Smoking & health
•Download as PPTX, PDF•
8 likes•3,983 views
The document discusses smoking cessation and approaches for quitting smoking. It covers the following key points: - Part I provides an introduction and discusses the health effects of smoking. - Part II outlines evidence that smoking increases risks of cancer and cardiovascular disease. - Part III discusses the benefits of quitting smoking. - Part IV describes two approaches - the 5A's model and 5R's model - that healthcare providers can use to help patients quit smoking through counseling and support. It details the steps in each model including asking about tobacco use, advising patients to quit, assessing willingness and barriers, assisting with treatment options, and arranging follow-up support.
More Related Content
What's hot
What's hot (20)
Similar to Smoking & health
Similar to Smoking & health (20)
More from MEEQAT HOSPITAL
More from MEEQAT HOSPITAL (20)
Recently uploaded
Recently uploaded (20)
Smoking & health
- 2. •IntroductionPart І • Health effects of smokingPart П • Benefits of quit smokingPart Ш . Approaches for smoking cessation
- 3. • Most smokers would like to quit and approximately 40% have made at least one attempt to do so in the past year. • Brief advice from a general practitioner (GP) increases cessation rates by about two-thirds, compared with no advice, and is highly cost-effective. Part І
- 4. Why Tobacco Is a Priority In a Busy Clinic? Make a Difference (<3min) More is More! Not willing now? WILL LATER Patient Satisfactio n Cost Effectiv e
- 7. There are approximately 600 ingredients in cigarettes. When burned, they create more than 7,000 chemicals. At least 69 of these chemicals are known to cause cancer.
- 8. Chemicals in Tobacco Smoke Found in Acetone Nail polish remover Acetic Acid an ingredient in hair dye Arsenic Rat poison Butane Lighter fluid Ammonia a common household cleaner
- 9. Chemicals in Tobacco Smoke Found in Cadmium Battery acid Carbon Monoxide Car exhaust fumes Methanol Main component in rocket fuel Nicotine Insecticide Tar Paving roads
- 12. Tar It mainly causes the cancers and chronic bronchitis and emphysema (COPD)
- 13. • Colorless, odorless, tasteless gas • Binds to hemoglobin & reduces the amount of oxygen in the blood. • Causes fat to deposit on walls of arteries Carbon monoxide binds to hemoglobin at the same sites as oxygen, but approximately 210 times more tightly.
- 14. Tobacco is an ADDICTIVE substance because it contains the nicotine A toxic colorless oily liquid which is the chief ACTIVE CONSTITUENT OF TOBACCO
- 16. • Depressed mood • Insomnia • Irritability or anger • Anxiety • Difficulty concentrating • Restlessness • Decreased heart rate • Increased appetite Nicotine withdrawal syndrome is characterized by four or more of the following signs:
- 17. The World Health Organization describes smoking as an EPIDEMIC that will cause 10 million, or 1 in 6 adult deaths, annually by 2030
- 18. Part П
- 19. Evidence is accumulating that smoking increases the risk of nearly all types of cancers and cardiovascular diseases
- 22. • Tobacco smoking is by far the leading cause of lung cancer • About 80% of lung cancer deaths are caused by smoking
- 26. Smoking represents the most readily preventable risk factor for morbidity and mortality
- 27. Part Ш
- 30. Part IV
- 31. The 5A’s model To Help Patients Ready To Quit The 5As Approach
- 32. Ask Advise Assess Assist Arrange • Easy to implement • Evidence-based • Clinical counseling approach The 5As approach
- 33. Ask Advise Assess Assist Arrange Ask if he/she uses any of the following tobacco products The 5As approach
- 34. The First Step In Treating Tobacco Use And Dependence Is To IDENTIFY Tobacco Users ASK
- 35. Ask Advise Assess Assist Arrange • Advise all smokers to quit in a clear, unambiguous way such as ‘the best thing you can do for your health is to stop smoking’. • The benefits of quitting should be discussed. • Use clear language • Use a strong tone • Use a personalized message The 5As approach These messages should be repeated at every opportunity
- 36. Ask Advise Assess Assist Arrange • Willingness to quit and barriers to quitting should be assessed, as well as smoking history and current level of nicotine dependence; patients should be asked about their timeline for quitting and about previous attempts. The 5As approach
- 37. Ask Advise Assess Assist Arrange ALL SMOKERS SHOULD BE OFFERED HELP TO QUIT • Appropriate patients should be offered pharmacologic assistance in quitting, such as nicotine replacement therapies, and varenicline. The 5As approach
- 38. Ask Advise Assess Assist Arrange • Follow-up visits have been shown to increase the likelihood of long-term abstinence and are especially useful in the first few weeks after quitting. The 5As approach
