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QUIT SMOKING - UNDERSTANDING AND PREVENT SMOKE - COURSE

(40) Quit Smoking

What is the Single Best Thing You Can Do to Quit Smoking?

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If I don’t inhale will I have less of a chance of getting a disease, such as lung cancer?

It is important to remember that there both direct and indirect risks from smoking, whether or not one inhales. You are still exposing your body to tar and nicotine. While not inhaling reduces the direct exposure of tar and nicotine to the lungs, it does not eliminate exposure.

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(41) Quit Smoking

Indonesia's tobacco children

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ANTI TOBACCO PROGRAM

SAVE KIDS INTERNATIONAL

ATP is an international program for school age children and teens to prevent the use of tobacco and illegal drugs, membership in gangs, and violence. It is a collaborative effort by law enforcement, educators, parents, and community leaders. It promoted the presence of police in the classroom as the most appropriate teachers for school children to learn that drugs and violence kill.

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(42) Quit Smoking

Quit Smoking Advice - Allen Carr

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What are the other prevention programs for children?

The No Tobacco Use Program (TNT Program). Muskegon County, Michigan developed its own tobacco prevention program, called the TNT Program. Upon completion of the program, the prevalence of tobacco use among teens declined.

The American Stop Smoking Intervention (ASSIST).The American Cancer Society partnered with the National Cancer Institute and local health departments to launch the ASSIST program in a number of communities. It is a multimodal approach to prevention and smoking cessation. The interventions include the media to increase pro-tobacco-control coverage, strengthening indoor clean air laws, and reducing youth access to tobacco.

ASPIRE. ASPIRE is another smoking prevention school based program. It includes a CD-ROM animation-based curriculum developed at the University of Texas Science Center at Houston. It is an interactive school curriculum with animation and video game elements, targeted to students in the 10th to 12th grades. The topical outline includes:

• The short-and long-term effects of smoking

• Social issues

• The addictive nature of smoking

• Tobacco advertising

• Society’s move from smoking as an acceptable activity to now when it is unacceptable

• Financial issues

The Youth Tobacco Prevention Policies and Programs in Schools and Communities, developed by The Department of Health and Human Services (DHHS). DHHS developed a curriculum for Tobacco Prevention in the public schools. They advised the use of peer educators and parents to teach children about the effects of smoking. DHHS suggested that the consequences of smoking on school grounds should be clearly communicated to all students, should involve both school officials and law enforcement, and should be consistently applied. Prevention programs should be across grade levels and should include health and social issues, resistance skills, and the influence of advertising on people’s choices. Besides classroom teaching, they recommended the establishment of a peer-to-peer mentoring program to support abstinence. Other suggestions are to supplement classroom education using the Internet and other media sources. The Internet has great appeal to young people because it provides an environment that can be graphically appealing, anonymous, and non-judgmental. It can also provide ongoing support.

Other smoking cessation programs may not be exactly like the DARE program but have similar components. Many schools have integrated tobacco and drug prevention into their health courses rather than having a stand-alone program. Communities and schools have joined forces to develop programs that use a multimodal approach, are culturally sensitive, and meet the needs of their population.

 How old should my child be before I talk to him or her about smoking?

The Center for Disease Control and Prevention (CDC) recommends that parents start a dialogue with their children about the use of tobacco by ages 5 or 6. Continue talking to your children through high school. If you wait until they are preteens, it may be too late. Many kids start using tobacco by age 11 years and many are addicted by age 14. Parents, grandparents, coaches, teachers, and other adults should keep communication ongoing and openly discuss tobacco and other drugs. Introduce the subject of smoking when a child is very young in simple language according to the child’s developmental age and in terms that the child can understand.

 If you wait until they are preteens, it may be too late.

 How do I talk to my child about smoking?

 The following guidelines will help you communicate with your child.

• Clearly state your own values.

• Focus on the immediate short-term consequences, such as bad breath, smelly clothes, yellow teeth, and poor performance in sports. Only discuss long-term consequences with teens, who understand the concept of links between tobacco use and disease and death.

