Methods of smoking cessation Disease caused by smoking

1. SMOKING CESSATION
PRESENTED BY:
ZAINABATH MAHNOORA
1st MPHARM
PHARMACY PRACTICE
NU20PHPP13

2.  It is defined as the process of discontinuing tobacco smoking.
 Tobacco smoke contains more than 4000 different chemical compounds
of all 3 phases, some of them are nicotine(addictive drug), tar, carbon
monoxide, lead, formaldehyde, nitrogen oxide, arsenic, benzene,
ammonia, toluene etc…
SMOKING CESSATION (QUITTING SMOKING):
2

3.  WHY SHOULD ONE QUIT SMOKING?
 Lengthen life expectancy
 Reduce risk of infertility issues
 To reduce risk of lung, kidney and heart diseases
 To feel healthier and have a healthy lifestyle
 To reduce risk of hypertension
 To protect your loved ones from dangerous second hand smoke
 To improve your olfactory and gustatory senses
 To decrease health care cost for the treatment of diseases
 To decrease work absenteeism

4.  DISEASES AND ADVERSE EFFECTS CAUSED BY SMOKING
 CANCER
cervical cancer, gastric/esophageal cancer, leukemia, lung cancer, pancreatic & oral/laryngeal
cancer
 CARDIOVASCULAR DISEASES
Cerebrovascular disease, coronary heart disease
 RESPIRATORY DISEASES
COPD, Pneumonia, accelerated decrease in lung function, cough, wheeze, dyspnea, asthma
 REPRODUCTIVE EFFECTS
Reduced fertility, fetal growth restriction, low birth weight, preterm delivery, sudden infant
death syndrome(SIDS)
 OTHER
Low bone density, hip fracture, peptic ulcer, poor wound heeling

6. NON-PHARMACOLOGICAL THERAPY FOR SMOKING
CESSATION
BEHAVIORAL INTERVENTIONS
CLINICAL INTERVENTIONS
MOTIVATIONAL INTERVENTIONS
 OTHER METHODS ARE
 “ COLD TURKEY ”
 NICOTINE FADING
 AVERSION TECHNIQUES

7. A strong dose –response relationship has been established between the intensity of
clinician counseling (both duration and frequency) and successful smoking
cessation. Healthcare professionals can increase the rate of tobacco cessation . An
interdisciplinary approach involving multiple providers may enhance cessation
rates.
BEHAVIORAL INTERVENTIONS:

8. CLINICAL INTERVENTIONS:
The five key components of tobacco cessation, the “ the 5 A’S ”
8

9. 9
ASK:
Do you
currently
use
tobacco?
START
With the 5 AS
• ASK
• ADVISE
• ASSESS
• ASSIST
• ARRANGE
ADVISE
: To
quit
ASSESS:
Are you
willing to
quit now
?
ASSIST
(Act):
Interview to
increase
motivation
to quit
ASSIST
(Act):
Encourage
continued
abstinence
ASSIST
(Act):
Provide
relapse
prevention
ARRANGE
(REFER) :
For follow
up
Counselling
And
Medication
ASSESS:
Have you
quit
recently?
challenges?
ASK :
Have you
ever used
tobacco?
yYES
yYES
YES
NO
NO
NO
NO
ASSIST
(Act):
Provide
appropriate
tobacco
dependence
treatment
yYES

10.  MOTIVATIONAL INTERVENTIONS
10

11. 11
 RELEVANCE : Use patient’ s health status , family situation , and history to personalize
as possible .
 RISKS : Include personal , auto , and long term health risks as well as environmental
tobacco smoke risk to family.
 REWARDS : Potential benefits of quitting tobacco use.—
Improving health of ones and family
 ROADBLOCKS : Identify potential barrier to stop and elements of treatment like
withdraw symptoms like weight gain and depression.
 REPETITION : Motivational intervention in repetition .

12.  OTHER METHODS
COLD TURKEY METHOD
• Means giving up smoking all at once with NRT or other drugs.
• Easy to succeed if you smoke for more than 10 cycles/day.
• STEPS:- Set a date .
 Prior a date – 2-4 weeks in future.
 Distract yourself from habits.
 Gather with friends and family
 Anticipate cravings by leisure time.
 Know withdrawal symptom are temporary

13.  NICOTENE FADING
• Gradually taper amount of nicotine by switching to cigarette with
less nicotine or with decrease in number of cigarette smoked.
• Efficacy is limited.
 AVERSION TECHNIQUE
• Ineffective method.
• Effective to unpleasant effects of high quick dose of nicotine.
• Smoking upto to a point of discomfort resulting in nausea /
vomiting.

14. 14
NICOTINE REPLACEMENT THERAPY
• It is a smoking cessation aid
• Reduce physical symptoms of nicotine withdrawal.
• Provide a non-tobacco controlled release amount of nicotine.
• Without exploring patients to carcinogens in smoke.
• Have lower and less variable plasma nicotine concentration.
• 1.5-2 fold increase in addition of long term success.
 PHARMACOTHERAPY FOR SMOKING
CESSATION
• FDA approved NRT dosage forms –
GUM , LOZENGES AND PATCHES

15. 15
• INDICATIONS :
 Patient should be mentally ready to quit .
 This can be used on one who smoke less than 1.5
packet of cigarettes.
 Or more than 10 cigarettes.
 simoultaneously with non- pharmacologic
measures (counselling ).

16. 16
• CONTRAINDICATION
 Acute cardiovascular disease
 Pregnant or breast feeding mothers.
 Safe for stable cardiovascular disease.
 Restricted to below 18 yrs.
 Asthma or depression patient

17. 17
 Other pharmacological methods
 Bupropion SR
 Clonidine
 Notriptyline
 Lobeline-herbal medicine
 Hypnosis
 Chewing cinnamon sticks
 Acupenture

18. 18
 BENEFITS OF SMOKING CESSATION
 Many adverse effects of smoking are partially reversible.
 Improved pulmonary function and circulation.
 Coronary heart disease risk decreases to half.
 Cancer risk is reduced to 30% -50%.
 Improve survival rate in cancer patient.
 COMPLICATIONS OF SMOKING CESSATION
 Withdrawal symptoms like tobacco cravings
 Depressed mood and insomnia
 Irritability, decreased concentration and anxiety
 Decreased Heart rate
 increased hunger
This complications can be resolved within 30 days except hunger which may persist more and can be resolved by
time

19.  REFERENCES:
1. R.A.Helmes, D.J.Quan, E.T. Herfindal, D.R. Gourley, editors. Tobacco use and dependence: Text
book of therapeutics, Drug and disease management. 8th edition. USA: Lippincott Williams and
Wilkins; 2000. 1554-1569.
2. L.Shargal, A.H. Mutnick, P.F. Souney, L.N. Swanson, editors. Over-the-Counter Weight Control,
sleep and smoking cessation aids: Comprehensive Pharmacy Review. 8th edition. India: Lippincott
Williams and Wilkins; 429-439
3. Hutter H, Moshammer H, Neuberger M. “Smoking cessation at the working places: 1year success of
short seminars”. International Archives of occupational and Environmental Health. 2006; 79(1): 42-8
4. Henningfield JE, Fant RV, Buchhalter AR, Stitzer ML. “Pharmacotherapy for nicotine
dependence”.2005; 55(5) 99-281

20. THANK YOU