Smoking Cessation Level 1
Training
Wirral Stop Smoking Service
Public Health Provider Services
Gibraltar House
Kelvin Road
Wallasey
CH44 7JW
Tel 0151
630 8383
Fax
0151 630 8390
Smoking Cessation Level 1
Training
Wirral Stop Smoking Service
Public Health Provider Services
Gibraltar House
Kelvin Road
Wallasey
CH44 7JW
Tel 0151
630 8383
Fax
0151 630 8390
Who smokes?
•
13m smokers
•
23% men
•
21% women
•
80% start as teenagers
11% girls (25% 15yrs old)
9% boys
•
70% want to quit
For every 100 teenagers who
smoke throughout life….
•
0 will be murdered
•
0 will die in an air crash
•
perhaps 1 will be killed on the road
•
BUT 50 will die before their time from
diseases caused by smoking
Smoking Prevalence is
higher……...
•
North
•
18-34yr olds
•
Mental health problems*
•
Certain ethnic groups
•
Disadvantaged areas
Intermediate Service -
•
GP practices
•
Pharmacies
•
Children’s Centres
•
Health Action Areas
•
Workplaces
•
……………….
What’s in Tobacco Smoke?
•
Nicotine
•
Carbon Monoxide
•
Tar
•
Other chemicals and
additives
Tar
•
Contains 60 cancer causing agents
•
Condenses in lungs leaving a sticky residue
•
‘Coats’ the cilia and lung tissues
•
Distributed to other body parts by
cardiovascular system
•
Volatile hydrocarbons affect liver enzymes
Carbon Monoxide
•
Colourless,odourless toxic gas
•
Reduces oxygen carrying ability of blood
•
Forces heart to work harder
•
Reduces exercise tolerance
•
Reduces oxygen supply to foetus
•
Thought to contribute to atherosclerosis
Nicotine
•
Powerful, fast acting, highly addictive drug
•
Hits the brain in 10 secs when inhaled
•
Increases heart rate and BP
•
Increases concentration
•
Depresses appetite
•
Acts as vaso constrictor
•
No cancer link
Smoking……...
•
Vasoconstriction
•
Atherosclerosis
•
abnormalities in blood vessels which affect
clotting
•
directly reduces life span of platelets
•
causes sticky platelets
•
prevents normal breakdown of tiny clots
•
nicotine raises LDL levels
ARECA LEAF AND BETAL NUT
Major health consequences of
Major health consequences of
smoking
smoking
The scale of the problem
Stroke
Cancers of the
mouth throat and
oesophagus
Coronary heart
disease
Chronic obstructive
pulmonary disease
Lung cancer
Pancreatic cancer
Ulcer
Bladder cancer
Low birth weight
baby
Peripheral
vascular disease
Other conditions associated with smoking
•
Angina risk 20 x risk
•
Buerger’s disease
•
Cataracts 2 x risk
•
Crohn’s disease
•
Depression
•
Duodenal ulcers
•
Chronic rhinitis
•
Fertility 30% lower
•
Graves’ disease
•
Hearing loss
•
Immune system impaired
•
Decreased lung function
•
Ocular Histoplasmosis
•
Optic neuropathy 16 x risk
•
Menopause 2 years early
•
Sudden Infant Death syndrome
•
Osteoporosis
•
Peripheral vascular disease
•
Psoriasis 2 x risk
•
Rheumatoid arthritis
•
Reduced sperm count
•
Tuberculosis
•
Macular degeneration 2 x risk
•
Low child birth weight 4 x risk
•
Vocal chord polyps
•
Increased sperm abnormalities
Health Impact
•
30% of all cancers
•
90% of all lung cancers
•
30% of all ischaemic heart disease &
strokes
•
70% of all chronic lung disease
Health Benefits
•
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
Health Benefits
•
24hrs - CO eliminated from body
•
2-12 weeks -Energy levels increase, sense of
smell and taste much improved
•
5-10 yrs - Risk of Cancer and MI reduced
Why do people keep smoking?
NICOTINE
ADDICTION
HABIT
SOCIAL
α4β2
Nicotinic Receptor
α4
β2
α4
β2
β2
NIC
Nicotine
Dopamine
Nucleus
Accumbens
(NAcc)
Ventral
Tegmental
Area
(VTA)
NIC
Effects of Nicotine
•
Rapidly absorbed
•
Sets off a complex chemical cascade
•
Affects the production of dopamine
•
Dual personality short v long puffs
•
Only 1-3mg/cig absorbed
•
KEEPS SMOKER ADDICTED
Regular smoking leads to a 300%
increase in brain nicotine receptors
On stopping smoking:
•
It takes 24-48 hours for nicotine to leave
the body
•
It takes 8-12 weeks for the nicotine
receptors to down-regulate
Withdrawal Symptoms
Symptom
Duration
Prevalence
Irritability/aggression < 4 weeks
50%
Depression
< 4 weeks
60%
Poor concentration
< 2 weeks
60%
Restlessness
< 4 weeks
60%
Increased appetite
> 10 weeks
70%
Night time awakenings
< 1 week
25%
Urges to smoke
> 2 weeks
70%
Light-headedness
< 48 hours
10%
Withdrawal Symptoms
WORSE if…...
•
Inhale deeply on cigs
•
Previous bad experience
•
Stress and boredom
LESS INTENSE if…..
•
Exercise
•
Out of ‘normal
environment’
•
Eating sugary foods
Available Therapies
•
Buproprion Hydrochloride SR – Zyban
•
Varenicline - Champix
Patche
s
•
Continuous -
•
Intermittent
-
Nasal
spray
Inhalato
r
Gum
Microta
b
Lozenge
•
Nicotine Replacement
Therapy
Nicotine Replacement Therapy
•
Available - prescription
voucher system via Wirral Stop
Smoking Service
over counter
•
Treatment lasts approximately 3 months
•
Some cautions
Zyban - What is it?
•
The first non-nicotine oral smoking cessation
therapy
•
Works within the brain - acting on the
neurotransmitters involved in nicotine addiction
and withdrawal
Varenicline - Champix
•
Oral
•
Blocks the rewards from and reduces the
cravings of cigarette smoking
•
Adults only
•
GP prescription only
Barriers to stopping
•
Tried before
•
I will one day...
•
Too stressed at the
moment
•
Weight increase
•
All my family/friends
smoke
•
I enjoy it
Our Barriers
•
No time
•
Not my job
•
Can’t see the point - they’ll only start again
•
Lack of confidence/skills
•
Expected patient resistance
•
Spoils relationship with patient
•
Lack of resources
•
Smoker oneself
Making
Changes
“I’ve set a
quit date”
Maintaining
Change
“I am an ex-
smoker”
Relapsing
“I have learnt a lot
and when I am ready
I will try again”
Not
Sure/Thinkin
g About
Change
“I have heard
about a new
treatment to
stop smoking”
Ready/Preparing to
Change
“How do I go about it?”
“I am not
interested in
stopping smoking
”
Stable “Safer”
Lifestyle
“I’m a non smoker
”
Cycle of
Change
Ask yourself
•What do you enjoy about
your smoking?
•Is there anything you
don’t enjoy about
smoking..?
•Do you see yourself as a
life long smoker?
•What happened last time
you stopped….?
Specialist Service provides:
Intensive support for clients
-
1/1 appts / Drop in
Phone contact
Home visits
Clinics held at:
Various venues across
Wirral
Clinics for staff:
Phone 630 8383 for
information
Prepared by: