QUITTING SMOKING –SOMETHING OLD AND SOMETHING NEW Part 1

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

We now have this and most other articles published in the Parkland Shopper on our Website. Please visit us at http://www.dcp.ca/
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

HAPPY NEW YEAR!!!! Have you quit smoking yet?

There has been a Manitoba wide smoking ban since October 1, 2004. It is hard to believe that is now over 3 years ago. Across the pond in the European Union, Ireland was first to institute smoking ban in March 2004. Bans now exist in Italy, Spain, Belgium and Britain. On January 1, 2008, the smoking ban in France was extended to bars, discotheques, restaurants, hotels and cafes. Those romantic images of people in Paris discussing the issues of the day in a Parisian café over a cigarette and café au lait are a thing of the past. Who says the world doesn’t follow Manitoba’s lead?

The big brained people who study how people make decisions say there are 5 stages of change: precontemplation, contemplation, preparation, action and maintenance. Let’s look at them in regards to smoking.

Stage 1: Precontemplation – Not thinking seriously about it yet.
So you are not planning on quitting smoking in the next 6 months? That is okay. Here is your home work: Write down three things you like about smoking. Yes I said like. For example, “Smoking relaxes me.” Bring these 3 points with you the next time you see your doctor or pharmacist or health nurse or any other health care professional. Have a quick conversation about your smoking. That isn’t too intimidating/annoying is it?

Stage 2: Contemplation – Starting to think about it.
What if you would like to quit smoking before June 15, 2008? That is good. Write down three things you don’t like about smoking. For example, “I am afraid my smoking hurts my grandchildren.” Bring these 3 points with you the next time you see your doctor or pharmacist or health nurse or any other health care professional. Are you afraid you have smoked too long to make any difference now if you quit? It is never too late. Within 8 hours of quitting your carbon monoxide level drops and your oxygen level returns to normal. After 48 hours your chances of having a heart attack start to go down and your sense of smell and taste start to improve. Let’s go to the other extreme. Let’s say you had an advanced smoking related lung disease called COPD and were on death’s door. If you quit smoking the COPD won’t go away, but it won’t get worse as fast.

Smoking is the number 1 cause of premature death in North America. The Health Canada says smoking causes 47,581 deaths annually. That is more than the total number of deaths from AIDS, car accidents, suicide, murder, fires and accidental poisonings combined. Of those 47,581 deaths, Health Canada estimates that 30,230 of the deaths were men, and 17,351 were women including 55 boys an 41 girls under the age of 1. You women are also working hard to close that gender gap. There were 9224 more smoking related deaths in 1998 than in 1989 with females accounting for more than 6531 of these increased deaths.

Death doesn’t scare, you? We all gotta die of something, you say? Well how about stopping smoking to reduce your chance of a debilitating stroke that leaves you unable to walk, talk or feed yourself. Even before something as drastic as a stroke, smokers start to suffer. Smoking decreases the blood flow to the skin, and this leads to leathery-looking skin and increased wrinkling. The more you smoke, the more likely you are to get cataracts -an eye problem that can lead to blindness. Smoking is the main reason people get cancer in the mouth. Smoking makes it harder for your saliva to remove germs in your mouth. Smokers get stains, bad breath, and a higher chance of gum disease. Smokers are twice as likely as non-smokers to develop psoriasis - a disfiguring red and silver rash that can occur anywhere on your body. Smokers are more prone to stomach ulcers. Smoker’s ulcers don't heal as fast as non-smokers, and they're more likely to recur. Finally, guys, smoking causes impotence.

Stage 3:Preparation – I am going to do it, but I need a plan
You have set the goal of quitting by Feb 18, 2008. That is very good. So, you have decided to quit, but you want something to reduce your cravings. Nicotine replacement is now available as a patch, gum, or an inhaler. There is a prescription pill called Zyban, and a new pill called Champix. They don’t have nicotine in them and works on brain chemicals that have to do with addiction. I will compare and contrast them pills next week. Maybe its time to try something different. How about a Nicotine Lollipop? Nicotine Lolli’s are items that we can customize for people under the direction of their doctor.

At the moment we make 2mg and 4mg Nicotine Lollipops in strawberry flavor, but we can customize the flavor or the strength under the direction of your doctor. The idea behind the Nicotine Lollipop is the same as the nicotine gum or nicotine patch, we are putting some of the nicotine back into your system that the cigarette used to provide. This will help reduce (not eliminate) the cravings for cigarettes. The added bonus is psychological. People who have used the Lollipop say they like that they are still putting something in their mouth like they used to do with cigarettes.

How do you use the Nicotine Lollipop and how long does it last? This will vary person to person, but in general one Lollipop will last about 1/2 a pack of cigarettes. During your regular cigarette break you put the Lollipop in your mouth for about 5 minutes or until the craving passes (whichever is less) and then you reseal the Lollipop in our special child proof container and put it away until your next craving. What strength of Lollipop do I need? Your doctor will help you choose when they write the prescription, but usually the 2mg Lollipop is for 1 or less packs a day, and the 4 mg is for people who smoke more than a pack a day.

As always if you have any questions or concerns about these or other products, ask your pharmacist.