy increases. Within one year Excess risk of coronary heart disease is half that of a person who smokes. Within two years Heart attack risk drops to near normal. Within five years Lung cancer death rate for the average former pack-a-day smoker decrease by almost half. Stroke risk is reduced. Risk mouth, throat and esophageal cancer is half that of a smoker. Within 10 years Lung cancer death rate is similar to that of a person who does not smoke. The pre-cancerous cells are replaced. Within 15 years Risk of coronary heart disease is the same as a person who has never smoked.
Hints to Help You Stop Smoking • Buy a pack at a time; no cartons. • Change to lower nicotine cigarettes. • Change to a cigarette brand you dislike. • Limit the places you smoke, for example only smoke outside. • Make cigarettes harder to get to. • Talk to yourself about reasons to stop. • Imagine the future benefits. • Use candy, gum, toothpicks. • When you have an urge, do something to take your mind off smoking. • Get more hobbies. • Exercise more. • Listen to relaxation tapes. • Use plastic cigarettes. • Smoke only part of a cigarette. • Time your cigarettes. • Use a tally sheet • Relax with a cool glass of water or juice. • Cut out "automatic" cigarettes. • Isolate smoking from other activities, like watching TV or reading. • Be aware of rationalizations for smoking. • Remember it isn't easy; just keep at it • Brush your teeth more often. • Praise yourself for any progress at all. • Tell your family how they can help you. • Keep track of money saved. • Give yourself rewards for Progress.. • Take it one day at a time. • Leave your cigarettes at home for short trips. • Have only one ashtray. • Avoid smokers and smoking areas. • Avoid thinking how hard it will be. • Review the reasons why you want to stop. • Get more rest. • Drink less coffee. • Set a goal each day for a cigarette count you will allow yourself to smoke. • Avoid as many situations as possible that trigger you to smoke.
Ideas & Strategies To Help You Quit • Don't feel discouraged because you have tried to stop many times before. Research shows it takes most people several attempts to stop smoking before finally quitting for good. So keep trying. Use what you learned from previous attempts to become successful this time. • Take it one day at a time. Stop worrying about how you will cope with never smoking again. Take it one hour at a time if necessary. • Remember that physical symptoms of withdrawal from nicotine decrease with time after you stop smoking. After they end, you will find it much easier to avoid smoking. • Think about how nicotine controls you. You smoke to avoid going through uncomfortable withdrawal symptoms if you stop. You are hooked. • Make a list of your reasons for wanting to quit smoking. Write them down. Don't forget the effects on family from second-hand smoke. Remember that children who see important adults smoking are more likely to become smokers. List all the benefits you expect from stopping. Keep the list with you and read it often for motivation. • Increase your motivation to stop by asking your doctor about the risks to you of continuing to smoke with your specific health conditions. • Even if you are still fairly healthy, cigarettes have caused damage. As long as you continue to smoke, more damage will occur. Your body begins to repair itself immediately after you smoke your last cigarette. • There are health benefits to stopping smoking no matter how much you have smoked or what your age. • The health benefits of stopping smoking add up more quickly that you think. See page 5 of this info packet. • Using a tally sheet is almost guaranteed to help you decrease your smoking. You will become more, aware of your smoking. You will learn how much you truly smoke. The tally sheet helps you cut out the cigarettes you light without thinking, the "automatic" ones. • When you use the tally sheet, it's almost guaranteed you will decrease your smoking. But many people only use it for awhile and then stop. Some say it's too much trouble. Others admi.t they really don't want to know how much they smoke. The tally sheet works, but only if you use it. If you stop using it, simply start again. • One way to wean yourself from nicotine is to gradually increase the amount of time between your cigarettes. Use a tally sheet to help you keep track of the time between your cigarettes. • Another way is to wean yourself from nicotine is to set a goal each day for the number of cigarettes you will smoke. Gradually reduce the number. Take as long as you need to do so. Follow the rule you will not return to a higher number of cigarettes per day once you have made a reduction. Use the tally sheet to keep track. • Another way to wean yourself from nicotine is to change to lower-nicotine cigarettes. Try not to smoke more of the lower nicotine cigarettes.
