Freeing Yourself From Tobacco
Tobacco is one of the toughest addictions there is - and one of the deadliest. Yet millions of Americans have quit the habit, and millions more have resisted the tobacco companies' slick marketing to get you hooked on cigarettes. Healthy Community Coalition is committed to offering support and assistance to anyone in our community looking for support in quitting tobacco or staying away from it so you never start. Below is some information on tobacco - how it impacts you, your health, and your family, and ways to quit.
For assistance in quitting, call the Maine Tobacco Helpline at 1-800-207-1230. The Maine Tobacco Helpline provides free confidential counseling and a voucher for nicotine replacement therapy if your insurance does not cover these products or you have no insurance. Simply for calling you will receive a quit kit to help you get started.
Health Effects of Smoking
What are the effects on individual smokers?
Tobacco kills about 2,500 people in Maine every year and nearly 430,000 people in the United States. That's more than illegal drugs, alcohol, AIDS and car crashes combined. Tobacco is the number one cause of death and disease, and is also the most preventable. Death usually follows years of suffering a reduced quality of life. In fact, the average smoker will die 15 years earlier than a non-smoker. If a smoker quits their life expectancy will improve.
All smokers are at extra risk for...
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Aortic aneurysm
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Cancer of the kidney and urinary bladder
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Cancer of the mouth, throat and voice box
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Cancer of the pancreas
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Cataracts
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Chronic bowel disease (Crohn's Disease)
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Chronic bronchitis
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Chronic obstructive pulmonary disease (COPD)
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Coronary heart disease (heart attacks)
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Emphysema
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Gum disease
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High blood pressure
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High cholesterol
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Lung cancer
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Osteoporosis
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Peptic ulcers
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Peripheral vascular disease (circulatory problems)
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Pneumonia/Influenza - the flu
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Sleep problems (falling asleep inappropriately and/or frequent waking)
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The common cold
- Thyroid disease (Grave's Disease)
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Tooth decay (cavities)
Female smokers are at an extra risk for...
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Cancer of the cervix (womb)
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Menstrual problems
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Fertility problems (Women who smoke are three times more likely than nonsmokers to be infertile)
What happens when you smoke during pregnancy?
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Smoking during pregnancy reduced oxygen and blood flow to the baby. This can cause the mother to have:
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Bleeding problems
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Labor complications
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Miscarriage
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Stillbirth
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Nutrition Deficiencies - (Example: in order to rid the body of cyanide brought in by cigarettes the body uses available protein and Vitamin B-12, instead of these vitamins going to the fetus)
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The fetus can be affected
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Premature birth (lungs are often not fully formed)
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Low weight at birth (this does not make labor easier. In fact a low-birth weight baby is at greater risk during labor)
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Infant may have asthma or allergies
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Infant has a 3 times greater chance of dying from Sudden Infant Death Syndrome (SIDS)
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Linked to childhood behavior problems
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Exposure to nicotine can raise the blood pressure and slow the heart beat on an unborn baby
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Carbon Monoxide is a poisonous gas that pushes oxygen out of mother's blood and can damage the baby's body and brain. The lead in cigarettes may also damage the baby's brain.
Nicotine Addiction
What makes tobacco addictive?
Nicotine is the addictive substance found in the leaves of the dried tobacco plant found in cigarettes, cigars, chewing tobacco, snuff, and pipe tobacco. Nicotine works as a stimulant that causes us to feel good or energized. It releases natural chemicals in our brains that cause us to feel more alert and calm. However, in order for the effects to last the person needs more and more nicotine. Eventually, our brains may lower our natural energy level or mood so people may continue smoking just to feel normal.
When some people go without tobacco for more than a few hours they may experience some withdrawal symptoms such as lack of energy, slight depression and difficulty concentrating. They continue to smoke to feel better. The withdrawal symptoms will pass within a few days if the person stops smoking or chewing. The body will already begin its healing process.
What's so different about nicotine?