• Be a good role model. Actions speak louder than words. Kids do what you do and not what you say. If you do smoke, then do not smoke in front of your children and don’t leave cigarettes where they can be easily reached. If a toddler eats cigarettes, it can be fatal. The best thing you can do for your child is to quit. Tell your children the reasons why you do not want them to smoke. Be honest. Share your mistakes. If you do smoke, tell them about your own struggles with addiction. Tell why you wish you had never started. Know that you may be effective in preventing your child from smoking, if you do quit.One-third of the children whose parents quit smoking are less likely to smoke.

• Help children to cope with life’s stressors. Listen, empathize, be supportive, and allow them to express their feelings. “Feelings are OK.” Build their self-esteem and self-confidence.

• Discuss problems and teach problem-solving skills. Allow them to make some of their own decisions that are age appropriate.

• Make household rules clear. Be consistent. Spell out the consequences for breaking the rules and do not hesitate to enforce them when necessary.

• Monitor the TV programs they watch, movies your child attends, the magazines they read, computer games they play, and their use of the Internet. Talk about how advertisers glamorize smoking and drinking and that the information found in advertisements gives a false impression.

• Participate in family dinners, family rituals, bedtime rituals, and family games and outings. Family togetherness is a great preventative strategy.

Teach your children how to cope with peer pressure. Most of the difficulties that children have to face are the social pressures from other kids. Practice with your child and/or role-play examples of how to handle peer pressure. Parents are the most important resource in preventing teen substance abuse, including smoking.

How do I know if my child will become a smoker?

Studies demonstrate that the two most important predictors determining your child’s risk of becoming a smoker are access to cigarettes and friends who smoke. The following is a quiz to assess the risk of your child becoming a smoker.

• Does your child hang around with other kids who smoke cigarettes? The smoking rate among kids who have three or more friends who smoke is 10 times higher than the rate among kids whose friends are smoke-free.

• Do you or your spouse smoke? Studies have shown that kids whose parents are smokers are at least twice as likely to smoke.

• Do your child’s siblings smoke? Having an older brother or sister who smokes triples the odds that a younger sibling will smoke.

• Is your child having trouble in school? Smoking is linked to poor academic achievement.

• Does your child have a lot of unsupervised time after school? Children who engage in structured after-school programs, such as clubs or sports, have a lower risk of smoking. Be involved in what your children are doing, and know the children and families with whom your children are involved.

• Is your child depressed? Several studies have linked cigarette smoking with symptoms of depression among adolescents.

• Is your child an adolescent? Children ages 11 to 15 in grades 6 to 10 are most vulnerable to peer influences and are most likely to try their first cigarette. If a friend or relative has died from a tobacco-related illness, talk to your teenage son or daughter about this person’s death.

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(43) Quit Smoking

What is the Single Best Thing You Can Do to Quit Smoking?

QS43

Should I enroll my child in a prevention program?

 School-based programs will support your conversations with your child about smoking, thus reinforcing the no smoking rule in your household. If your school does not have a tobacco prevention program, find a program for your child in your local area. Then suggest through the Parent Teachers Association (PTA) that your school develop one. The information found in these questions should give you ideas about designing a program for your school and community. Not only will your child benefit from attending a prevention program, but if you are smoker, you will benefit, too.

 My spouse is a heavy smoker who refuses to get help to quit. What should I do?

There is not much you can do until he or she is ready to quit. Many smokers have tried to quit but have not been successful. Consequently, they have “given up.” Others remember the discomforts of the withdrawal symptoms and would rather not have to go through that experience again. Other people freely admit that they love to smoke and do not want to give it up. Different personalities and different experiences contribute to different attitudes toward smoking. Many smokers do not realize that new ways are available to assist smokers to quit, which may decrease the negative experiences of withdrawal. If the smoker is willing to think about the possibility of quitting, a spouse can help by collecting information about smoking cessation programs and provide his or her loved one with information about the opportunities for quitting.

