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Disclaimer: The material contained in this video presentation provides general information on the management of chronic obstructive pulmonary disease. This information is for reference purposes only and should not be considered medical advice. For specific information and recommendations based on your health condition, please consult your medical provider.
Bryan Brubaker: Hi, my name is Bryan Brubaker. I'm a pharmacy clinical specialist focused on respiratory illness, and today we're going to talk about smoking cessation. Want to quit using nicotine? If you do, you're not alone. Since 2002, there have been more former smokers than current smokers, and 70% of smokers or tobacco users report that they've either attempted to quit or have considered quitting in the past year.
Benefits of quitting smoking. Immediately after stopping, the air around you is no longer dangerous to others, including your pets. Within 20 minutes, your blood pressure and your pulse rate return to normal. After about eight hours, your carbon monoxide levels will drop and your oxygen levels will increase. Over about one to three months, your circulation and your breathing improves, making it easier to walk and do other activities of daily living. At one year, your overall wellness increases, your lungs are able to clean themselves better and prevent infection, and your risk of coronary heart disease is half that of a smoker. At five years, your stroke risk is that of a non-smoker, and your risk for cancer of the mouth, esophagus and throat are half that of a smoker. After 10 years without smoking, your life expectancy is comparable to a non-smoker's.
Costs of tobacco use. Everyone knows that there is a health cost to using tobacco, but there's also a significant financial and time impact to your life as well. Over the course of your lifetime as a smoker, you'll spend an average of $124,000 on cigarettes, $170,000 on healthcare associated with tobacco illness, and you'll lose $253,000 due to absenteeism in wage. If you smoke a pack a day over the course of a year, you'll lose 15 to 25 days of your time to smoking.
Understand why you use nicotine. Nicotine is a highly addictive chemical. When you smoke tobacco, nicotine is taken up into the brain within a few seconds. Once there, it causes the release of mood altering chemicals that can cause mild euphoria, appetite suppression, and increased alertness. Most people say they smoke for a particular reason. It is a stimulant, so it helps to get them going in the morning or helps to perform certain tasks better. They like handling the cigarette or what we call the ritual of smoking. They feel pleasure or relaxation when they smoke. And cravings will always reinforce all of these things. When you decide to stop using nicotine, you will probably experience withdrawal symptoms, depending on how much you use. This will cause an uncomfortable feeling, especially in the first weeks after stopping.
Nicotine use is a repetitive task, and patterns of use develop around other routine tasks that you perform in any given day. These patterns can be very difficult to change once they've been ingrained. Dependence creates triggers and cues that can be activated by a host of things in your life, including social events, anxiety, stress, or even food items.
Choosing a quit plan. As with anything in life to make yourself successful, you should have a plan before you start quitting. You should prepare alternatives to smoking in advance that you enjoy, avoid temptations whenever and wherever possible, and never allow smoking to be an option. There are many different ways to quit smoking. Many folks prefer cold turkey, where they feel they don't need assistance or any type of tapering dose. Cutting down gradually can help to lessen the withdrawal symptoms of quitting smoking. This can also include nicotine replacement therapy and the addition of online or group counseling. Alternative methods exist as well, such as hypnosis or individual counseling, but you should ultimately select what you feel is most appropriate for yourself.
When deciding to quit using tobacco, it's important to find a motivation, whether that's your own health, your children or family, the safety of your pets, or to save money. Finding your why, documenting it and sharing it with others will help to reinforce your plan as you go forward with quitting tobacco. You should choose activities that interest you that you would like to pursue that will help to replace your smoking habit. Exercise is a great option to smoking. You should also consider the ritual of smoking and come up with some things for you to do with your hands, such as drawing, knitting, or anything else to keep them busy. You can also focus on rewards, such as pleasure and relaxation events like a massage or a hot bath that you can work towards while you continue your quitting attempt.
When attempting to quit using tobacco, it's helpful to tell family, friends and coworkers about your plan to quit. They'll often want to help any way that they can. Telephone and in-person counseling is also available to anyone for free in the state of Florida. They can provide educational material, knowledge and other valuable experience to help you be more successful. Consider if nicotine replacement therapy is right for you. This will depend on how much you currently smoke and if you're using any other products to help you quit. Finally, when you're deciding to quit, you should set a quit date and you should tell other people when that quit date is. I'd also recommend that you write it down, put it on a calendar, put it in your wallet. That will help to keep you accountable when it's time to quit.
Nicotine replacement therapy. There are many types of nicotine replacement therapy available. The most two common types are nicotine patches and gum or lozenges. The patches come in 7, 14 and 21 milligram strengths, and your dose will depend on the amount of tobacco that you're using daily. The idea with the nicotine patch is to provide you with a low level of nicotine in your bloodstream throughout the day to reduce cravings. You may still have cravings while you're using a nicotine patch, and in that case, it may be appropriate to use nicotine gum or a lozenge as well. These provide a small bump in your nicotine levels, which would be comparable to smoking a cigarette, and would help to control a craving. This type of nicotine replacement therapy is used in decreasing strength and frequency over time, generally over a period of six to 12 weeks, until cessation is achieved and maintained.
Nicotine replacement therapy by prescription only. There are two additional nicotine replacement products that are available with a prescription, the nicotine inhaler and the nicotine nasal spray. Both of these products are used in a similar fashion to the gum or the lozenges, with the intention to give you a small boost in nicotine blood levels whenever you experience a craving. Keep in mind that these are generally a lot more expensive than the over-the-counter counterparts, and nasal and oral irritation is a common side effect of both of these products.
Prescription medications. Chantix, or Veranicline, is considered by many as the gold standard for quitting smoking. It helps to displace nicotine from the receptor in the brain, which means that you can even smoke when you initially start your Chantix therapy. It may not be appropriate for use in patients with significant renal impairment, serious psychiatric illness, or who are currently undergoing dialysis. Bupropion, or Zyban, is another prescription medication that was used before we had Chantix. It also interferes with the dopamine release in the brain that nicotine causes. This medication may not be appropriate for patients with a history of seizures or eating disorder. Most common side effects for Bupropion are dry mouth and insomnia, and it's usually started one to two weeks before the quit date.
This slide contains resources to help you quit smoking. I'd like to specifically mention the AHEC Florida Network, because they are responsible for distributing nicotine replacement therapy and providing quit classes. Thank you.