Smokeless Tobacco and Smoking Cessation Program A Program

Smokeless Tobacco and Smoking Cessation Program A Program from the Society of Otorhinolaryngology-Head and Neck Nursing, Inc. By Jan Adams, RN, BSN, MPA, CNA, CORLN 5/26/2021

Train the Trainer n This course will assist you, the trainer, in presenting the SOHN Smoking Cessation Program to your patients, community and for yourself if you are a smoker n A CD of the Program is provided for your use. 5/26/2021

Presenting the Program n The SOHN Smoking Cessation Program is designed in four parts. The entire program can be presented in one sitting or broken into smaller sessions. n Statistical information is provided to help the Trainer be better informed about tobacco and tobacco products. 5/26/2021

Why are we here? n This course is presented to make you aware of the effects of tobacco, how it affects your performance and what resources are available to assist you in stopping tobacco use 5/26/2021

What we will discuss Facts and Figures about tobacco use in the US n Health risks associated with tobacco n Cigarette and smokeless tobacco use and abuse n How to quit-tips n 5/26/2021

Smokeless Tobacco and Smoking Cessation Program Overview n Session One: Tobacco Abuse: Facts and Figures Complete registration information n Verbalize an understanding of the program n Schedule “Quit Day” n Complete the tobacco use record n 5/26/2021

Smokeless Tobacco and Smoking Cessation Program Overview n Session Two: Smoking Cessation: Issues and Strategies Understanding addiction n Identify stages of behavior n What are the effects of tobacco on the body n Coping Strategies n 5/26/2021

Smokeless Tobacco and Smoking Cessation Program Overview n Session Three: Quitting Effectively Quit day n Withdrawal Symptoms n Quitting tips n 5/26/2021

Smokeless Tobacco and Smoking Cessation Program Overview n Session Four: Maintaining a Tobacco Free Life Style Strategies that help n Handling a lapse n Identify methods to remain smoke-free n References n 5/26/2021

Recommendation from the CDC and Public Health Service on Insurance coverage Tobacco use treatment DOUBLES quitting success rates n Cover at least 4 30 minute sessions including telephone and individual counseling n Cover both Rx, OTC and prescription meds n Provide counseling and meds for 2 attempts/yr n Eliminate or minimize copays n 5/26/2021

Facts and Figures 46 million Americans smoke cigarettes - 25% of the population n Most prevalent is age 25 -44 n Average to start smoking is 14. 6 years old n One out of every 5 high school students smoke n 4400 children between the ages of 12 and 17 use tobacco for the first time every day n 5/26/2021

Facts and Figures 2004 – Age Estimates 18 -24 yo – 28. 5% n 25 -44 yo – 25. 7% n 45 -64 yo – 22. 7% n Over 65 yo – 9. 3% n Men – 25. 2% n Women – 20. 0% n 5/26/2021

Facts and Figures (Con’t) In 2002 - 28. 4% of high school students used tobacco n In 2002 - 13. 3% of middle schoolers used tobacco n n Unfortunately, from 2002 -2004 this percentage has not changed 5/26/2021

Trends in Tobacco Use 2002 n n n Non-Hispanic 21. 7% Pipe use 3. 7% Hispanic cigar use 10. 8% 5/26/2021 2004 n n n Decreased to 17. 1% Pipe use is 1. 7% Cigar use is 13. 3%

Of Importance Among smokers <18 years old 63. 9% were not asked for proof of age to purchase tobacco n 62. 1% were not denied their purchase when proof was shown n 15. 1 million (41. 1%) of adult smokers have stopped at least once n 5/26/2021

Prevalence of Tobacco Use Indian/Alaska Natives – 40. 8% n Caucasian – 23. 6% n African American – 22. 4% n Hispanic – 16. 7% n Asian – 13. 3% n 5/26/2021 Source: CDC, May 2004

Legislative Impact 16 states continue to have no restrictions on smoking n In 2004 – Delaware, Florida, Idaho, Maryland, New York and South Dakota banned smoking in workplaces and restaurants n Utah and Vermont banned smoking in restaurants n Delaware, Maine, Massachusetts, NY banned smoking in bars n Delaware, Massachusetts, NY banned smoking in all three!!! n 5/26/2021

More Facts n There are 4, 000 substances found in cigarettes and 43 of them are known to cause cancer. 5/26/2021

Facts and Figures Smoking causes more deaths per year than all addictive substances combined - that is about 450, 000 deaths per year n One out of every five deaths is from tobacco n 5/26/2021

Cigar and Pipe Smokers Beware! Cigar use has increased by 34% n Mortality is lower than that of cigarette smokers but more than that of non-smokers n Mainly the 45 -65 year olds n 5/26/2021

How safe is smokeless tobacco? n Tobacco in cigarettes is recognized as a major cause of cancer, heart disease and hundreds of deaths per year n Tobacco does not suddenly become safe when it is chewed instead of inhaled 5/26/2021

Facts about Smokeless Tobacco: A Dangerous Alternative Smokeless tobacco is highly addictive n It causes about 27, 000 cases of oral cancer per year n It kills at a younger age than cigarettes n It has 100 times higher concentration of cancercausing agents than cigarettes – (28) n Most commonly used by 18 -25 yo n 7. 6 million Americans over the age of 12 have used smokeless tobacco this month n 5/26/2021

