1. Effect of Nicotine on the Body
Session #2
Effect of Nicotine on the Body
Benefits of Quitting

2. Outline Session #2 Welcome and introductions Program format
Group guidelines
Why we smoke
Nicotine dependence/addiction
Is smoking harmful?
Benefits of quitting
Registration forms
PACT - MHG

3. General Program Format
Slide presentation
Exercise break
Questions and discussion
Guest speakers
6-8 weeks, 1.25 hours each week
This is an outline of the general format for all sessions – guest speakers may or may not be involved for some sessions, depending on the time available and the interests of the group.
Number of sessions and length of each can be adjusted accordingly.
PACT - MHG

4. Program Information for positive, balanced lifestyle
Increase skills and confidence to make healthy choices
Exercise, relaxation, nutrition, positive thinking
Environment – personal and community
Reduce or quit tobacco use
Share information, develop support system
PACT - MHG

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

6. Who should attend? ANYONE! Ready to reduce or quit tobacco use
Not sure if want to reduce or quit
Do not want to reduce or quit
Do not use tobacco but want to learn about process
ANYONE!
PACT - MHG

7. What do you hope to learn?
Manage withdrawal/cravings
Exercise
Nutrition
Relaxation
Stress management
These are the ideas generated from an actual session 1 – adjust accordingly for each new group – ask for additional ideas, especially if new attendees at Session 2
PACT - MHG

8. Do you use tobacco? Yes No
Some non-tobacco users and some who have already quit may attend – for social reasons and/or to learn about the process.
PACT - MHG

9. What type of tobacco? Cigarettes Chew/snuff Cigars/cigarillos Pipe
PACT - MHG

10. Why do we smoke? Worried about something Stimulant Weight control
Keep occupied
Habit
Social
Boredom
These are the ideas generated from an actual session 1
Could start with a blank slide and add notes to slide during discussion so this reflects the experience of the particular group
PACT - MHG

11. Wiggle Break!!
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12. Starts as a habit… Quickly changes to dependence and addiction
Physical or psychological
A chronic relapsing medical condition
PACT - MHG

13. Which is most addictive?
Alcohol
Caffeine
Heroin
Nicotine
PACT - MHG

14. Most addictive is…
Alcohol
Caffeine
Heroine
Nicotine
PACT - MHG

15. 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

16. Cigarettes are a highly manipulated drug delivery devise
Cigarettes are a highly manipulated drug delivery devise. There are two different thicknesses of paper so that when you are smoking it burns quicker and when you are not smoking it burns slower. Freon is added to the tobacco to puff it up, titanium oxide causes an increased speed of burning
Cigarettes are capable of killing half of all users when used exactly as intended. (Free basing invented by tobacco industry – need to recruit replacement smokers to replace those that have died.
When talking about tobacco use it includes cigarettes, pipe, cigars and snuff.
Cigar smokers may spend up to an hour smoking a single large cigar that can contain as much tobacco as a pack of cigarettes producing the same level of nicotine exposure as a pack a day smoker,
Also a single session of waterpipe smoking which may last up to an hour, and may deliver as much tar as an entire pack of cigarettes and involves inhaling 100 to 200 times the volume of smoke inhaled with a single cigarette. Commonly used heat sources used to burn the tobacco are likely to increase the health risks.

17. Why is smoking harmful? Exposure to more than 4000 chemicals
Hydrogen cyanide, formaldehyde, benzene, tar, arsenic, acetone, naphthalene, carbon monoxide
50 chemicals known to cause cancer
Smoking reduces lifespan
Increased risk of suicide
Causes 80% of addiction related deaths
PACT - MHG

18. Some of the chemicals in tobacco
Cyanide – poison used in gas chambers
Formaldehyde – embalming
Benzene – industrial solvent/fuel, dyes, synthetic rubber
Arsenic – ant poison
Acetone – paint stripper, nail polish remover
Naphthalene – mothballs
Carbon monoxide – car exhaust
NICOTINE
PACT - MHG

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

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

21. Adverse health consequences of smoking are well known and include COPD, Cancers, CHD, peripheral vascular disease, HTN, stroke, dyslipidemia, pneumonia, influenza, PUD, tooth decay, gum disease, osteoporosis, cataracts and the list goes on.
SHS – combination of poisonous gases, liquids and breathable particles; 2/3 of the smoke from a burning cig is not inhaled and it takes about 3 hours for 95% of smoke from one cigarette to leave a room
3hand smoke – lead, arsenic etc settle on furniture, curtains, clothing etc.
Adults exposed to SHS – increased chance of lung cancer by 25%; heart disease by 10% and increased chance of cancers; smoking during pregnancy causes low birth wt and increased chance of SIDS 2 to 8 times more often.
Children – resp illness, pneumonia, bronchitis, otitis media, learning problems, ADHD and diabetes

22. 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….
Brainstorm with participants how they would benefit from reducing or quitting smoking.
PACT - MHG

23. Are you thinking of reducing or quitting?
Yes No
Not sure
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24. Weekly Activity
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25. Questions?
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26. 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

27. See you next week – same place, same time!
PACT - MHG