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Please Quit!

November 17, 2011

This Holiday Season Don’t Hesitate To Ask for That Special Gift From Your Loved One:


With the close of 2011 at our heels, we begin thinking about giving thanks, exchanging gifts and New Year’s resolutions. Many of us are looking for gift ideas now, and so hopefully this article will inspire us to ask a loved one for a very special gift…..There’s no guilt involved with asking for this gift, even with the economy the way it is. Why not ask a loved one (could be your spouse, daughter, son, cousin, friend, etc.) to do something special for you; quit smoking. You have tried before, you say, and to no avail. I understand. Honestly, I must share that I was determined to choose a light topic to write about for this month’s article in keeping with the holiday theme. Then I received the news that a friend of mine passed away on Saturday. Less than one year ago he was diagnosed with a brain tumor, which had metastasized from the lung. He was a heavy smoker. His wife is an oncology nurse. Now I feel compelled. In Paul’s honor, let’s talk about smoking cessation, and the importance of asking your loved one to quit before it’s too late.

Ask your Physician, in general what is the single most effective thing one can do to improve their general health status?  If you are a smoker, your Physician will say smoking cessation. In review, smoking can cause lung cancer, as well as other cancers, cardiovascular disease, emphysema, and other chronic lung diseases. Although 70 percent of patients who smoke say they would like to quit, only about 8 % do so without any help. The advice of a physician alone can improve smoking cessation. Physicians, Nurse Practitioners, nurses and all health care workers should take advantage of each contact with smokers to support smoking cessation. Why is it important to ask a loved one, or a patient if they are willing to stop smoking more than just once. Timing is everything. Five stages of readiness to change addictive behaviors are identified, namely a pre-contemplation stage, contemplation stage, preparation stage, action and maintenance stage.  During the pre-contemplation stage, the person thinks that smoking is not a problem. The person begins to realize that smoking is a problem in the contemplation stage. During the preparation stage, the individual wants to quit smoking. During the action stage the person actually quits smoking. At this point one of two things will occur. The individual will remain a non-smoker or relapse. If they relapse, reassure the individual that people often cycle through stages several times before reaching stable abstinence. There’s no shame involved. Try again!

Nicotine in itself is not what causes disease, but it is addictive. One reason why it is difficult for smokers to stop, besides the fact that nicotine causes dependence, is that it produces withdrawal symptoms when people stop or reduce their smoking. Success for smoking cessation can be improved for smokers who are provided with ongoing motivational support, treatment therapies and follow-up. Nicotine replacement therapy (NRT) has been available for almost 30 years, and is considered very safe and effective. The treatment duration with NRT is relatively short, usually 10- 12 weeks. All types of NRT provide lower doses of nicotine than people get from cigarettes. NRT does not provide a complete replacement for cigarettes, or willpower, but it reduces withdrawal symptoms. All NRT products have similar success rates. The patch is discreet, but tablets, gum and lozenges allow the person more control over how quickly the dose is obtained.  Bupropion, also known as Zyban is an alternative drug therapy to NRT. It is an antidepressant that was discovered to help smokers quit. It helps to reduce withdrawal symptoms, and increases the chances of a person’s quitting smoking long term. It is only available by prescription, and it is taken in tablet form, once a day for the first 6 days and then twice a day for the remainder of an 8 week course. Encourage your loved one to discuss these options and others further with their physician.

If a physician offers a prescription for nicotine replacement or Bupropion to a patient in the pre-contemplation stage, it is unlikely to be successful because the person has not yet acknowledged there is a problem with smoking and therefore, will not accept any interventions to assist with cessation.  So what can we do to help an individual who is in the pre-contemplation stage move into the contemplation stage?  As health care providers there are effective interventions such as educating the patient about the effects of smoking, recommending changes in behavior, providing options for achieving behavioral change, and following up with subsequent visits to reassess readiness to quit. What can be done in the meantime? Here’s where you come in. Help provide motivation and support. If your loved one has failed at quitting, tell them that most people do, but the chances of quitting increase with each attempt.  Reach out to  everyone in your circle, and  ask for that special gift from those you love. Ask them to quit, tell them how much it would mean to you for them to quit because you love them, not just because it’s unhealthy. Just ask for the gift of their health and spread this message through love this Holiday Season.

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