Ideas & Strategies [cont.] • Keep your hands and mouth busy with other things than cigarettes. Play with a pen, paper clip, or rubber band. Keep a toothpick, coffee stirrer, or cinnamon stick in your mouth. Use sugar-free chewing gum or hard candies. • Stop buying cartons. Buy one pack of cigarettes at a time, even if it costs you more money. The more inconvenient and. expensive it is for you to buy more cigarettes, the fewer cigarettes you will smqke. • Change to a brand of cigarettes you dislike. Make sure the new brand does not contain more nicotine than the one you gave up. • Limit the places where you allow yourself to smoke. Stop smoking inside where. you live. You must go outside to smoke. Stop smoking in your car. • Make it inconvenient to get to your cigarettes. Avoid carrying them around with you at home or at work. The more difficult it is for you to get to your cigarettes, the fewer you will smoke. Keep them in another room, another office, or in your vehicle. Take short trips without any cigarettes at all. • The first few weeks after stopping smoking are the hardest. During this time, be prepared to focus much of your energy on coping with not smoking. Arrange your activities and responsibilities over this period so that other stress on you is reduced. • Pay attention to when and where you are the. most likely to smoke. Which times of the day, places, and ' activities most strongly trigger you to smoke? Avoid as many "triggers" as you can. Learn to cope with the others one at a time. For each one, have your plan ready for what you will do to keep yourself from smoking. • Make sure you give yourself the credit you deserve for the progress you have made.. If you have cut down on your smoking or begun smoking lighter cigarettes, you are on your way to stopping totally. • Give yourself rewards for your progress. We all need rewards to keep us working hard. Do not give yourself cigarettes as rewards. If you do not want to gain weight, do not reward yourself with food. • Help yourself relax by slow, deep breathing. Breathe in deeply through your nose. Hold the air in for just a moment. Then breathe out slowly through you mouth with your lips pursed. Practice relaxing yourself while sitting in a comfortable chair in a quiet place. Close your eyes. Breath in and out slowly and deeply. Concentrate on your breathing. If your ·mind wanders, just bring it back to concentrating on your breathing. Use your imagination to help yourself relax further. Imagine that with each breathe out, you feel heavier and heavier, sink deeper and deeper into the chair, and descend deeper and deeper into.a comfortable state of relaxation. Take five, ten, or fifteen minutes at least once or twice a day to practice relaxing yourself. • Get more rest. You probably need it. Remember that nicotine is a stimulant. Many people use cigarettes to give them energy because they do not get enough rest. Once you stop smoking and your body recovers, you will have more energy than you had when you were smoking.
Ideas & Strategies [cont.] • Ask a friend or a relative to be your main support. Choose someone who will understand and know how~to help you. Ask if he or she is willing to talk to you when you are having strong cravings to smoke. • There are many different ways to help yourself relax. Some people listen to music. You may want to take a shower-or bath. Use what has worked for you before but avoid alcohol. • It is harder to stop when there are others who smoke where you live. Ask your family and friends to help by not smoking around you and by not allowing their cigarettes to lie around. • Brush your teeth more often. Have your teeth cleaned after you stop smoking. Notice how much fresher your mouth feels when not smoking. Your breathe is no longer unpleasant. • Tell other people you are quitting smoking. You may be more motivated to succeed knowing others are watching. • At the time of your last cigarette, carry out some "ceremony" which is meaningful to you and marks the importance of the occasion. Hold the ceremony with those family and friends present wlio are worried -about your health and welfare. • Best thing to do after a meal is get up and get busy. Don't sit in the usual place in which you smoke. • Talk with others about what they did to quit. Remember, what works for one person does not always work for others. Try out ideas which you think might work for you. • Use what you have learned from beating other addictions to help you stop using nicotine. • As you watch others smoke, think of what they are doing to their bodies. Then watch yourself in a mirror while you smoke. • Cut down on drinking alcohol or cut it out, at least until you are solidly stopped from smoking. Cigarettes and drinking go together. When you drink, your self control is worse. • Cut down on the amount of coffee. Cigarettes and coffee go together. Try drinking your coffee where you cannot smoke. Cigarettes make your body get rid of caffeine more quickly. When you smoke less, you will need less caffeine. • Make a list of the benefits you will experience by quitting smoking. What good things do you expect will happen to you after you stop? Get a picture in your mind of how your life will be better after you quit smoking. • Get more exercise. Make it regular. Walking is fine. start with what you can do now and increase your exercise gradually. Keep yourself consistent by maintaining a record of your exercise on a calendar. Exercise with a "buddy" to keep it interesting. Exercise gives you more energy while at the same time keeps you relaxed mentally. • Plan enjoyable and relaxing activities for yourself as rewards for quitting, especially during the first few weeks after stopping smoking. • Figure out how much money you will save by stopping smoking. Think about what else you can spend the money on.
Post-Smoking Weight Gain The facts 1. The majority of smokers who quit gain weight. Most gain less than 10 pounds but about 10% gain as much as 30 pounds. 2. For many smokers, especially women, fear of gaining weight is a reason they keep smoking. 3. The amount of weight gained following stopping smoking cessation is a minor problem for health compared to the risks of continuing to smoke. 4. Because smoking affects the body’s metabolism, even quitters who do not increase their food intake are likely to gain some weight. Strategies to cope with weight gain 1. Try to put your concerns about weight on the back burner. You are most likely to be successful if you first try to quit smoking, and then later take steps to reduce your weight. Tackle one problem at a time! 2. Until you are confident that you have quit smoking for good, do not try to limit your food intake. Don’t starve yourself. But eat healthy foods. When you want a snack, eat fruits or vegetables. Stay away from fatty foods, chips and sweets. 3. Ask yourself if you are really hungry or just bored or eating because of stress. It helps to stay active and do things to distract you. 4. Be aware what circumstances trigger you to over-eat, such as watching TV, having a lot of high-calorie foods around, or being tired. Don’t leave all the extra food on the table in front of you after the meal. Avoid as many triggers as you can. For example, prepare yourself a reasonable portion from the kitchen and bring it to the table. Make sure you get enough rest. 5. One of the most important strategies is to increase your exercise here are some tips: a. Schedule exercise into your day. b. Find a “buddy” to exercise with you. c. Try different physical activities so you don’t get bored. d. Start your exercise off slowly so you don’t get hurt. Remember if you injure yourself you can’t exercise all. e. Pick exercise that you enjoy and that you convenient for you, for example take walk or ride a bike.
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