A “Change Model,” or the “Trans-Theoretical Model” is a process model that identifies stages that a smoker must traverse in order to achieve abstinence. The stages are:

• Pre-contemplation: The person is aware that he or she has a problem but has not seriously thought about making a change.

• Contemplation: The person begins to see that the behavior is a problem and seriously considers making a change but remains ambivalent about doing so.

• Preparation: The person has decided to make a change and has a specific plan to do so in the near future.

• Action: The person implements an action plan and begins to make the desired changes.

• Maintenance: The person has made the desired change and works to avoid relapsing into the original behavior (smoking).

• Termination: The person is safely through the process, experiences zero temptation, and have the ability to resist any temptation 100% of the time. If a spouse understands these phases, he or she can help a loved one along the pathway to abstinence. During the pre contemplation and contemplation stages, if the loved one is open to discussion, the spouse can provide information, and also they can talk about a future plan to quit and what the spouse can do to help the smoker quit. Together they can identify a “quit” date. The spouse can provide empathy and support during the next two phases, preparation, and action. The nonsmoker spouse may have to overlook the irritability that the smoker is feeling that may lead to some negative behaviors. The “blues” also may contribute to behavior changes. The negatives should be ignored and the positives should be supported. The spouse can help with the maintenance phase by ensuring that the couple’s social life takes place only in smoke-free environments and that they socialize solely with nonsmokers. The spouse should constantly offer support during the maintenance and termination stages as well as throughout the withdrawal process. A supportive, loving relationship can go a long way to helping the smoker along the path to a healthy lifestyle.

Joseph’s comment:

For many years, I dabbled in trying to quit here and there with little success. Even with the physical ramifications of smoking starting to affect my body, I seemed to have no success. No matter how many people tried to help and encourage me from the outside, I truly don’t think I could get on the journey to quitting until I hit my own personal bottom. I tried “smoking cessations” once before, with no luck. Like the old saying goes, “If at first you don’t succeed, try, try, again.” My second time around, when it came up to the quit date, I put the cigarette down, using the “patch” as an aid, and made it through the first 24 hours. I was so filled with hope that I tried for another day and succeeded. At that point, I felt I was in a “zone.” I stopped looking at it as quitting forever and just not smoking one day at a time

 EPIDEMIOLOGY

 What is Healthy People 2010? Is smoking cessation included in its national goals?

The Department of Health and Human Services (DHHS) has been setting national objectives for Americans’ health since the 1980s when it first published Health Objectives for the Nation. Subsequently, it published Healthy People 2000 and recently Healthy People 2010. DHHS is responsible for overseeing the nation’s health. Their goals have been established to improve the health status of the U.S. population as well as the availability and quality of health services so the life span of Americans can be extended. DHHS encourages the establishment of prevention programs, including smoking cessation, and monitors the national health status and the achievement of the goals set in the Healthy People 2000 and 2010 reports. Every ten years, a Healthy People report that addresses the national public health trends is presented to the Secretary of DHHS, the President, and the U.S. Congress. The report also includes goals on prevention and strategies to be achieved over the next 10-year period. Both Healthy People 2000 and 2010 have two overarching goals: to increase the quality of health care during each American’s lifetime and to eliminate health disparities. Ten indicators are used to measure the nation’s health. Each of the indicators reflects a major health concern.

 The health indicators are listed as follows:

1. Physical activity

2. Overweight and obesity

3. Tobacco use

4. Substance abuse

5. Responsible sexual behavior

6. Mental health

7. Injury and violence

8. Environmental quality

9. Immunization

10. Access to health care

The indicators 3, 4, and 8 are factors involving tobacco use and addiction. Health indicators are selected based on the ability to motivate the public to act, the availability of the data to measure progress, and the importance of the indicator to the overall health of Americans. The selection process is done by consensus. The authors of the document are from both the private and public sectors of communities across the country. The report is the outcome of a shared vision about improving the health of the nation, preventing disease, and improving the quality of life of all citizens.

