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  • Second hand smoke is smoke from lit end of a cig, cigar, pipe and exhaled by smokerToxic mixture of gases & particlesContains more that 4,000 chemicals250 or more are toxic gases50 or more can cause cancer
  • How many of you know someone that smokes?How many of you know someone who feels trapped by their addition to cigarettes? How many of you know someone who wants to quit smoking or is trying to quit smoking?How many people know someone who has had tobacco related disease, like cancer, heart disease or COPD?
  • Monitored or directly funded research supporting the idea that individuals with schizophrenia were: less susceptible to the harms of tobacco andthat they needed tobacco as self-medicationPromoted smoking in psychiatric settings by: providing cigarettes and supporting efforts to block hospital smoking bans
  • What are some myths about smoking in the behavioral health population that you have?
  • Everyone knows that nicotine is the addictive ingredient in tobacco, but not everyone understands what nicotine really is and how it causes addiction. Nicotine is a poison that used to be widely used in insecticides. Drop for drop, nicotine is more poisonous than strychnine or cyanide. A toddler or pet needs to eat only 4 cigarettes to die. Nicotine poisoning is one of the most frequent reasons for calls to Poison Control CentersAsk: How many drops of pure nicotine placed on your tongue would kill you? [Note to presenter: you may wish to bring a small bottle with an eye dropper, ask someone to stick out their tongue, and pretend that the bottle contains nicotine. Then you would direct the question to the individual or to entire audience.}Answer: two drops. All chemical addictions work in the same way: each dose of the chemical activates and multiplies the brain’s receptors for that substance. When the receptors aren’t receiving the chemical, they begin to scream for another dose. Nicotine is no different. When you deprive the brain’s receptors of nicotine, over time they begin to deactivate and urges to smoke fade away. But smoking even one cigarette can activate the receptors, and the cycle of addiction can begin all over again.
  • Over time, people begin to associate certain activities or images with smoking. Those activities and images then begin to trigger the urge to smoke. Common triggers include ashtrays, having a drink, driving, eating, coffee, sex, talking on the phone, and seeing someone else smoke.
  • It’s vital to learn how to prevent slips – smoking a cigarette or two – from turning into a relapse – going back to smoking.If you do slip, avoid “all or nothing” thinking. It’s all too easy to think, “I just smoked a cigarette, I may as well smoke the whole pack.” That kind of thinking will lead you into relapse. Slipping is common in any behavior change attempt. Plan in advance what you’re going to say to yourself if you slip: “It’s only one cigarette. If I think about what made me light up, I can figure out a way to handle that in the future. I can do this. I just need to go back to my plan and not smoke again. ”.
  • Ask: Have any of you tried any of these products? Answer: People’s personal experience with these products will vary, just as with any other medication. It’s important to use them correctly. Always contact your health care provider with questions. Authorities recommend that all people trying to quit smoking should use effective medications. The exceptions are people who smoke less than 10 cigarettes per day, adolescents under 18 years of age, pregnant or breastfeeding women, and people with certain medical conditions. The products on the top row are available over the counter; the others require a prescription. With these medications, nicotine is absorbed more slowly and evenly than through the lungs. There will not be the instant feeling of reward that was a part of smoking. But there is enough nicotine in the replacement products to calm sensations of withdrawal.
  • Zyban® and Chantix® do not contain nicotine. Both are available by prescription only. Unlike nicotine replacement products, these medications are taken before quitting. Each medication works with brain chemistry in a different way to help with quitting smoking. Zyban stimulates the brain’s pleasure systems, gives the sensation of alertness & energy, and reduces withdrawal symptoms such as cravings, irritability & depressed mood. Ask your doctor if you should take Zyban along with a nicotine replacement product. Zyban is a form of the antidepressant Wellbutrin, which means the two medications should not be taken together. Chantix prevents nicotine from reaching receptors in the brain, so smoking is not as pleasurable as it used to be.
  • Products such as e-cigarettes, snus [pronounced snoos] and dissolvable tobacco have been developed to make it easier for people to continue to smoke, especially in areas where smoking is prohibited. E-cigarettes are now considered to be tobacco products by the FDA.
