Tobacco De-addiction

1. OH & FWC, Jamnagar
DEADDICTION

2. OH & FWC, Jamnagar
MAINTAIN TOBACCO FREE
LIFE STYLE
“SAY TO TOBACCO THAT
TU BACK HO FROM YOUR
LIFE”

3. OH & FWC, Jamnagar
TOXIC TO THE BODY
OBNOXIOUS
BAD FOR HEALTH
ADDICTIVE
CAUSES CANCER
CAUSES SEVERAL DISEASES
OPPRESSIVE TO MIND
TOBACCO MEANS

4. OH & FWC, Jamnagar
DO YOU KNOW ?
IT HAS BEEN ESTIMATED THAT AN
AVERAGE OF 14 MINUTES OF LIFE IS
LOST FOR EACH CIGARETTE SMOKED
TOBACCO USERS LOOSE AN AVERAGE OF
20-25 YEARS OF NON-TOBACCO LIFE
EXPECTANCY
IN INDIA ONE PEOPLE DIE EVERY 40
SECONDS BECAUSE OF TOBACCO RELATED
PROBLEMS

5. OH & FWC, Jamnagar
DO YOU KNOW ?
ONE THIRD OF ALL CANCERS IN INDIA
ARE TOBACCO RELATED
90% OF ORAL CANCERS ARE DUE TO
TOBACCOP USE
50% OF ALL CANCERS IN MAN ARE DUE TO
TOBACCO USE
25% OF ALL CANCERS IN WOMAN ARE
DUE TO TOBACCO USE
90% OF LUNG CANCER DEATHS ARE
CAUSED DUE TO SMOKING

6. OH & FWC, Jamnagar
TOBACCO IN INDIA
TOBACCO IS SMOKED – IN CIGARETTES,
BIDIS, CHUTTA AND HOOKAHS
TOBACCO IS CHEWED – IN PAANS WITH OR
WITHOUT LIME AND BETEL NUTS
TOBACCO IS USED – AS SNUFF,GHUTKAS
AND IN PAN MASALA

7. OH & FWC, Jamnagar

8. OH & FWC, Jamnagar

9. OH & FWC, Jamnagar
TOBACCO CONSUMPTION
20%
55%
25%
CIGARETTE
BIDI
CHEWING
TOBACCO,
PANMASALA

10. OH & FWC, Jamnagar
CAUSES OF ADDICTION
• From elders - My Father is my “Hero”
• Party & Journey with Fri‘end’s
• Festivals - Shivratri, Gokulashtami, 31st
Dec. Party.
• Tradition in Occasions (Marriage, Engagement etc.)
• Physical Tiredness, Fatigability
• Stress - daily work / job
• Long time duration of work (to be alert)
• Hobbies, Status Symbol, Style
• Low self esteem, low courage, low stamina
• In chronic user-withdrawal syndrome

11. OH & FWC, Jamnagar
TOBACCO CONTENT
TAR NICOTINE
CIGARETTE 18 – 28 mg 15.49-19.95 mg
BIDI 45 – 50 mg 21.2 mg

12. OH & FWC, Jamnagar
TOBACCO CONTAINS
• There are 4,000 substances found in
cigarettes and 43 of them are known to
cause cancer .

13. OH & FWC, Jamnagar
What are in ingredients in
tobacco?
• Polonium210 (nuclear waste)
• Acetaldehyde (irritant)
• Lead (nerve poison)
• Formaldehyde (embalming fluid)
• Cadmium (found in batteries)

14. OH & FWC, Jamnagar
More ingredients
• N-Nitrosamines (known carcinogen)
• Benzopyrene (known carcinogen)
• Uranium 235 (nuclear waste)
• Nicotine (addictive substance)

15. OH & FWC, Jamnagar
TOBACCO CAUSES
LEADS TO BAD BREATH, STAINING OF
TEETH AND POOR PERSONAL HYGIENE
CIGARETTE SMOKING INCREASES THE
CHANCE OF GASTRODUODENAL ULCER
CONSUMING GUTHKA RESULTS IN ORAL
SUBMUCOSAL FIBROSIS A DISEASE WHICH
RESTRICTS MOUTH OPENING