Other products such as alcohol, caffeine, tranquilizers and chocolate can produce small mood changes like nicotine. But nicotine provides a bigger boost than chocolate or a cup of coffee. Nicotine passes into our brains very quickly. The nicotine in chewing tobacco and snuff is absorbed quickly into the blood stream because your mouth is filled with tiny blood vessels near the surface of your inner cheek and gums. Although once you quit smoking or chewing, some changes can last for long periods of times which may explain why some people get cravings to smoke many months or years after quitting.
Is the addiction purely chemical?
No. Although changes in the brain and body chemistry are large part of addiction, smoking is also a learned behavior. A one-pack a day smoker will take a puff from a cigarette more than 70,000 times in a one-year period. We begin to learn or associate things such as the way we hold or light a cigarette or take it out of the package with the pleasant feeling or a sense of relief that it brings us. We also learn to associate having a cigarette with other things we do
How do I know if I am addicted to nicotine?
The easiest way to see if you are addicted is to stop smoking and if you have any withdrawal symptoms or feel you need to smoke again, you are addicted to cigarettes. A person can become addicted after only one cigarette.
Can addiction be overcome?
Although it is difficult to give up smoking-it can be done. 3,500 Americans stop smoking everyday. Don't get discouraged if you relapse. It takes the average smoker 6-11 serious quit attempts before they conquer their addiction. Each time you relapse you will learn to refine your quit plan to one that is more successful. You should feel proud for each step towards a tobacco-free lifestyle.
The Effects of Tobacco Smoke on Others
What is environment tobacco smoke?
Environmental tobacco smoke (ETS or secondhand smoke) is a Class A carcinogen (cancer causing agent) composed of the smoke exhaled from a smoker as well as the smoke released from the end of a burning cigarette, pipe or cigars. In fact, the effects of one cigarette in a room or car can last up to two weeks. It consists of more than 4,000 chemicals, fifty of which cause cancer, including carbon monoxide, formaldehyde, benzene, chromium, nickel, vinyl chloride and arsenic.
Does ETS affect health?
ETS kills an estimated 70,000 nonsmoking Americans every year. Scientific evidence suggested that individuals who have repeated exposure to second-hand smoke are more likely to develop and die from heart problems, lung cancer and breathing problems. It can also cause chest infections, ear infections, coughing and throat irritation.
What risks does ETS pose to children?
Children exposed to second-hand smoke are more likely to develop bronchitis, pneumonia, colds, coughing/wheezing, sore throats, eye irritations, allergies, asthma, increased incidences and severity of asthma attacks in children who already have asthma, and ear infections. Secondhand smoke causes fluid to build up in middle ear. Middle ear infections are the most common cause of childhood operations and hearing loss.
What risks does ETS pose to infants?
Every year in the United States there are 150,000-300,000 cases of infections in infants and children under the ages of 18 months who breathe secondhand smoke resulting in 7,500 to 15,000 hospitalizations. The American Lung Association estimates up to 15,000 child hospitalizations each year are due to secondhand smoke. Babies are three times more likely to die from Sudden Infant Death Syndrome if they are exposed to smoke before and after pregnancy.
Can ETS be filtered out?
Unfortunately, many of the products in smoke are in a gas form. Therefore, secondhand smoke cannot be entirely filtered out through ventilation systems or special fans. In fact, many fans can spread the tobacco smoke into rooms where no one has been smoking.
Will smoking outside reduce the exposure to chemicals?
Smoking outside does decrease the exposure to chemicals in the cigarettes, however it does not eliminate the risks. In fact many of the chemicals are brought into the home through clothing. This is particular important when infants are in the home, because often babies will be resting against the clothes of someone who has just smoked and will be exposed to the chemicals. New research is being conducted to discover the strength of the nicotine exposure to infants from clothing exposure because it is being linked to Sudden Infant Death Syndrome (SIDS).
What are the health benefits of quitting?
