Confident Conversations About Tobacco

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Confident Conversations About Tobacco
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Agenda for Todays Session

1. Why is this important?
2. What is your role?
3. Maine Treatment Resources

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• 1. Why Is It Important
• To Discuss Tobacco Use?

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Health Impact of Tobacco Use
More people die from tobacco than from alcohol,
other drugs, homicides, suicides and motor
vehicle accidents combined U.S. Preventable
Causes of Death, 2000
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Toxins in Tobacco Harmful to Health

• Over 4,000 chemicals
• Over 50 are carcinogenic

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Secondhand Smoke Risks

• Adults
• Heart attack
• Lung cancer
• Other cancers
• Asthma
• Allergic responses
• Children
• Ear infections and colds
• Bronchitis, pneumonia, and other lung infections
• Increases allergies and asthma and makes them
  worse
• Burns and fire deaths

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Risk to the Fetus(from primary smoking or
secondhand smoke)

• Low birth weight
• Higher risk of delivering a preterm infant
• Higher perinatal mortality
• Increased bleeding during pregnancy
• Higher risk of miscarriage
• Higher risk of birth defects
• Development of weaker lungs
• Greater risk of respiratory infections

The Health Consequences of Involuntary Exposure
to Tobacco Smoke A Report of the Surgeon
General, U.S. Department of Health and Human
Services (2006)
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Tobacco Smoke and Pets

• Malignant lymphoma in cats
• Lung cancer in dogs
• Nasal cancer in dogs

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Thirdhand Smoke

• Thirdhand smoke is the toxic particles that
  remain after visible smoke is gone They pose a
  risk to infants and children who inhale them
• 250 poisonous chemicals in cigarette smoke
  include
• lead, arsenic, cyanide
• Babies and young children absorb, swallow or
  inhale residue from clothes, upholstery, rugs,
  toys, skin hair
• Studies are in process to measure the level of
  health effects on babies and children

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Thirdhand Smoke

• Thirdhand smoke can
• Affect brain development
• Cause learning or cognitive defects
• React with other chemicals in the air to form
  strong cancer causing agents

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Secondhand Thirdhand Smoke

• Ventilation does not eliminate the risk
• Separation within a house does not eliminate the
  risk
• What to do to protect children, the elderly and
  others?
• Take it outside and wear jacket/cap that can be
  removed before returning inside
• Dont smoke in the car
• Dont allow others to smoke in the home and car
• Quit smoking

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New Tobacco Products

• Are not banned by smoke-free laws
• Were designed to be used where smoking is not
  permitted
• Are still harmful because they contain tobacco
• Are still addictive because they contain nicotine

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2. What is your role?
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Encourage Change

• Begin with listening
• Seek to understand

• Serve as an ally
• Offer respect

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Give Clear and Consistent Messages

• Quitting is very important to your clients
  health
• You have a significant influence over your
  clients
• They appreciate your asking about their tobacco
  use
• Your help gives clients resources and helps them
  to be successful

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Understanding Tobacco Treatment

• Tobacco is a chronic disease
• Tobacco is an addiction
• Quitting is a process
• Public Health Service Guidelines
• Has evidence-based methods
• Prepares physicians to use 5 As
• Describes approved Nicotine Replacement Therapy
  (NRT) medications

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Evidence-Based Methods

• Talking (less than 5 minutes) is effective in
  helping people quit
• Approved medications (nicotine patch, lozenge and
  gum) increase the rate of quitting
• Positive support is helpful

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The Five As, Recommended for Health Care
Providers
ASK about tobacco use, every time.
ADVISE quitting.
ASSESS interest in quitting.
ASSIST by offering help when ready to try.
ARRANGE follow-up
Treating Tobacco Use and Dependence (2008)
www.ahrq.gov
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We recommend that you use the first three As
ASK

• Do you smoke or use other tobacco?
• Any use in the past 6 months?

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ASSESS

• Have you tried to stop in the past?
• How did that go?
• How do you feel about quitting?

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ARRANGE

• Provide appropriate resources
• Refer to the Maine Tobacco HelpLine
• Refer to local resources support groups

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Understanding Slips Relapse

• Slips and relapse are part of the quitting
  process
• Avoid shame and blame focus on what was
  accomplished
• Re-assess readiness to quit and agree on next
  steps
• Each time someone tries to quit, the chances of
  success get better, not worse!

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3. Maine Treatment Resources
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Maine Tobacco HelpLine

• Is free and available to any Maine resident
• Is a HelpLine and not a Hot Line
• When people call and register
• They receive a quit packet with information
• A quit date is set and a quit plan created
• Caller will receive 4 follow-up calls
• If eligible, the caller may have the opportunity
  to participate in the medication program

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Medication Voucher Program of the Maine Tobacco
HelpLine

• Nicotine patch, gum or lozenge
• 4 week supply, given for up to 8 weeks
• Eligibility 18 or over, no insurance, or
  insurance with no Nicotine Replacement Therapy
  (NRT) coverage
• MaineCare does provide coverage for NRT
• Paperless process the individual just picks up
  the NRT at the pharmacy of his/her choice

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Build a Routine

• Discuss tobacco status at each visit be
  comfortable with the process.
• Use the 3 As Ask, Assess, Arrange
• Chart progress at each visit
• Remember that relapse is part of the process.
  Encourage the client to continue with their quit
  attempts
• Provide information about the Maine Tobacco
  HelpLine

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Local Resources
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Help for Your Clients

• Partnership For A Tobacco-Free Maine Phone
• 207-287-4627
• (District Tobacco Coordinator name
• and number here)
• (HMP name and number here)