The Healthy People reports are used by many organizations, communities, and policy-makers to measure, compare, and improve the health status of local communities. Information for specific health issues is also developed and distributed to special populations, such as gays and lesbians, people with disabilities, rural health populations, women’s health organizations, and healthcare professionals who work with special populations. Healthy People 2010 provide a framework for health advocates to develop strategies to improve access to quality health care. Many public health officials consider tobacco-related diseases as the most critical healthcare concern, particularly because these diseases are easily preventable through public education, legislation, and the development of prevention and cessation programs.

 What are the rights of smokers and nonsmokers?

 Smokers’ organizations throughout the United States have developed to combat what they perceive has been a systematic effort to deprive them of their rights. The two main organizations are the American Smokers Alliance and the National Smokers Alliance. Other smokers’ rights groups with international membership include Freedom Organization for the Right to Enjoy Smoking Tobacco (FOREST) and Fight Ordinances and Restrictions to Control and Eliminate Smoking (FORCES). Controversy has surrounded these organizations due to their link with tobacco companies Smoker’s Rights

The following are the Smokers’ Bill of Rights:

 As a smoker, I am entitled to certain inalienable rights, among them:

 • The right to the pursuit of happiness

• The right to choose to smoke

• The right to enjoy a traditional American custom

• The right to be treated courteously

• The right to accommodation in the workplace

• The right to accommodation in public places

• The right to unrestricted access to commercial information about products

• The right to purchase products without excessive taxation

• The right to freedom from unnecessary government intrusion

If you do a Google search using “smokers’ rights” as keywords, the R.J. Reynolds Tobacco Company comes up at the top of the list. In order to better understand the perspective of the tobacco company’s positions regarding smokers’ rights and the sale of cigarettes, you may visit their Web site. Below is a short excerpt that gives an example of their guiding principles and beliefs:

• Nicotine in tobacco products is addictive but is not considered a significant threat to health.

• No tobacco product has been shown to be safe.

• An individual’s level of risk for serious disease is significantly affected by the type of tobacco product used as well as the manner and frequency of use

 TOBACCO REGULATION

 • Tobacco products should be regulated in a reasonable and consistent manner, and they should remain legal and consumer-acceptable. The prohibition, in any form, of tobacco products is neither practical nor desirable.

• Smoking restrictions should exempt adult venues such as bars and taverns.

 HARM REDUCTION

 • Decreasing the health risks and harm directly associated with the use of tobacco products is in everyone’s best interest.

• Adult tobacco consumers should have access to a range of tobacco, nicotine, and cessation products and should be given information in order to make an informed choice on the relative risks of each product.

 Nonsmoker’s Rights

Organizations like the Group Against Smoking and Pollution (GASP), founded in 1971, developed anti-smoking chapters throughout the country to limit smoking in public areas, including restaurants, airplanes, trains, and buses. The organization developed a Bill of Rights for Nonsmokers. It focused attention on environmental smoke. By the 1990s, anti-smoking groups and public health advocates had effectively influenced state legislators to limit public use of tobacco products. By then, consumers no longer tolerated even low risks to health from secondary smoke. The following is the Bill of Rights for Nonsmokers.

I have the right to:

• Be smoke-free in any situation

• Review my list of reasons to stop smoking frequently, particularly before any social gathering

• Ask others not to smoke in my home, office, or car

• Sit in nonsmoking sections

• Support legislation to protect nonsmokers from the dangers of passive smoking in public places

 

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(44) Quit Smoking

How To Quit Smoking - How To Stop Smoking For Good With These Two Easy Methods

QS44

What are the current trends in quitting smoking?

The number of smokers in the United States is declining, as public awareness regarding the dangers of smoking have become more widely accepted and more local communities are banning smoking in public places. Among Americans, smoking rates shrunk by nearly half in three decades (from the mid-1960s to mid-1990s), falling to 23% of adults by 1997. However, worldwide, especially in poor countries, the number of smokers is growing. In the developing world, tobacco consumption is rising by 3.4% per year. In the developing world, concerns about the use of tobacco are not considered as important as concerns about adequate nutrition, safe drinking water, and communicable diseases.