Your health begins to improve within twenty minutes of quitting. Within a short time, you will feel better, breathe better, and even smell better. Your food will taste better. And you will add years to your life.
Benefits of Quitting
In 20 minutes:
Blood pressure drops to normal
Pulse rate drops to normal
Body temperature of hands and feet increases to normal
In 8 hours:
Carbon monoxide level in blood drops to normal
Oxygen level in blood increases to normal
In 24 hours:
Chance of heart attack decreases
In 48 hours:
Nerve endings start re-growing
Ability to smell and taste is enhanced
In 3 weeks:
Circulation improves
In 3 months:
Walking becomes easier
Lung function increases up to 30%
In 1-9 months:
Coughing, sinus congestion, fatigue, shortness of breath decrease
Cilia re-grow in lungs, increasing ability to handle mucus, clean the lungs, and reduce infection
Body's overall energy increases
In 1 year:
Excess risk of coronary heart disease is half that of a smoker
In 5 years:
Lung cancer death rate for average former smoker (one pack a day) decreases by almost half
Pre-cancerous cells are replaced
Risk of cancer of the mouth, throat, esophagus, bladder, kidney, and pancreases decreases
In 15 years:
Risk of coronary heart disease is that of a non smoker
Are you ready to quit?
First, are you ready to set a date
The process of ending tobacco use requires a series of choices and changes that lead to a goal. You have to know in your heart it is time, and your life is worth it. Many smokers find it helps to set a date when you will quit smoking for good.
The process begins with a desire to stop, motivation to make changes, willingness to experience discomfort during withdrawal, and persistence in making changes in behavior and thinking to maintain your goal. Nearly 46 million people have successfully quit smoking and you can do it too!
Learning to live tobacco-free takes time. You may feel uncomfortable at first, but it will not last forever. You may wonder if the goal is really achievable or worth all the struggle. The feelings of loss and awkwardness are all part of the process but the rewards will be great.
For assistance in quitting, call the Maine Tobacco Helpline at 1-800-207-1230. The Maine Tobacco Helpline provides free confidential counseling and a voucher for nicotine replacement therapy if your insurance does not cover these products or you have no insurance. Simply for calling you will receive a quit kit to help you get started.
Planning for Quit Day
When making a quit plans it is important to set a Quit Date - You pick a day on the calendar and on that day you quit. It will give you time to prepare for the big day. You can start taking medicine before the quit day and have nicotine replacement medicines on hand.
A good quit plan includes:
1. Consultation with your doctor about various quit methods.
2. Choose a method to quit- Methods include cold turkey (abruptly stopping without reducing the amount of cigarettes), tapering (Cutting down until you are only smoking five cigarettes and then quitting), and setting a quit-date (pick a calendar and on that day quit. It will give you time to prepare for quit day and start a nicotine replacement therapy).
3. Know your triggers. There are many questionnaires to help you discover what triggers you to crave a cigarette. Practice new coping techniques for these triggers.
4. List the reasons you want to quit. It may help to keep the list nearby.
5. Make a list of individuals you can call when you are having a strong urge to smoke.
6. Decide if you will use Nicotine Replacement Therapy or other methods to cope with withdrawal symptoms.
How to cope with withdrawal
What is withdrawal?
- When you stop smoking, your brain and body begin the process of healing. People can experience symptoms of nicotine withdrawal that may include any of the following:
- Irritability, frustration, anger, or anxiety. This is very common. Explain to people so they know why you are having problems.
- Difficulty in concentrating. Plan ahead and write to do lists.
- Restlessness/nervousness. You may be "fidgety" and restless. Keep your hands busy.
- Increased appetite. Drink lots of water. Choose healthy snack choices such as low-fat or non-fat yogurt, Rice cakes, air popped popcorn, vegetable sticks, frozen 100% juice bars, Jell-O, pretzels, and saltines.