  • Note to presenter: Distribute information on available programs (provided by your local office). Or, you may be asked to let employees know they will receive information via their employer.
  • Nami presentation

    1. 1. Everyone Can Live Smoke-Free<br />Presentation to NAMI<br />August 4, 2011<br />
    2. 2. What We Do<br />Prevent Kids From Smoking<br />Reduce Exposure to Secondhand Smoke<br />Fight Big Tobacco<br />
    3. 3. <ul><li>Tobacco Facts
    4. 4. Who Smokes?
    5. 5. Barriers to Tobacco Intervention
    6. 6. Myths?
    7. 7. Current Projects
    8. 8. Process of Quit Smoking </li></ul>Agenda<br />
    9. 9. You Tube Viedo<br />
    10. 10. Tobacco use, alone kills more people each year, than all deaths from HIV, drugs, alcohol, car crashes, suicides and murders COMBINDED!<br />Smoking is the leading cause of preventable death<br />Tobacco Kills!<br />
    11. 11. 435,000 deaths in the US/year<br />4.8 million deaths worldwide/year<br />10 million annual deaths estimated by year 2030<br />50,000 annual deaths in the US due to second-hand smoke exposure<br />Tobacco’s Deadly Toll<br />
    12. 12. What is in a Cigarette?<br />
    13. 13.
    14. 14. Secondhand Smoke is Toxic<br />Asthma <br /> Cancer<br /> 4,000 chemicals<br /> No Safe Level <br /> of Exposure<br /> Heart Disease<br />
    15. 15. A Wellness Philosophy<br />To assist people to lead meaningful lives in their communities, we need to promote behaviors that lead to health<br />
    16. 16. Persons with mental illnesses die up to 25 years earlier and suffer increased medical comorbidity<br /><ul><li>Often from tobacco related diseases
    17. 17. More likely to die from these diseases than from their alcohol use</li></ul>Smoking and Mental Illness<br />
    18. 18. Tobacco’s Deadly Toll<br /><ul><li>200,000 of the 435,000 annual deaths are people with mental illness and substance use disorders
    19. 19. For patients in treatment for alcohol and drug dependence, more than half die from tobacco-caused illnesses¹
    20. 20. Among treated narcotic addicts, smokers’ death rates are 4 times that of nonsmokers²</li></ul>¹Hurt et al., 1996<br />²Hser et al., 1994; Lynch & Bonnie, 1994<br />
    21. 21. Smoking by Diagnosis<br />% Smoking<br />None Maj. Dep. S-phrenia Alcohol Anxiety Drug Bipolar<br />
    22. 22. <ul><li>30% - 35% of mental health providers smoke as compared to-
    23. 23. Primary Care Physicians 1.7%
    24. 24. Emergency Physicians 5.7%
    25. 25. Psychiatrists 3.2%
    26. 26. Registered Nurses 13.1%
    27. 27. Dentists 5.8%
    28. 28. Dental Hygienists 5.4%
    29. 29. Pharmacists 4.5%</li></ul>Smoking Among Mental Health Providers<br />
    30. 30. <ul><li>Rates of smoking are 2-4 times higher than among the general population.¹
    31. 31. About 41% of people with mental illness & substance use disorders smoke.²
    32. 32. 60% of current smokers report having had a mental health or substance use diagnosis sometime in their lifetime.¹
    33. 33. This population consumes 45% of cigarettes smoked.³ 111</li></ul>Smoking and Behavioral Health<br />
    34. 34. “I’ve been schizophrenic since I was 14. I was told more or less when I went to the hospitals that cigarettes help control certain areas in my brain and the way we function out in society. I became more of a smoker because I was told it would help me with my illness. I was taught more about it helping my illness than I was about cancer and stuff like that.”<br /> - Consumer focus group participant<br />Morris et al, 2009<br />
    35. 35. <ul><li>Expectation of failure
    36. 36. Lack of knowledge
    37. 37. Fear of withdrawal symptoms
    38. 38. Fear of weight gain
    39. 39. Concern about recovery
    40. 40. Concern about stress management (tension, anxiety)
    41. 41. Doubt about dealing with boredom
    42. 42. Part of daily routines
    43. 43. Integral to social activity
    44. 44. Tobacco industry targeting</li></ul>Barriers to Tobacco Interventions: Client/Consumer Factors<br />
    45. 45.