 Worldwide, especially in poor countries, the number of smokers is growing. In the developing world, tobacco consumption is rising by 3.4% per year.

 What is the prevalence of tobacco use?

Prevalence refers to the current number of people suffering from a particular illness or engaged in a particular activity relative to the population at large over a specified period of time. Point prevalence refers to a defined point in time (such as January 1, 2009) while period prevalence refers to a defined period in time (such as January 1, 2008 through January 1, 2009). It is defined in terms of the ratio of people with a condition compared to the total population. Today one out of every five adults smokes regularly.

A 2007 Time magazine article on the “Science of Addiction” reported that there are 71.5 million tobacco users in the United States, of whom 23.4% are men and 18.5% are women. Among cigarette smokers, the lowest rate of smokers live in the western section of the country and the highest live in the Midwest and the southeast tobacco-producing states. The proportion of smokers in the adult population has fallen from a high of 46% in 1950

to 21% in 2004. The World Health Organization in 2003 estimated that there were 1.3 billion smokers worldwide. The numbers may vary from source to source, but all of the data point to a worldwide epidemic of pandemic proportions.

 Smoking Prevalence

Percent of Smokers

 

Region                                                                     Men -Women

 Africa – 29 - 4

United States – 35 - 22

Eastern Mediterranean – 35 - 4

Europe - 46 - 26

Southeast Asia – 44 - 4

Western Pacific – 60 – 8

The numbers are expected to reach 7 billion by 2025. The growth will be among people living in poor developing countries and the uneducated.

What are the mortality rates from smoking in the United States? Worldwide?

Mortality rates are the rates of deaths in a population during a given time and in a given place. Smoking kills over 435,000 U.S. citizens each year. More Americans die each year from tobacco than from fires, car accidents, illegal drugs, murders, and AIDS combined. Tobacco kills more people in two days than crack and cocaine kill in a year. More than 50,000 Americans die from secondhand smoke, according to the Centers for Disease Control and Prevention (CDC). Sixteen million people lost their lives because of an addiction to nicotine between 1950 and 2000.

These numbers add up to a thousand American deaths each day from smoking cigarettes. Most of the deaths occur to people between the ages of 35 and 69 years. Nearly five million people died from smoking worldwide in 2000, and smoking killed nearly as many people in developing countries as in developed countries. The World Health Organization (WHO) estimates that tobacco kills a person every 10 seconds worldwide and, at the current growth rate for both the general population and number of smokers, the death rate from smoking may exceed 10 million a year in 30 years.

How successful will I be at quitting smoking?

Epidemiologic data report that 70% of the 45 million smokers in the United States today want to quit, and approximately 44% try to quit each year. The vast majority of these attempts is without support and is unsuccessful. Only 4% to 7% will actually succeed. These statistics may discourage both smokers and clinicians because the majority of smokers struggle through multiple periods of abstinence and relapse. Because of the chronic, relapsing nature of tobacco dependency, the most effective way to understand and treat it is by recognizing it as a chronic disease. By approaching it as a chronic disease, clinicians will better accept its relapsing nature and the requirement for ongoing, long-term care, which includes continued patient education, counseling, and advice over time.

These strategies are similar to the way you would approach other chronic diseases such as diabetes, hypertension, or asthma. The introduction of numerous effective treatments in the past 15 to 20 years now gives the clinician and patient many additional options over the long haul. Clinicians should provide tobacco-dependent patients with brief advice, counseling, and appropriate medication. Assessing and treating tobacco use as a chronic disease generally leads to greater patient satisfaction and improved success at eventually quitting.

Joseph’s comment:

Quite honestly, while I was smoking, I did not think I could be successful. Something inside me kept making me try different techniques. It wasn’t until I put the cigarette down for a few 24 hour periods that I really started to believe I could be successful, and there was hope for me becoming a nonsmoker.

The introduction of numerous effective treatments in the past 15 to 20 years now gives the clinician and patient many additional options over the long haul.

 

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