Information about Addiction – Tobacco

We Have to Know about the Addiction – Tobacco

Mortality and Morbidity

• Results in premature death. Years of life lost due to smoking (Male – 13.2 Female – 14.5)
• Causes significant disease and disability

Cardiovascular Effects

• A cause of coronary heart disease
• A cause of cerebrovascular disease (stroke)

Cancer

• A cause of lung cancer
• A contributing factor for pancreatic cancer
• A cause of laryngeal cancer
• A contributing factor for renal cancer
• A cause of cancer of the oral cavity (lip, tongue, mouth, and pharynx)
• Associated with gastric cancer/stomach cancer
• A cause of esophageal cancer
• A cause of bladder cancer

Respiratory Diseases

• A cause of chronic bronchitis
• A cause of emphysema
• Acceleration of age-related decline in lung function among adults
• Other respiratory effects: Increased cough, phlegm production, wheezing, respiratory infections

Women’s Health Effects

• A cause of intrauterine growth retardation, leading low birth weight babies
• A contributing factor for cervical cancer
• A probable cause of unsuccessful pregnancies (SIDS)

Delayed conception

Low bone density among postmenopausal women, and risk of hip fractures

Other Health Effects

• Adverse interactions with occupational hazards that increase the risk of cancer
• Alteration of the actions and effects of prescription and nonprescription medications
• Adverse surgical outcomes related to wound healing and respiratory complications
• A probable cause of peptic ulcer disease
• Erectile dysfunctions
• Cataract

Environmental Tobacco Smoke (ETS)

• Individuals who are constantly exposed to environmental tobacco smoke can have the following problems even they do not have the habit of smoking. Explain the caller can cause following risks to his/her family members/friends who are present with him usually when he is smoking.
• A cause of lung cancer in nonsmokers
• Associated with higher death rates from cardiovascular disease in nonsmokers
• In children, associated with respiratory tract infections, increased prevalence of fluid in the middle ear, additional episodes of asthma, and increased severity of symptoms in children with asthma, and a risk factor for new onset of asthma in children who have not previously displayed symptoms.
• Associated with increased risk of sudden infant death syndrome (SIDS).
• Associated with increased irritant effects, particularly eye irritation, among allergic persons.

Other problems

• premature wrinkling
• bad breath
• stained teeth
• yellow fingernails
• gum disease
• bad-smelling clothes and hair
• Increases the health risk to loved ones and those around you
• Effect on a sense of smell and taste
• Smoking prevalence is significantly higher among people with mental health problems than in the general population

Discuss The Benefits Of Quitting

• Ensure the caller that quitting smoking is the best thing to improve their quality of life and health. Former smokers live longer than those who continue to smoke.
• Within 8 hours, the level of carbon monoxide in your body decreases and oxygen increases to normal levels.
• After just two days, the risk of heart attack begins to decrease. After the first year, the risk of heart attack is cut in half.
• Within just 48 hours, your sense of smell and taste improve and return to normal.
• After three days, your lung capacity will have increased, making breathing easier.
• Within 10 years, the risk of dying from lung cancer is cut in half
• Within 15 years, the risk of dying from a heart attack is equal to a person who never smoked.
• The health benefits of quitting occur for all types of smokers, men and women, young and old.
• Quitting increases social acceptance
• Discuss the amount of money that can be saved and utilized for better purposes, basing on caller’s socio-demographic profile (present costs, possible costs)

Advice On Crafting A Quit Plan

•  Encourage the caller to write down his/her reasons for quitting and to look at the list often for support. If the caller is illiterate encourage him to think about these reasons and remember them often.
• Explore the level of dependency of the caller. Levels of dependency vary from individual to individual. 80% of smokers have a cigarette every one to two hours throughout the day. A highly addicted smoker – smoking more than 25 cigarettes a day – ranks the first cigarette in the day as the most important, and will smoke within 30 minutes of waking up
• Encourage the caller for the systematic reduction in the number of cigarettes he consumes over a period of time.
• Otherwise, help the caller to pick a day to quit smoking during a non-stressful period. Encourage him to pick this date periodically like a particular day in a week, fortnight or month.
  • Mark it on your calendar.  Choose a “normal” quit date. Try not to quit smoking during holiday/vacation season, major work deadlines, or big life events such as weddings.
  • Discard cigarettes, lighters, and ashtrays at home.
  • Stock up on oral substitutes — sugarless gum, carrot sticks, hard candy, cinnamon sticks, coffee stirrers, straws, and/or toothpicks.
• Encourage the caller to reward self for every successful attempt. Help him to identify the ways and types of self-rewarding.
• If the habit is triggered by any particular identifiable problem of the caller life. Help the caller in addressing the problem concerned.

