Cessation of Smoking Flashcards
Principal fatal diseases caused by smoking
are
cancer, COPD and CVD
Health benefits of smoking cessation
Increased longevity
• Stabilisation of lung cancer risk (but not absolute decline)
• Heart disease risk declines towards non- smoker level over 10 years
• Accelerated decline in lung function reduced
• Improved reproductive health
• Improved recovery from surgery
20 mins after quitting
blood pressure and pulse rate return to normal
8 hours after quitting
blood nicotine & CO halved, oxygen back to normal
24 hours after quitting
CO eliminated; lungs start to clear mucus etc.
47 hours after quitting
nicotine eliminated; senses of taste & smell much improved.
72 hours after quitting
breathing easier; bronchial tubes begin to relax; energy levels increase
2-12 weeks after quitting
circulation improves
3-9 months after quitting
lung function increased by <10%; coughs, wheezing decrease
5 years after quitting
risk of heart attack halved
10 years after quitting
risk of lung cancer halved compared to continued smoking;
risk of heart attack equal to never- smoker’s.
What are the Psychological pathways to Quitting
transtheoretical Model of Behaviour Change
stage model
what are the 6 steps in the stage model
pre-contemplation contemplation preparation action maintenance relapse
pre-contemplation
Characteristics: Lack of Awareness or lack of intent to change
• Strategy: Short messages to attract attention, bring up potentially novel and highly relevant facts previously not considered
Contemplation
- Characteristics: Increased awareness of negative aspects of smoking. Has intention to quit within 6 months.
- Strategy: Dispel Negative Myths about quitting smoking; reinforce willpower to quit
Preparation
- Characteristics: Some small behavioral changes to quit have been made; intent to quit within 1 month (can set a “quit date”)
- Strategy: Longer messages, offer concrete tips and methods
Action
- Characteristics: Individual has implemented plan to stop, still adjusting to the change
- Strategy: Offer specific relapse prevention advice for nicotine dependence to include advice on the nicotine patch
Maintenance
- Characteristics: Long term adjustment as a non-smoker, content with new lifestyle without cigarettes
- Strategy: Congratulate and advise ongoing vigilance to keep off cigarettes
4 A’s Approach to Smoking Cessation
Consistent with strategies developed by the National Cancer Institute, the American Medical Association, and others
The 4 A’s
ask - about tobacco use
advise - to quit
Assess - willingness
Assist - in quit attempt
arrange - follow up
advise
must be clear, strong
and personalised
Assess
- Assess the patient’s willingness to quit within the next 30 days.
- If a patient responds that s/he would like to try to quit within the next 30 days, move on to the Assist step.
- If the patient does not want to try to quit, use the 5 R’s to try to increase motivation.
Assist
- Suggest and encourage the use of problem-solving methods and skills for smoking cessation
- Provide social support as part of the treatment
- Arrange social support in the smoker’s environment
- Provide specific self-help smoking cessation materials
Arrange
- Follow up to monitor progress and provide support
- Encourage the patient
- Expresswillingnessto help
- Ask about concerns or difficulties
- Invitept.totalkabout his/her success
the 5 R’s
relevance risks rewards roadblocks repetition
relevance
• Ask patient to identify why quitting might be personally relevant, such as:
– children in her home
– need for money
– history of smoking- related illness
risks
- Ask, “What have you heard about smoking ?”
* Reiterate benefits for the patient and his/her children
Rewards
- Your will get more oxygen after just 1 day
- Your clothes and hair will smell better
- You will have more money
- Food will taste better
- You will have more energy
Roadblocks
- Negative moods
- Being around other smokers
- Triggers and cravings
- Time pressures
Overcoming Roadblocks: Negative Moods
- Suck on hard candy
- Engage in physical activity
- Express yourself(write, talk)
- Relax
- Think about pleasant, positive things
- Ask others for support
Triggers and Cravings
Cravings will lessen within a few weeks
• Anticipate “triggers”: coffee breaks, social gatherings, being on the phone, waking up
• Change routine—for example, brush your teeth immediately after eating
• Distract yourself with pleasant activities: garden, listen to music
Time Pressures
• Change your lifestyle to reduce stress • Increase physical activity