- 40. Relevance Risks Rewards Roadblocks Repetition To INCREASE MOTIVATION to quit The 5Rs approach
- 41. COMPONENT DESCRIPTION Relevance Encourage the patient to identify reasons to stop smoking that are personally relevant Risks Advise the patient of the harmful effects of continued smoking, both to the patient and to others, incorporating aspects of the personal and family history whenever possible Rewards Ask the patient to identify the benefits of smoking cessation Roadblocks Explore the barriers to cessation that the patient may encounter Repeat Include aspects of the five R's in each clinical contact with unmotivated smokers The 5Rs approach
- 42. BARRIERS TO QUITTING SMOKING Barriers Discussion Weight Gain The health benefits of quitting is almost always greater than the health effect of extra weight. On average, 4-5 kg after 12 months. Drinking water & choosing low calories food. About 1 in 5 quitters do not gain weight. Coping with Stress Smoking actually increase the stress during the day due to nicotine withdrawal between the cigarettes. They will be more relaxed after quitting.
- 43. BARRIERS TO QUITTING SMOKING Barriers Discussion Withdrawal from nicotine They can usually be controlled with stop- smoking medication and behavioral strategies. Craving get weaker over time. Fear of failure Unsuccessful attempts at quitting can be reframed as learning experiences and can increase the chance of success next time. Peer or social pressure It may be best to avoid friends who smoke for the first few weeks. Suggest asking friend not to offer cigarettes and, if possible , not to smoke around your patient.
Editor's Notes
- Brief advice from a general practitioner (GP) increases cessation rates by about two-thirds, compared with no advice, and is highly cost- effective. One component of Young Moms Connect is training for health care providers on six maternal and child health best practices
- Cost Effective:- When we compare the treatment cost (1000 SAR) to the cost of smoking complication e,g, (STROKE) (75000 SAR) we can see the cost effective clearly. https://www.ncbi.nlm.nih.gov/pubmed/23954598
- The American Lung Association is a voluntary health organization whose mission is to save lives by improving lung health and preventing lung disease through education, advocacy and research. The organization was founded in 1904 Nicotine is created by the tobacco plant as an insecticide to protect it from bugs. In large doses it is a poison, and is used commercially as an insecticide. In tobacco smoke, it is what keeps you addicted, but it is not the major source of negative health effects. Tar is the black/ yellow sticky residue or resin that results from burning tobacco. It contains most of the chemicals and nicotine, and is responsible for the toxic and cancer causing effects. Once inhaled into the lungs, tar coats the “cilia” or little hairs coating our lungs that help move out toxins or dust particles. The tar makes it so they can’t move and trap the toxins, so they start to build up in the lungs and gets in the way of oxygen trying to come into your body, which leads to the coughing and rough breathing.
- The American Lung Association is a voluntary health organization whose mission is to save lives by improving lung health and preventing lung disease through education, advocacy and research. The organization was founded in 1904
- – active component in – released in Lead – used in batteries – a – used as – material for
- 11
- Tar is the black/ yellow sticky residue or resin that results from burning tobacco. It contains most of the chemicals and nicotine, and is responsible for the toxic and cancer causing effects. Once inhaled into the lungs, tar coats the “cilia” or little hairs coating our lungs that help move out toxins or dust particles. The tar makes it so they can’t move and trap the toxins, so they start to build up in the lungs and gets in the way of oxygen trying to come into your body, which leads to the coughing and rough breathing. تترسب هذه المادة اللزجة في الحويصلات الهوائية فتعطل تبادل الغازات فيها, كما أنها تحوي موادا شديدة الضرر وأهمها المواد الهيدروكربونية المحدثة للسرطان, وهي مواد عضوية مكونة من الكربون والهيدروجين وتحتوى على مادة البنزوبيرين, أي فحم مهدرج, وليست فحما مائيا.
- 13
- The nicotine in cigarettes stimulates your body to produce adrenaline, which makes your heart beat faster and raises your blood pressure, making your heart work harder. Nicotine is created by the tobacco plant as an insecticide to protect it from bugs. In large doses it is a poison, and is used commercially as an insecticide. In tobacco smoke, it is what keeps you addicted, but it is not the major source of negative health effects.