- Problems falling asleep or frequent waking. Try exercises such as walking or swimming. Try to get more sleep. If you cannot sleep, get up and read or watch TV. Do something to take your mind off smoking.
- Slight depression or feeling down. It may help to talk to someone who is trying to quit, has quit, or a counselor.
- Coughing. A few people have heavy coughing for one or two weeks. Coughing is good for your lungs and helps clean them of tars left there by smoking. Carry hard candy with you.
How long does withdrawal last?
When you stop smoking, withdrawal is worse within the first forty-eight hours and begins to lessen after three or four days. After one week to ten days all withdrawal symptoms should be gone. It is extremely important that you find positive ways to help you cope. If you can get through the first few days, you have a better chance of succeeding.
Dealing with withdrawal
You must plan for the possibility of withdrawal by taking time for yourself, get busy with a new project or whatever works best for you. It's important that you let people know that you are trying to quit smoking and ask for their support and encouragement. Planning for withdrawal symptoms is very important. Let people know what you are going through and ask for their support.
Other useful techniques include the following:
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Organize your day to avoid needing a cigarette to get yourself going.
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Get more exercise. It gives you energy. Try walking or just chores.
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Chew sugar-free gum, carrot sticks, cinnamon sticks, pretzels or licorice sticks. Brush your teeth or rinse your mouth with mouthwash.
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Avoid getting over tired. If you get plenty of sleep you will not need a "pick me up" cigarette.
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Keep your hands busy. Wear a loose rubber bank on your wrist. Snap it when you feel nervous.
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Doodle with a pen or pencil when you are on the phone or in a meeting.
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Handle a coin or paperclip.
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Squeeze a small ball.
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Take up a hobby.
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Try deep breathing exercises.
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Listen to music.
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Talk things out with a friend or loved one.
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Think of the negative health affects of smoking like cancer, heart attacks or leg amputations.
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Keep of list of the pleasures of being a nonsmoker.
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Do more things to give you pleasure.
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Treat yourself to something special.
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Start an exercise program (check with your doctor first).
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It may be easier for you to quit when things are going well in your life. Avoid situations that trigger your urge to smoke.
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Change your routines, work habits and driving route.
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You may need to avoid your smoking friends for a little while.
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Throw away your ashtrays.
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At home, send other smokers outside to smoke.
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Go to places where you are not allowed to smoke.
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Nicotine gum or patches can help you cope with the cravings. Zyban (an antidepressant) or Chantix (non-nicotine quit aid for adults) has been shown to help with the addiction. Your doctor must prescribe it.
How can I cope with stress without cigarettes?
For many smokers they usually cope with stress by smoking. While smoking can provide a sort burst of energy or bring about a temporary calm, in the long run it actually increases stress. Practice the 4 D's: Delay, Distract, Deep breathing and Drink water. The following are also great ways to deal with stress:
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Find one or two people to talk to or keep a journal.
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Lean one or two relaxation techniques, such as listening to soft music, taking a bath, or going for a massage.
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Become more physically active.
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Maintain a healthy diet.
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Learn to deep breath. Take a slow deep breath in through your nose and hold it for a count of five. Push your tummy out at the same time. This makes the air go deeper into your lungs where the smoke used to go. Slowly breathe out through your mouth to the count of seven. Repeat this three times, and feel the relaxation as your stress drops away.
Plans to avoid triggers
When you are feeling sad and blue and want to smoke, you know (deep down) that a cigarette is only a temporary answer. Having a cigarette will only make you feel worse in the long run and you may even become more depressed because you could not stick with your decision to quit.
You may need to do something with your hands.
You may wake up a lot during the night, have trouble falling asleep or dream about smoking. Remember; usually within a month being tobacco free will help your sleeping pattern improve.
Switch to non-alcoholic drinks during the first two weeks of withdrawal, especially fruit juices. For the first few weeks, drink only with non-smoking friends.
Nibble on low calories foods or doodle while drinking coffee or tea. If the urge to smoke is very strong, drink your tea or coffee faster than usual and change activities or rooms.
