STOP SMOKING! START THINKING!

Smoking is a practice in which a substance, most commonly tobacco or cannabis, is burned and the smoke is tasted or inhaled. This is primarily practiced as a route of administration for recreational drug use, as combustion releases the active substances in drugs such as nicotine and makes them available for absorption through the lungs. It can also be done as a part of rituals, to induce trances and spiritual enlightenment.

FORMS OF SMOKING:
Beedis Cigarettes Pipes Cheroots Chuttas Reverse smoking Dhumti Hooklis Chullium Hookah

ILL EFFECTS OF SMOKING:

Many health groups are continuously reminding people about the harmful effects of smoking on the body, aside from the fact that it is habit forming. Once these effects set in, they may be hard to treat, some are even irreversible. Health risks from smoking begin as soon as the person starts smoking. Toxic ingredients in cigarette smoke travel throughout the body, causing damage in several different ways.

SHORT TERM EFFECTS:

Increased blood pressure Increased heart rate Narrowing of the arteries Reduced amount of oxygen the blood can carry

Carbon monoxide levels in the blood rise Creates an imbalance in the demand for oxygen by the cells

LONG TERM EFFECTS:

cancer Lung diseases Heart disease Cardiovascular diseases Stroke Osteoporosis and weakened bones Circulatory problems Ulcers Premature aging Damage to the fetus Low sperm count and impotence Spontaneous abortion (miscarriage) Decreased lung function Bronchitis Infections Chronic obstructive pulmonary disease

DO YOU KNOW??????????
There are over 4,000 chemicals in cigarettes. 51 of them are known to be carcinogenic.

REASONS WHICH PEOPLE SAY FOR SMOKING:

Coping with anger, stress, anxiety, tiredness, or sadness Smoking is pleasant and relaxing Smoking is stimulating Acceptance being part of a group As a way to socialize Provides support when things go wrong A way to look confident and in control Keeps weight down Rebellion defining self as different or unique from a group A reminder to breathe Something to do with your mouth and hands Shutting out stimuli from the outside world Shutting out emotions from the inside world Something to do just for you and nobody else A way to shift gears or changes states An way to feel confident A way to shut off distressing feelings A way to deal with stress or anxiety A way to get attention

CYCLE OF ADDICTION:
NICOTINE is the chemical that makes cigarette smoking addictive. It is an alkaloid that constitutes approximately 0.63.0% of the dry weight of tobacco, with biosynthesis taking place in the roots and accumulation occurring in the leaves. It functions as a chemical with particular specificity to insects; therefore nicotine was widely used as an insecticide in the past. In low concentrations (an average cigarette yields about 1 mg of absorbed nicotine), the substance acts as a stimulant in mammals and is the main factor responsible for the dependence-forming properties of tobacco smoking. According to the American Heart Association, nicotine addiction has historically been one of the hardest addictions to break. It is just as addictive as heroin or cocaine. Smoking is a habit that is not easily stopped. The body and mind want and need the nicotine.

THUS IF A PERSON SMOKES MORE THAN FIVE CIGARETTES A DAY, HE/SHE IS USUALLY ADDICTED.

WHAT IS NICOTINE WITHDRAWL SYMPTOMS?

When smoking has ceased, the reduced nicotine intake will disturb the balance of the central nervous system, causing the withdrawal symptoms to occur. Common symptoms that include: intense craving; anxiety, tension, restlessness; frustration, impatience; difficulty concentrating; headaches; increase appetite and weight gain; low mood; insomnia and tiredness; many studies have found a link between depression and smoking.

START THINKING!!!

Going smoke free is the one single thing you can do to dramatically increase your chances of living a longer and healthier life. Once you stop smoking your body will begin to heal within 20 minutes.