- 16
- Tobacco use is a worldwide epidemic. By 2000, tobacco killed at least 4.9 million people annually (Ezzati and Lopez, Lancet 2003; 362: 847-52), accounting for 1 in 10 adult deaths. But by 2030, tobacco will be responsible for 10 million annual deaths, or 1 in 6 adult deaths—”more than the projected death tolls from pneumonia, diarrheal diseases, TB and the complications of childbirth for that year combined.” Who is consuming tobacco? The demand in developed countries is declining slowly. This is mostly due to an increased awareness of the damaging health effects of smoking, together with anti-smoking measures of governments including intensified anti-smoking campaigns, and banning of advertising and increased taxation. The demand among developing countries, however, has rapidly increased. A major part of the projected increase in demand is expected to be in the Far East, particularly China. The share of China in total world tobacco demand is around 37% in 2010. Overall, by 2010, the share of developed countries in world tobacco consumption is projected to be only 29 percent (1998: 34 percent), while the share of developing countries will be 71 percent. By 2030, 70% of deaths will be from “low-and middle-income countries. An efficient and systematic surveillance mechanism to monitor the epidemic is one of the essential components of a comprehensive tobacco control program.
- This is mage is more expressive than text.
- Smokers are almost twice as likely to have a heart attack compared with people who have never smoked.(British Heart Foundation) 2. Beaglehole R, Bonita R, Horton R, Adams C, Alleyne G, Asaria P, et al. Priority actions for the non communicable disease crisis. Lancet. 2011;377(9775):14381447. doi: 10.1016/S0140-6736(11)60393-0. [PubMed][Cross Ref] How does smoking damage your heart? Smoking increases the risk of developing cardiovascular diseases, which includes coronary heart disease and stroke. Smoking damages the lining of your arteries, leading to a build up of fatty material (atheroma) which narrows the artery. This can cause angina, a heart attack or a stroke. The carbon monoxide in tobacco smoke reduces the amount of oxygen in your blood. This means your heart has to pump harder to supply the body with the oxygen it needs. The nicotine in cigarettes stimulates your body to produce adrenaline, which makes your heart beat faster and raises your blood pressure, making your heart work harder. Your blood is more likely to clot, which increases your risk of having a heart attack or stroke. Take a look at our cardiovascular disease page to find out more about blood clots and the damage they can do to your body.
- This picture really shows how smoking affects all parts of your body, not just with cancer risk, but also with chronic diseases or other problems. For example, smoking not only can cause mouth and throat cancer, but causes rotting and falling out teeth. This is also just an overview list of the disease names, but there is a spectrum of symptoms that may not fit under a chronic disease status. Smoking can damage the lining of the blood vessels and cause the build-up of fatty deposits in the arteries (atherosclerosis). It raises the heart rate and blood pressure by causing narrowing of the blood vessels (vasoconstriction). It increases the likelihood of forming blood clots in the arteries leading to heart attacks. It reduces the flow of oxygen to the heart and damages the heart muscles.
- تزيد الاصابة بالسكري نتيجة المواد السامة التي تنتج داخل الجسم من التدخين وتؤدي الى زيادة مقاومة الخلايا للانسويلين The risk of developing diabetes increases with the number of cigarettes smoked per day HOW SMOKING CAUSES TYPE 2 DIABETES Smoking increases inflammation in the body. Inflammation occurs when chemicals in cigarette smoke injure cells, causing swelling and interfering with proper cell function. Smoking also causes oxidative stress, a condition that occurs as chemicals from cigarette smoke combine with oxygen in the body. This causes damage to cells. Evidence strongly suggests that both inflammation and oxidative stress may be related to an increased risk of diabetes. https://www.cdc.gov/tobacco/campaign/tips/diseases/diabetes.html
- Reference: WHO
- Tobacco cessation counseling using the 5 A’s approach The 5As provide health professionals with a framework for structuring smoking cessation support. The elements of the 5As are ask, assess, advise, assist and arrange follow-up.10 Figure 1 shows this approach in detail.
- regularly ask all patients if they smoke and record the information in the medical record. Use a concerned, helpful tone when you ask about smoking Use a multiple choice format Use either a written survey or clinical interview Asking “Do you smoke” isn’t as effective as asking in a multiple choice format. Use a non-judgmental tone. Ask at multiple visits to your office. All patients should be asked about tobacco use and assessed for motivation to quit at every clinical encounter.