Identify Triggers And Help The Caller To Break Them

• Smokers learn to associate the pleasures of smoking with all of the daily activities they usually perform while smoking. For example, if an individual smokes while drinking a cup of coffee, the sight and smell of a cup of coffee could trigger the craving for a cigarette or make the craving worse.
• Since an addicted individual smokes many cigarettes over the course of one day, many such connections are made. If one smokes while driving to work, getting into the car can result in a craving for a cigarette. If one smokes after dinner regular having dinner can make you want a cigarette.
• One needs to identify and plan for all of the places and behaviors he/she associates with smoking before he/she will be able to entirely quit using tobacco. Once triggers are identified (those people, places and things that trigger one to crave for a smoke), the routine can be changed and behaviors can be substituted and the respective connections between triggers and smoking can be eliminated.
• If the caller is not able to identify any such association, ask him to a chart each cigarette that he smokes for the next few days.
• Ask him to enter the time, place, and with whom did he smoke, what was the reason for smoking, and his thoughts on how it will be easy or difficult to give that particular cigarette up.
• Ask him to call back and help him in nailing down the associations and help him to identify a comprehensive plan to break these associations.

Help The Caller To Deal With Withdrawal Symptoms

• Make the caller aware that every quit attempt follows a withdrawal phase which usually lasts for one week. Usually, smokers get back to habit because of their inability to cope with withdrawal symptoms. Prepare the callers to deal with withdrawal symptoms.
• The common withdrawal symptoms that accompany nicotine cessation are
  • Physical – Chest tightness, Slight sore throat, Coughing, Nasal drip, Bad Breath, Nasty taste, Bleeding gums, Headaches, Stomach pain, Nausea, Constipation, Weight gain
  • Psychological or Behavioral – Cravings, Anxiety, Irritability, Restlessness, Anger, Impatience, Inability to concentrate, Feeling tired or fatigued, Trouble sleeping
• Encourage the caller to stay away from smoking areas as exposure to smoking areas makes it difficult to deal with withdrawal symptoms and tempts the individual to smoke.
• Encourage the caller to adapt to a healthy lifestyle by developing good food and sleep habits, some sort of regular exercise to the body etc.
• Encourage him to rest more than his usual periods of rest during the withdrawal phase.
• Advice the caller to drink lots of water and eat nutritious food as it contributes to reducing the severity levels of withdrawal symptoms.
• Advise the caller to practice relaxation exercises during a bout of withdrawals.
• Advise the caller to take the help of his support system while dealing with withdrawal symptoms.

Help The Caller Decide On Cessation Products

Nicotine patches

• Available over the counter
• The nicotine patch is placed on the skin and supplies a small and steady amount of nicotine into the body
• Nicotine patches contain varying concentrations of nicotine (21mg, 14mg, or 7mg, for example) and the user reduces the dose over time.

Nicotine gums

• Available over the counter
• Nicotine gum is chewed to release nicotine that is absorbed through tissue inside the mouth.
• The user chews the gum until it produces a tingling feeling, then the gum is placed (parked) between the cheek and gum tissue.
• Nicotine gums have varied concentrations of nicotine (typically 2mg or 4mg) to allow the user to reduce the amount of nicotine in their system.

Nicotine Lozenges

• Available over the counter
• Nicotine Lozenges look like hard candy and are placed in your mouth to dissolve slowly.
• The Nicotine lozenge (typically 2mg or 4mg dose of nicotine) releases nicotine as it slowly dissolves in the mouth.

Nicotine inhalers

• Prescription only
• A nicotine inhaler consists of a cartridge attached to a mouthpiece. Inhaling through the mouthpiece delivers a specific amount of nicotine to the user.

Nicotine nasal sprays

• Prescription only
• Nicotine nasal spray is a pump bottle containing nicotine that is inserted into the nose and sprayed.
• Nicotine nasal spray can be used for fast craving control, especially for heavy smokers.

Suggest Professional Help

• If the dependency level of the caller is very high and the caller is not able to quit the habit even after trying the above tips advise him to seek the professional help.
• Psychiatrists, De-addiction centers, Clinical Psychologists are the professionals who can provide substance abuse treatment. Depending on the caller’s place select any of these available professionals from the database and motivate the caller to access their services.