Session #3 Cravings, withdrawal and coping strategies

Outline Session #3 Welcome and introductions Group guidelines How smoking impacts Mental Health How smoking impacts Physical Health How smoking affects non-smokers Costs of smoking Withdrawal symptoms Registration forms PACT - MHG

Group Expectations Review… Review flipchart or insert slide from week 1 for review Ask for a volunteer to read out loud PACT - MHG

Why is nicotine so addicting? In brain in 7-10 seconds from inhaling Binds to receptor – releases dopamine Dopamine increases pleasure, relaxation, alertness Decreases fatigue, anxiety, stress PACT - MHG

Why is smoking harmful? Exposure to more than 4000 chemicals 50 chemicals known to cause cancer Smoking reduces lifespan Smoking reduces lifespan, quality of life Increased risk of suicide Causes 80% of addiction related deaths PACT - MHG

Smoking reduces lifespan Every cigarette smoked reduces your life by 8 minutes A pack a day smoked loses: 3 hours per day ~ 1 day per week ~ 48 days per year PACT - MHG

Smoking reduces quality of life Heart disease Lung disease Cancers Ulcers Skin, eyes, teeth, mouth, throat… PACT - MHG

Smoking affects non-smokers Heart disease Lung disease Cancers Fetus/infants/children Pets 2nd & 3rd hand smoke PACT - MHG

Smoking is expensive A pack-a-day costs more than $84/week $360/month $4380/year (based on average $12/pack) What could YOU do with that extra money? Easier to pay rent/groceries, buy clothes, personal items, occasional movie or eating out, ……. Can generate some interesting discussion! One paatient saved enough money to buy contact lenses!! PACT - MHG

Symptoms caused by smoking Cough Trouble breathing Bad breath Stained fingers Dental problems Cold hands/feet PACT - MHG

Diseases caused by smoking Lung disease Heart disease Cancer Ulcers Poor circulation PACT - MHG

Benefits of reducing/quitting Within 20 minutes – heart rate slows Within 48 hours - ↓ risk of heart attack After 1 year - risk of heart attack ↓ 50% Reduce blood pressure, reduce risk of complications of diabetes Less stress and anxiety Some medication doses can be decreased The very best thing you can do for your health MORE money for food, rent, clothes…. PACT - MHG

Wiggle Break!! PACT - MHG

Does smoking reduce stress? NO! Initially seems to ↓ stress and ↑ relaxation BUT… The effect is very brief Withdrawal between cigarettes ↑ stress and anxiety PACT - MHG

Afraid to reduce/quit because… …… Record ideas from group discussion PACT - MHG

Withdrawal Symptoms Cough Headache Irritable, grumpy Tired, can’t sleep Restless, can’t concentrate Hungry PACT - MHG

Cough WHY: lungs work better and clear mucous which has blocked airways TIME: a few days DO: drink lots of fluids, hot water with lemon/honey Sugarless cough drops or hard candies PACT - MHG

Headache WHY: TIME: DO: more oxygen, less carbon monoxide in body 1-2 weeks DO: drink lots of water, take pain reliever, relaxation exercise, warm bath PACT - MHG

Irritable, Grumpy WHY: TIME: DO: body craves nicotine, missing pleasure feeling TIME: 2-4 weeks DO: reduce caffeine, walk or other exercise, deep breathing, hot bath, relaxing music (Let family & friends know this might happen – ask for their help) PACT - MHG

Tired, can’t sleep WHY: TIME: DO: Brain is adjusting to lack of nicotine TIME: 2-4 weeks DO: reduce caffeine, avoid caffeine in afternoon/evening, exercise, deep breathing, bedtime routine, hot bath/shower, relaxing music PACT - MHG

Restless, can’t concentrate WHY: Brain is adjusting to lack of nicotine stimulation TIME: Less than 2 weeks DO: Make to-do lists, allow extra time for tasks, exercise, deep breathing PACT - MHG

Hungry WHY: TIME: DO: Hand-mouth habit Food smells and tastes better 10-12 weeks DO: Drink lots of water, low-calorie, healthy snacks, keep hands busy (crafts, puzzles, hobbies) exercise PACT - MHG

Common strategy? EXERCISE! PACT - MHG

Remember… Withdrawal symptoms are normal – they are positive signs that your body is starting to heal!! PACT - MHG

Some advise is not helpful! PACT - MHG

Try using the 4 Ds Drink plenty of water Delay for 5-7 minutes Do something else Deep breathing PACT - MHG

Are you thinking about reducing or quitting? Yes No Not sure PACT - MHG

Weekly Activity PACT - MHG

Forms For any new attendees Program registration Consent form Tobacco/health history Fagerstrom/Why Registration and consent forms facilitate - de-identified research - billing by the presenter’s pharmacy to a fund which is administered by the drug plan - the program is NOT “free” – there is a cost, but the participants are not required to pay that cost - the money is a pharmacy fund, not government funds - advise doctors/dentists re quit attempt, encourage their support - some medication doses may need to be adjusted, pharmacist will discuss with prescriber for those who quit or significantly reduce use – pharmacist may check provincial drug records (PIP) Forms take a fair amount of time, most participants will need assistance to complete. Helpful to have a second person available for this part of the process. PACT - MHG

See you next week! PACT - MHG