- Where do you think we can ask for smoking?
- If you're a smoker, stopping smoking is the single most important step you can take to protect the health of your heart. Even brief physician advice may prompt an additional 1 to 3 percent of patients to attempt cessation and improve quit rates compared with patients who receive no advice (relative risk = 1.7). Strongly urge all tobacco users to quit Use clear language Use a strong tone Use a personalized message This is the portion of the counseling session where you make your recommendation to her, you share important information and you answer her questions all as part of starting the conversation about quitting. For pregnant women, provide clear, strong advice to quit with personalized messages about the impact of smoking on mother and fetus. Tailor to her personal situation Use positive language Focus on positive benefits of quitting Use appropriate motivational messages Tailor your advise to the patient’s situation and their responses to the ASK portion. Use positive language and focus on the positive benefits of quitting. Its important to not make the patient feel criticized or shamed, instead let her that you are aware of how hard this is and that you want to be a support to her. “I know I’m asking you to do something that takes a lot of effort, but my best advice to you (and your baby) is to quit smoking. I also see from your questionnaire that you have a history of bronchitis and asthma. Quitting smoking will help you feel better (and provide a healthier environment for your baby).” Physicians should strongly advise patients to quit smoking, and use motivational interviewing techniques for patients who are not yet willing to stop smoking. Clinical contacts with unmotivated patients should emphasize the rewards and relevance of quitting, as well as the risks of smoking and anticipated barriers to abstinence. These messages should be repeated at every opportunity.
- Appropriate patients should be offered pharmacologic assistance in quitting, such as nicotine replacement therapies, bupropion, and varenicline. Use of pharmacologic support during smoking cessation can double the rate of successful abstinence. Using more than one type of nicotine replacement therapy (“patch plus” method) and combining these therapies with bupropion provide additional benefit. Offer support and additional resources (e.g., referral to counseling, http://www.smokefree.gov, 1-800-QUIT-NOW, pharmacotherapy); help patients to anticipate difficulties and encourage them to prepare their social support systems and their environment for the impending change Withdrawal: Common nicotine withdrawal symptoms (e.g., irritability, anxiety, restlessness) peak within the first week of abstinence and last two to four weeks; NRTs can be helpful because they gradually decrease nicotine dependence; smokers should also be advised to decrease caffeine intake* Depression: Smokers are more likely than nonsmokers to have a depressive episode,12and smokers with depression are less likely to successfully quit13; smoking cessation may trigger depression in those with a history of depression14; physicians should consider monitoring the mood of smokers during quit attempts and screen for depression in those who have repeatedly been unable to quit; bupropion (Zyban) may be an appropriate cessation aid for smokers at risk of depressive relapse Weight gain: Although most smokers gain fewer than 10 lb (4.5 kg) after quitting, weight gain can vary (10 percent will gain 30 lb [13.5 kg])15; although this weight gain poses less health risk than smoking, concern about weight gain may interfere with the quit attempt; sustained-release bupropion or an NRT (particularly gum or lozenges) may be helpful in these patients because they delay weight gain while in use4; it may be easier to monitor and adjust food intake/exercise balance after immediate tobacco cravings are no longer as prominent
- Physicians also should arrange to have repeated contact with smokers around their quit date to reinforce cessation messages. Follow-up plans should be set; for patients who have recently quit, it is important to elicit the benefits of quitting and ask patients to anticipate and problem solve about situations that might lead to relapse; follow-up contacts should also be used to readjust the dosages of therapeutic agents that may be altered by smoking cessation (e.g., beta blockers, antipsychotics, insulin, benzodiazepines)*
- Strategies A1 to A3 need to be delivered to each tobacco user, regardless of his or her willingness to quit
- التدخين يسبب انسداد الشهية نتجية من تأثيرة السلبي ع حلمات الذوق وحاسة الشم والتي يستعيدها المقلع عن التدخين وبالتالي تنفتح الشهية للطعام ويعد التدخين من أهم الأسباب التي تؤدي إلى فقدان الشهية، فهو يطلق سلسلة من المركبات الضارة التي تؤثر في أعضاء مختلفة في الجسم، خصوصاً مركز الشهية القابع في منطقة الهيبوتالاموس في قاع المخ، ما يدفع الشخص إلى تناول كميات أقل من الطعام.