Keep cigarettes, ashtrays, matches and lighters out of reach.
Hold the phone with the hand you used for smoking. Keep some gum by the phone and chew while you talk.
Like many smokers you may like to light up when you are driving or watching TV. Sit in a different place or clean your car and make sure to use deodorizers to hide the tobacco smell.
Know what kinds of foods increase your urge and stay away from them. Brush your teeth or use mouthwash right after meals.
Is Weight Gain Inevitable?
Weight gain is not inevitable and some people may not gain notable weight. A few studies show that those who continue to smoke and those who quit smoking will gain the same amount of weight over a period of ten years. However, quitting smoking can trigger changes in eating habits by altering the body’s metabolic rate.
Remember the not smoking is your first priority. Do what you can now to avoid weight gain but accept the fact you might gain a few pounds. If you do, chances are you will lose it in a few months and you can concentrate on a healthier lifestyle. REMEMBER: You are better off in terms of appearance, health, and sense of control, not smoking.
What can you do to avoid weight gain?
To avoid weight gain, choose healthy foods to help you cope with the triggers to smoke. For example use a rice cake instead of a candy bar to keep your mouth busy. Eat well-balanced meals to curb food cravings. Exercise regularly can control weight gain and actually increase the chance of success when quitting smoking. Exercise can change your body composition and the rate in which you burn calories. It also reduces stress. Talk to your doctor before beginning a workout program and plan a program designed for your age and condition
Feel free to call the Healthy Community Coalition at 1-800-525-3136 for more tips on how to avoid weight gain when quitting smoking.
Nicotine replacement therapies and medications
View Tobacco Treatment Medication Dosing Chart. (pdf)
Nicotine Replacement Therapy (NRT) will reduce some of the withdrawal symptoms that you may have when you quit smoking, such as nervousness, short temper, trouble concentrating, etc. When dosed properly, people do not become dependent on NRT.
How do you obtain NRT?
It is important that even though you can get most NRT over the counter that you talk with a physician or a counselor from the Maine Tobacco Helpline to ensure you have proper instructions and are taking the correct dose of the medication. This may or may not include nicotine replacement and other medications.
How can I pay for NRT?
MaineCare covers Nicotine Replacement Therapy for people over the age of eighteen (pregnant women excluded). Some health insurance companies do cover NRT. If not call the Maine Tobacco Helpline for information on the nicotine replacement vouchers offered to people over the age of eighteen, not pregnant or breast feeding, and have not experienced a cardiac even in the past eight weeks and have no insurance or pharmacy benefit for NRT. Talk with your doctor about your decision to quit smoking. He or she can help you plan a program that may work best for you.
Alternative Methods Include acupuncture or hypnosis.
The Maine Tobacco Helpline at 1-800-207-1230 or your physician can help you decide the proper dose of the Nicotine Replacement Therapy you choose. Make sure to contact your doctor if you are experiencing any side effects after taking the medication or if you stop taking the medication as directed.
Don't give up, quit again!
Sometimes, when you are quitting, there may be times when you will suffer from a "lapse": for example, when you smoke a used cigarette from an ashtray, or light a cigarette, put it in your mouth, and then put it out. If you let it, this lapse can lead to a "relapse" and you may find yourself using tobacco as before or even more heavily. However, only you have the power to choose how you will handle a "lapse." If you identify the problem, learn from it, do something about it and maintain a positive attitude, you will continue on your way toward, maintaining a tobacco-free life. Using tobacco is a complex behavior and you may need practice to change. The number of quit attempts will help increase your chances for success next time. Look at what triggered the relapse and figure out how to handle it differently. Don't feel discouraged.
If you end up smoking once again, forgive yourself. It often takes more than one try to be totally free of tobacco. Set another quit date, get some support, and try again. Don't give up! nothing worth doing in life is ever easy. Try again for yourself, your spouse, your children, or your grandchildren.