QUITTING TOOLS:
Smoking tobacco is both a psychological habit and a physical addiction. The act of smoking is ingrained as a daily ritual and, at the same time, the nicotine from cigarettes provides a temporary, and addictive, high. Eliminating that regular fix of nicotine will cause your body to experience physical withdrawal symptoms and cravings. To successfully quit smoking, youll need to address both the habit and the addiction by changing your behavior and dealing with nicotine withdrawal symptoms. Ways of quitting are: TOBACCO CESSATION COUNSELING NICOTINE REPLACEMENT THERAPIES{NRT}

PHARMACOLOGICAL METHODS OTHERS TREATMENT MODALITIES

1. TOBACCO CESSATION COUNSELING:

Its a behavioral approach of smoking cessation. WHO in collaboration with the Government identified 13 Tobacco cessation centers in 2002 in diverse settings (cancer treatment centres, psychiatric centres, medical colleges and NGOs) to help people to stop tobacco use. Most of these clinics were started on the 31st of May, 2002 on the occasion of World No Tobacco Day.A The trained investigators have established centres at various centres and the WHO supports the staff and infrastructure. Each centre has a medical officer, clinical psychologists and medical social workers. Information about the subject is collected on a structured clinical record form. In addition, the software for a standardized patients intake form was developed to ensure uniformity in data collation across the country. It is a 5A method counseling given by trained health care professionals.

ASK ADVICE ASSESS ASSIST ARRANGE

Ask about tobacco use status at every visit Document tobacco use status Provide clear advice to quit Discuss health benefits of quitting Discuss health risks of smoking Assess willingness to quit smoking Refer to guideline for counseling, 1-800-QUITNOW Provide motivational intervention The 5 Rs Provide educational and self-help materials Set a quit date and develop a quit plan Discuss triggers and coping strategies Provide support and help Arrange (Follow-Up) Contact on or near quit date Follow-up at next visit, by phone, or by letter

2. NICOTINE REPLACEMENT THERAPY (NRT):

Nicotine replacement therapy (NRT) is the name given to stop-smoking medicines that release nicotine into the bloodstream to help counter cravings and reduce other withdrawal symptoms when you quit (nausea, headaches, irritability, dizziness). These products don't give you the same sort of buzz as you get from cigarettes, but they do reduce cravings. NRT isn't meant to replace smoking, but to slowly wean you off nicotine.

FIVE NICOTINE REPLACEMENT PRODUCTS FOR SMOKING CESSATION

- NICOTINE GUM is a substance that slowly releases nicotine when chewed or placed in between the cheek and gum. The gum gives you much lower amount of nicotine than a cigarette, at the same time decreasing your cravings for cigarettes. The amount and frequency of gum you need to use varies from brand to brand. Nicotine gum is not for everyone. - NICOTINE PATCHES are self-adhesive strips that contain nicotine. You have to apply one patch a day to your skin, which should be clean, non-hairy and dry. The patch releases small quantities of nicotine that is absorbed into your bloodstream through your skin. Put on the patch in the morning and take it off before sleeping otherwise it can hamper your sleep. At first, you might need to use the highest strength - 21 mg. This is the typical dose if you were smoking 20 cigarettes a day. The two common side-effects with nicotine patches are local skin irritation and sleep disturbance. Hydrocortisone cream can ease skin irritation. Sleep disturbance usually happens in people who use the patch for 24 hours, so use the patch for 16 hours only. - NICOTINE LOZENGES are hard candies which dissolve and slowly release nicotine into the mouth. Each lozenge last for about half an hour. Generally, you can use about nine lozenges a day during the first six weeks and then begin tapering off. Do not use lozenges beyond three months. The common side effects with lozenges are soreness of gums, throat irritation and stomach upset. Just like the side-effects of other nicotine replacement products, these sideeffects do not last long. - NICOTINE NASAL SPRAY is a spray pump containing nicotine in an aerosolized form. The smoker sprays it into their nostrils and the nicotine is quickly absorbed into the nasal membranes. Unlike other replacement products, nicotine is absorbed very fast by this mode. The typical dose of nicotine nasal spray is 5 times each hour or 40 times per day. Generally, you need to use your initial dose for a period for 8 weeks and then start to taper off over 4 to 6

weeks. The common side effects include nose and throat irritation, cough, sneezing, watery eyes. Most of these side effects disappear after 7 to 14 days. - THE NICOTINE INHALER OR "THE PUFFER" comprises of a slender plastic cartridge containing a porous nicotine plug. When you puff on to the cartridge, nicotine vapors are absorbed via the lining of the mouth. A single cartridge can yield 400 nicotine vapor puffs. The vaporized nicotine will make its way into your throat. During the first 3 months of its use, you can use 6 to 16 cartridges a day and then begin reducing the number during the next 6 to 12 weeks. The advantage of an inhaler is that it matches the behavioral aspects of smoking. The side effects are irritation of the mouth's lining, runny nose, coughs and digestive problems.