16. OH & FWC, Jamnagar
CORONARY ARTERY (HEART)
DISEASE

17. OH & FWC, Jamnagar
SHORTNESS OF BREATH-LUNG
DISEASES & CANCERS

18. OH & FWC, Jamnagar
GANGRENE OF FOOT,
INTERMITTENT CLAUDICATION

19. OH & FWC, Jamnagar
SUB-MUCOSAL FIBROSIS

20. OH & FWC, Jamnagar
STAINING OF TEETH

21. OH & FWC, Jamnagar
GUM ULCER GINGIVITIS

22. OH & FWC, Jamnagar
IRRITATING COUGH, MOUTH
ULCER

23. OH & FWC, Jamnagar
ORAL CAVITY LARYNX
FLOOR OF THE MOUTH TONGUE

24. OH & FWC, Jamnagar
ORAL CAVITY CANCERS

25. OH & FWC, Jamnagar
ORAL CAVITY CANCERS

26. OH & FWC, Jamnagar
ORAL CAVITY CANCERS

27. OH & FWC, Jamnagar
ORAL CAVITY CANCERS

28. OH & FWC, Jamnagar
Tobacco
Health Effects
28

29. OH & FWC, Jamnagar
EFFECT ON REPRODUCTIVE
RISK OF MISCARRIAGE
DELIVERY
ATH
WEIGHT BABY
TOBACCO & WOMEN

30. OH & FWC, Jamnagar
NICOTINE CAUSES…..
FOLLOWING INHALATION, NICOTINE
IS ABSORBED INTO BLOODSTREAM
AND ITS EFFECTS ON THE BRAIN ARE
FELT 7 -8 SECONDS LATER
NICOTINE IN SMALL AMOUNTS
GENERALLY STIMULATES NERVE
IMPULSES AND IN LARGE AMOUNT
INHIBITS THEM

31. OH & FWC, Jamnagar
NICOTINE CAUSES…..
INCREASE IN HEART RATE
INCREASE IN BLOOD PRESSURE
INCREASE IN HORMONE
PRODUCTION
CONSTRICTION OF BLOOD VESSELS
CHANGES IN BLOOD COMPOSITION
CHANGES IN METABOLISM

32. OH & FWC, Jamnagar
WhatWhat NICOTINENICOTINE doesdoes cause is:cause is:
An Addiction ToAn Addiction To NICOTINENICOTINE!!
When you’reWhen you’re
addicted toaddicted to
nicotine, as 88% ofnicotine, as 88% of
tobacco users are,tobacco users are,
YOU’VE GOTTAYOU’VE GOTTA
HAVE IT!HAVE IT!
Your brain and your
Nicotinic Receptors
send messages back
and forth and when
the message is that
you need NICOTINE,
much unhappiness
ensues!!
That’s where theThat’s where the
cravings come from!cravings come from!

33. OH & FWC, Jamnagar
CARBON MONOXIDE
CAUSES….
CARBON MONOXIDE (CO) COMBINES MORE
READILY WITH HAEMOGLOBIN THAN
OXYGEN (O2) DOES,CARRYING CO ROUND
THE BODY INSTEAD OF OXYGEN
CO AFFECT THE ELECTRICAL ACTIVITY OF
THE HEART
FATTY DEPOSITION IN THE ARTERIAL WALL
AFFECTING THE CIRCULATION

34. OH & FWC, Jamnagar
TAR CAUSES…..
TAR IS A BROWN STICKY SUBSTANCE
WHICH COATS THE LUNG LIKE SOOT IN A
CHIMNEY AND MAKING IT LESS ELASTIC.
IRRITIRANTS IN TAR ALSO DAMAGE THE
LUNG, CAUSING NARROWING OF
BRONCHIOLES, COUGHING, AN INCREASE
IN BRONCHIOLE MUCUS AND DAMAGE TO
SMALL HAIRS WHICH HELP PROTECT THE
LUNGS FROM DIRT AND INFECTION.

