Confident Conversations About Tobacco

1. Confident Conversations About Tobacco

2. Agenda for Today’s Session • Why is this important? • What is your role? • Maine Treatment Resources

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

4. 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

6. Toxins in Tobacco Harmful to Health • Over 4,000 chemicals • Over 50 are carcinogenic

7. 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

8. 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)

9. Tobacco Smoke and Pets • Malignant lymphoma in cats • Lung cancer in dogs • Nasal cancer in dogs

10. 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

11. 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

12. 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 • Don’t smoke in the car • Don’t allow others to smoke in the home and car • Quit smoking

13. 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

14. 2. What is your role?

15. Encourage Change • Serve as an ally • Offer respect • Begin with listening • Seek to understand

16. Give Clear and Consistent Messages • Quitting is very important to your client’s 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

17. 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 A’s Describes approved Nicotine Replacement Therapy (NRT) medications Understanding Tobacco Treatment

18. 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

19. The Five A’s, Recommended for Health Care Providers Treating Tobacco Use and Dependence(2008) www.ahrq.gov

20. We recommend that you use the first three A’s:ASK • Do you smoke or use other tobacco? • Any use in the past 6 months?

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

22. ARRANGE • Provide appropriate resources • Refer to the Maine Tobacco HelpLine • Refer to local resources & support groups

23. 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!

24. 3.Maine Treatment Resources

26. 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

27. 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

28. Build a Routine • Discuss tobacco status at each visit; be comfortable with the process. • Use the 3 A’s: 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

29. Local Resources

30. 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)