    46. 46. <ul><li>Promotion of health
    47. 47. Changing philosophy around addictions & co-occurring treatment
    48. 48. Putting the “T” back in ATOD
    49. 49. Increased treatment effectiveness
    50. 50. A key component of the recovery process
    51. 51. You are in the best position to offer these services</li></ul>Why Now? This slide needs WORK<br />Competing demands<br />Tobacco as socialization activity, behavioral reward<br />Staff acceptance and promotion<br />Not part of current treatment milieu<br />Lack of reimbursement for services<br />
    52. 52. County of San DiegoBuilding Better Health<br />3<br />Behaviors<br />4<br />Diseases<br />Over<br />50 %<br />Of all deaths<br />Smoking<br />Poor nutrition<br />Lack of physical activity<br />Heart disease/stroke<br />Cancer<br />Type 2 diabetes<br />Respiratory conditions,<br />
    53. 53. 100% of California state psychiatric facilities are smoke-free<br /><ul><li>Napa – 7/08
    54. 54. Coalinga – 8/08
    55. 55. Atascadero – 11/08
    56. 56. Patton – 4/09
    57. 57. Metro – 4/09</li></ul> “There have been no significant <br /> Issues in any of the hospitals” <br /> California Department of Mental Health<br />Smoking in Psychiatric Facilities<br />
    58. 58. <ul><li>Right to smoke is not protected under the law
    59. 59. Smokers are not a “protected class” such as age, race, gender, etc.
    60. 60. No smoking policies are legal
    61. 61. Same as the restriction of “no pets”
    62. 62. No smoking policy is not discrimination</li></ul>There is NO Constitutional Right to smoke!<br />
    63. 63. Slide about SAY<br />
    64. 64. San Diego County Tobacco Control Coalition<br />Collaboration<br />Materials<br />Trainings<br />Quit Smoking<br />Help<br />
    65. 65. How You Can Help<br />
    66. 66. Quitting SmokingHow you can quit or help a friend quit<br />
    67. 67. Quit Smoking3 Chains of Addiction<br />Physical<br />Psychological<br />Social<br />
    68. 68. Where Are You?<br />Living as a Nonsmoker<br />Staying Quit <br />Slipping & Relapsing<br />Quitting<br />Ready to Quit<br />Thinking About It<br />Not Ready<br />
    69. 69. Ready to Quit<br />Are you willing to set a quit date within 30 days?<br />
    70. 70. Smoking Triggers<br />
    71. 71. Money Saved Slide<br />
    72. 72. -Mark Twain<br />Slipping and Relapsing<br />“Quitting smoking is easy.I’ve done it a hundred times.”<br />Every relapse begins with a slip, but not every slip ends in a relapse.<br />
    73. 73. Staying Quit<br />Have you stayed quit for 6 months or longer? <br />
    74. 74. Breaking the Chain of Addiction: FDA-Approved Nicotine Replacement Products*<br />*The American Lung Association in California and SAY San Diego do not endorse any products.<br />Over the counter products: <br />Prescription products:<br />
    75. 75. Both are prescription products:<br />Other FDA-Approved Medications<br />*The American Lung Association in California and SAY San Diego do not endorse any products.<br />
    76. 76. Don’t use products that haven’t been approved by the FDA for quitting smoking<br />x<br />x<br />x<br />x<br />
    77. 77. Self-help guide<br />Groups<br />Online<br />Telephone counseling<br />If you’re ready to quit<br />
    78. 78. Thank You<br />Lisa Archibald, American Lung Association in California <br />619-683-7520 ·<br />Mary Badiner, Social Advocated for Youth (SAY) San Diego <br />858-974-3603 x207 · <br />