3. PHARMACOLOGICAL METHOD: ZYBAN (150mg tablets) (bupropion hydrochloride):

Zyban is a prescription medicine to help you stop smoking. Studies have shown that a significant number of people managed to remain smoke-free for at least 6 months while taking Zyban. For many patients, Zyban reduces withdrawal symptoms and the urge to smoke. This medicine is only one part of a general plan to help you manage your smoking habit. Zyban reduces the craving for smoking and so helps you to stop smoking. Its exact mechanism of action is not fully understood, but it is believed that it interacts with chemicals in the brain called noradrenaline and dopamine, which are associated with craving and withdrawal.

Nortryptiline (antidepressant) Clonidine Buspirone (anxiolytic)

4. OTHER TREATMENT MODALITIES:

AROMATHERAPY:
A 2006 book reviewing the scientific literature on aromatherapy identified only one study on smoking cessation and aromatherapy; the study concerned black pepper oil.

HYPNOSIS:
Clinical trials studying hypnosis and hypnotherapy as a method for smoking cessation have been inconclusive, however, a randomized trial published in 2008 found that hypnosis and nicotine patches "compares favorably" with standard behavioral counseling and nicotine patches in 12-month quit rates.

HERBS:
Many herbs have been studied as a method for smoking cessation including LOBELIA AND ST JOHN'S WORT. St. John's Wort is effective at treating mild to moderate depression and shares biosimilar properties to the FDA approved drug bupropion,

sold under the brand name Zyban, approved for smoking cessation. The results of the study were inconclusive but St. Johns Wort showed few adverse events. Lobelia has been used to treat respiratory diseases like asthma and bronchitis, and has been used for smoking cessation because of chemical similarities to tobacco, but lobelia is now listed in the FDA's Poisonous Plant Database. Lobelia can still be found in many products sold for smoking cessation and should be used with caution, although there are effective herbal smoking cessation aids that do not contain lobelia.

COLD TURKEY:
It describes the actions of a person who abruptly gives up a habit or addiction rather than gradually easing the process through gradual reduction or by using replacement medication. The supposed advantage is that by not actively using supplemental methods, the person avoids thinking about the habit and its temptation, and avoids further feeding the chemical addiction.

EAR CLIPS ( ACUPUNCTURE AURICULOTHERAPY):

There are various ways of doing auriculotherapy, for example some therapists use cold laser to stimulate the points, whereas others use the very thin traditional acupuncture needles. Still others use low voltage TENS machines to activate the points that will help you to give up smoking. The therapist will take your pulses, and details of your medical history and your smoking history. Then they will gently stimulate certain acupuncture points in the ear, to help you to release your nicotine addiction. A typical treatment session usually lasts between 30 minutes and an hour, depending on the therapist's method of treatment. This length of the session gives enough time for your body's endorphins to work to help detox you from the nicotine. The ear seeds or clips enable you to stimulate a specific point every time you have a craving for nicotine. Because this works on the body systems, it enables you to have the support you need to give up.

ELECTRONIC CIGARETTE OR e-CIGARETTE:

An electronic cigarette, or e-cigarette, is an electrical device that simulates the act of tobacco smoking by producing an inhaled mist bearing the physical sensation, appearance, and often the flavor and nicotine content of inhaled tobacco smoke; though without its odor, and intended to omit its health risks. The device uses heat (or in some cases, ultrasonic) to vaporize a propylene glycol- or glycerin-based liquid solution into an aerosol mist, similar to the way a nebulizer or humidifier vaporizes solutions for inhalation. Most electronic cigarettes are portable, self-contained cylindrical devices the size of a ballpoint pen or magic marker; though sizes vary, mainly due to differing battery capacities. Many electronic cigarettes are designed to resemble actual cigarettes or cigars, or even pipes. Most are also reusable, with replaceable and refillable parts, but some models are disposable.

CONCLUSION:
Cigarette smoking is thus the chief, single avoidable cause of death in our society and most important public health issue of our time. Smoking not only affects us, but also the ones around us. Thus let us join together to make our society a smoke-free one, by counseling for tobacco cessation.

Live! And Let Live.