35. OH & FWC, Jamnagar
Tobacco & Diabetes
Smoking and Diabetes both
reduce the amount of oxygen
reaching your bodily tissues,
resulting in poor circulation.
Smoking raises your blood
sugar level making it harder
to control your diabetes.
Of people with diabetes who
need amputations, 95% are
smokers.

36. OH & FWC, Jamnagar
Tobacco & Diabetes
Nicotine is a vessel constrictor, reducing
the body’s blood flow. Smoking
increases cholesterol levels and hardens
arteries.
Diabetes increases cholesterol levels and
the levels of some other fats in your
blood.
The combined cardiovascular risks of
smoking and diabetes is as high as 14
times those of either smoking or diabetes

37. OH & FWC, Jamnagar
Tobacco & Diabetes
Together, diabetes and tobacco use make it
twice as likely that you will develop heart
and blood vessel disease.
People with diabetes who smoke are 3
times more likely to die of cardiovascular
disease than are other people with diabetes.
Deaths from heart disease in women with
diabetes have increased 23% over the past
30 years compared to a 27% decrease in
women without diabetes.

38. OH & FWC, Jamnagar
PASSIVE SMOKING

39. OH & FWC, Jamnagar
EFFECT OF PASSIVE SMOKING
TO CHILDREN & OTHERS
Coughing and wheezing
Asthma
Sore throats and colds
Eye irritation
Hoarseness
39

40. OH & FWC, Jamnagar
TheThe
FagerstromFagerstrom
Scale ofScale of
Addiction:Addiction:
Fagerstrom’s Scale of AddictionFagerstrom’s Scale of Addiction
1. How soon after you wake up do you have your first
cigarette or chew?
Within 5 minutes = 3
6 – 30 minutes = 2
31 – 60 minutes = 1
After 60 minutes = 0
2. Is the first cigarette/dip he day the most enjoyable?
Yes = 1 No = 0
3. Do you smoke/chew more frequently in the morning than
the rest of the day?
Yes = 1 No = 0
4. Do you have cravings for tobacco when you are in places
that you cannot smoke?
Yes = 1 No = 0
5. If you are too sick to go about your normal activities, do
you still smoke/chew?
Yes = 1 No = 0
6. How many cigarettes/cans do you smoke/chew per day?
31+ 3
21-31 2
11-20 1 Score: _____ out of 10
<10 0
Here’s what it means:
Score: 0-3 Mildly Addicted
4-6 Moderately Addicted
7-10 Significantly Addicted
(A 4 0r less will have less trouble
quitting)
(A 5 or more will have problems)

41. OH & FWC, Jamnagar
QUITTING SMOKING

42. OH & FWC, Jamnagar
If someone has Rs 20 per day for
addiction…
Like Chewing, Smoking, Drinking & Others
If he quit ADDICTION…
He may have Tata Nano / Wagon R
????? How ?????

43. OH & FWC, Jamnagar
Better to ‘use’ than ‘waste’
• One day: Rs. 20  One month: Rs. 600
• One year: Rs. 7,200 Five yrs: Rs.36,000
• Ten yrs: Rs. 1,80,000
• Invest 1,80,000 for 5 yrs as FD at 10% (bank)
Total 1,80,000 +18,000 = 1,98,000
almost Rs. 2 lac at 5 yrs & Rs. 4 lac at 10 yrs
• So at 5 yrs-one may have ‘Tata Nano’
• At 10 yrs-one may have ‘Wagon R’

44. OH & FWC, Jamnagar

45. OH & FWC, Jamnagar
Quit Day
• Make this a very special day !! Set a date
and stick to it.
• You must have a plan!
• Review coping strategies.
• Review your likes and dislikes.
• Get rid of all tobacco products.