Types of Smokeless Tobacco n Snuff or Dip – finely ground tobacco in dry or moist form such as Skoal or Copenhagen. Also comes in sachets n Chewing tobacco - loose leaf tobacco such as Red Man. It also comes in a plug , twist or loose leaf 5/26/2021

Smokeless is more dangerous! n An average size dip or chew held in the gum for 30 minutes has as much nicotine a 4 cigarettes! 5/26/2021

What you should know about Smokeless Tobacco 1 tin of snuff contains a potentially lethal dose of nicotine n The nicotine in 2 tins per week equals smoking 1. 5 packs of cigarettes per day n for every 5 tons of tobacco grown - 3 people die n 5/26/2021

What else you should know about Smokeless Tobacco There has been a 50 fold increase in oral cancers in which smokeless tobaccounts for 90% of those cancers n There is a 50% fatality rate in 5 years n 6. 7% of HS students use smokeless n 3. 7% of middle school students use smokeless n 5/26/2021

Types of Diseases Caused By Smokeless Tobacco Throat cancer and oral cancer n bladder cancer n larynx (voice box) cancer n Stomach ulcers and/or cancer n heart attacks n lung disease n 5/26/2021

More Bad News……. . Dippers are 4. 5 times more likely to have high cholesterol n Women who use smokeless tobacco have 3 times more stillbirths n Smokeless tobacco causes gum disease, permanently stained teeth and tooth deformities n 5/26/2021

What are in ingredients in tobacco? Polonium 210 (nuclear waste) n Acetaldehyde (irritant) n Lead (nerve poison) n Formaldehyde (embalming fluid) n Cadmium (found in batteries) n 5/26/2021

More ingredients N-Nitrosamines (known carcinogen) n Benzopyrene (known carcinogen) n Uranium 235 (nuclear waste) n Nicotine (addictive substance) n 5/26/2021

Nicotine Replacement Options Gum, patches, spray, lozenge, Inhaler n Zyban ®, Wellbutrin® n Cold turkey n 5/26/2021

Advantages to Quitting Within 20 minutes: n blood pressure and pulse drops to normal n body temperature in the feet and hands returns to normal n 5/26/2021

Advantages to Quitting n n n Within 8 hours Carbon monoxide level drops to normal oxygen level increases to normal 5/26/2021 n n Within 24 hours Chances of a heart attack drops by 50%

Advantages to Quitting n n n Within 48 hours Nerve endings begin to regrow The ability to smell and taste improves 5/26/2021 n n n Within 72 hours Bronchial tubes relax lung capacity increases

Advantages to Quitting n n Within 1 -9 months Coughing, sinus congestion and fatigue decreases Cilia re-grow lung cancer death rate is cut in half 5/26/2021 n n Overall energy level increases Incoming air thru the nose and air passages is cleaner and infections decrease

Stages of Behavior Changes Pre-contemplation n Contemplation n Preparation n Action n Maintenance n 5/26/2021

Pre-Contemplation Not considering a change at this point n May be defensive about tobacco use n Needs help realizing benefits of cessation n 5/26/2021

Contemplation Intends to change - one day n Knows what tobacco does to the body n Costs outweigh benefits right now n Low self-confidence n Needs help identifying triggers and ways to quit n 5/26/2021

Preparation Ready to learn n Making small changes to avoid tobacco n Needs to create a plan of action n Needs lots of support n 5/26/2021

Action Making changes and monitoring progress n At great risk for lapse n Needs to be assertive n Needs support n 5/26/2021

Maintenance Sustaining the change in behavior n Maintaining smoke-free for 6 months or more n Feels very confident n Needs a support group n 5/26/2021

Fagerstrom Level of Dependence Test n This test was developed by Fagerstrom and is frequently used in Smoking Cessation courses to determine the level of dependence 5/26/2021

What are your likes and dislikes about tobacco? n Discussion of the likes and dislikes of tobacco often encourages one to find alternatives. n This helps identify visually what tobacco means to you 5/26/2021

Quit Day Make this a very special day !! Set a date and stick to it. n You must have a plan! n Review coping strategies. n Review your likes and dislikes. n Get rid of all tobacco products. n 5/26/2021

Triggers to Smoking/Chewing and Coping Techniques n What triggers you to use tobacco? Identify when you crave tobacco In the car n When drinking n When stressed n n What coping techniques may help alleviate use 5/26/2021

Withdrawal Signs Cravings n irritability n tenseness n trouble concentrating n constipation or irregularity n restlessness n 5/26/2021

Stress Management Attitude n Think! n Count to ten n Relaxation exercises n Plan ahead n Learn to say “NO” n 5/26/2021

Tips For Quitting Drink lots of water n Get rid of tobacco in the house and car n Remove all ashtrays n Increase fruits and veggies n Think positive n Call a friend for support n Hang out with Non-smokers n 5/26/2021

Maintaining Your Balance Recreation - get outside n Social - avoid smoky places n Spiritual - get in touch n Physical - get active n Mental - relax n Vocational - stay busy n 5/26/2021

What if I slip? Quit tobacco use immediately n Think about what happened and avoid it n Recognize that there was a problem n Learn from the mistake and move on n 5/26/2021

Want More Information? References on the internet and addresses n Call on your support system/nurse to help n Good Luck! n 5/26/2021