46. OH & FWC, Jamnagar
Withdrawal Signs
• Cravings
• Irritability
• Tenseness
• Trouble in concentrating
• Constipation or irregular bowels
• Restlessness

47. OH & FWC, Jamnagar
Stress Management
• Attitude
• Think!
• Count to ten
• Relaxation exercises
• Plan ahead
• Learn to say “NO”

48. OH & FWC, Jamnagar
Tips For Quitting
• Drink lots of water
• Get rid of tobacco in the house and car
• Remove all ashtrays
• Increase fruits and veggies
• Think positive
• Call a friend for support
• Hang out with Non-smokers

49. OH & FWC, Jamnagar
Maintaining Your Balance
• Recreation - get outside
• Social - avoid smoky places
• Spiritual - get in touch
• Physical - get active
• Mental - relax
• Vocational - stay busy

50. OH & FWC, Jamnagar
20 minutes:
Blood pressure and pulse rate drops to normal;
8 hours:
Oxygen level increases to normal & carbon monoxide
level drops in blood.
24 hours:
Chance for a heart attack goes down.
48 hours:
Ability to smell and taste improves; walking is becoming
easier.
2 weeks to 3 months:
Blood circulation improves. No more cold hands and
cold feet. Lung function increased up to 30%.
BENEFITS OF QUITTING TOBACCO

51. OH & FWC, Jamnagar
1 month to 9 months:
Coughing, sinus congestion and shortness of breath
have decreased dramatically.
1 year:
Risk of coronary heart disease is cut in half.
5 years:
Risk of stroke reduced to that of a nonsmoker. Risk of
cancers of the mouth, throat and esophagus cut in
half. Risk of lung cancer reduced in half.
10 years:
Risk of dying from lung cancer is cut in half
15 years:
Risk for coronary heart disease and stroke is the same
as for a lifelong nonsmoker.
BENEFITS OF QUITTING TOBACCO

52. OH & FWC, Jamnagar
What we’re leading up to isWhat we’re leading up to is
usingusing NRTNRT oror
Nicotine Replacement Therapy!Nicotine Replacement Therapy!
SafeSafe nicotinenicotine is available by patch, gum,
lozenge, inhaler and nasal spray. The patch,
gum and lozenge can be purchased over the
counter: without a prescription!

53. OH & FWC, Jamnagar
Here’s what we recommend
for our patients:
Use as much NRT as you
need to not have cravings,
crabbiness, anxiety or any
of the other classic
symptoms of nicotine
withdrawl.
Use it long enough to let
your nicotine receptors go
back to doing what they are
supposed to be doing.
Then, wean it very slowly!
NRT

54. OH & FWC, Jamnagar
Weaning...Weaning...
After you find the dose that works for
you, stay at that level for 4 weeks. Then
begin weaning in increments of 7mg
(The patch comes in 7, 14 and 21mg doses) spending
3-4 weeks at each level and always
returning to a higher level if the symptoms
sneak back up on you!
Don’t be in a hurry!Don’t be in a hurry!
If you try to hurry, your receptors will make you
crave and you will want to smoke.

55. OH & FWC, Jamnagar
OK! Sorry to beat thisOK! Sorry to beat this
Nicotine thing to death,Nicotine thing to death,
but just one more thing:but just one more thing:
When you use the patch,
even at the right dose,
occasionally you may
experience what we call
a “breakthrough
craving.” If it’s
something you can’t
handle on your own just
by taking some deep
breaths or some sips of
water, using additional
NRT from gum or
lozenges is OK!
The use of NicotineThe use of Nicotine
Lozenges or Nicotine GumLozenges or Nicotine Gum
can give you the extracan give you the extra
edge you may need!edge you may need!

56. OH & FWC, Jamnagar
Other Stuff!Other Stuff!
Zyban… Wellbutrin… Bupropion...Zyban… Wellbutrin… Bupropion...
These medications are all the same thing: Bupropion.
Wellbutrin is marketed as an antidepressant; Zyban was
marketed as a stop-smoking drug; Bupropion is the generic
equivalent of both. They act by affecting the dopamine
producing area of the brain (the pleasure and reward
center). In doing so, the need for nicotine may be reduced.
Lots of potential side-effects!
For some, it worked GREAT!! For others: not so much!

57. OH & FWC, Jamnagar
Enjoying Tobacco?

58. OH & FWC, Jamnagar
If You Truly Love Your Family Than