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Quit Smoking

Why Quit

There are over 4,000 chemicals in tobacco smoke - including Nicotine (the addictive part), Tar (the main carcinogen), Carbon Monoxide (reduces oxygen levels in the blood - therefore energy levels and puts an extra strain on the heart, also especially dangerous in pregnancy) and many many other carcinogenic chemicals like cyanide, benzenes, formaldehyde and arsenic.
There is a know causative link between smoking, even second-hand or passive, and early death from diseases like cancer and heart disease. Other diseases caused by smoking include respiratory diseases, ulcers in the digestive system, increased blood pressure, stroke, impotence in males, blindness, skin damage and cancers of the mouth and throat. Smoking during pregnancy can lead to a low-weight/small baby, childhood respiratory conditions like asthma, and miscarriage.

Tobacco is the only drug that we take that has no beneficial effects, only bad effects. The only product that KILLS when used NORMALLY as intended. Half of regular smokers will eventually be killed by their addiction.

In the UK smoking is the single most preventable cause of illness and premature death. There are 120,000 deaths a year - 300 every day - directly caused by smoking, with an average of 16 years of life lost. Exposure to second-hand smoke at work causes about 617 premature deaths a year.

Stopping smoking before the age of 45 means a life expectancy only slightly less than a non-smoker, and quitting at any age has many benefits - both short and long term. After this age every year of continued smoking reduces your life expectancy by three months. Smoking also affects the health of people around you - your family, friends and strangers - who breathe in the secondhand smoke - exposing them to the same diseases as smokers including cancer and heart disease.

Stages of Quitting Smoking

Pre-contemplation. Smokers deny they have a problem, or think it doesn't apply to them i.e. smoking is not harmful or addictive, "my grand-mother smoked 50 a day and lived to 102". They can get defensive if challenged.
Contemplation. Smokers are starting to think about quitting , both the reasons not to (fear of withdrawal, gaining weight etc) and the benefits of quitting. Smokers may be seeking out information about giving up.This is a good time to come and see us
Preparation. Smokers are preparing to quit, maybe even cutting down on the number smoked, or switching to a low-tar brand. This is a good time to set a date to quit. Come and see us if you didn't before. Success is dependent on commitment. The more work and thought someone puts in during the preparation stage the more likely they are to succeed. Another good tip is to go without cigarettes for 24 hours during this stage to experience the impact and be prepared for it.
Action. That is quitting - either "Cold Turkey" or with Nicotine replacement (Niquitin, Nicorette, Nicotinell etc), or other medicines like 'Zyban' (Bupropion) or 'Champix' (Varenicline). The nicotine levels have fallen and your body doesn't like it! The withdrawal symptoms peak around day 2 and are a positive sign that the body is de-toxing.
Maintenance. Usually after 6 months of quitting. This can be the hard part as it is easy to relapse (eg on holiday, abnormally stressed or alcohol impairment), and can last from months to years, you have to talk yourself out of going back to smoking or relapsing.
Termination. The temptation to go back is no longer there, and you have no desire to smoke at all, and may even find other people smoking repulsive.

Giving up smoking, you may go through stages 1 to 5 many times in your attempts to quit, and this is helpful as each attempt is a step to one day reaching stage 6. In fact few people achieve stages 1 to 6 in one attempt. Having been to stage 4 is helpful in future attempts to give up smoking as you then know what to expect from your body as you cut out your addiction to nicotine, and your lungs recover from the inhalation of smoke and other chemicals.

Smoking is both a physical addiction (Nicotine) and psychological addiction (relaxing, socialising and habitual). Nicotine replacement can help with the first, we give you some ideas to deal with the second, together the two can give you an 80% chance of giving up.

What we do to help

We provide a free counseling service funded by the local Primary Care Trust(PCT) in each branch area.

An article from the Pharmaceutical Journal about Green Light and Smoking cessation.

How we help

All Green Light counselors are certified and trained by the PCT, and are continually retrained to ensure we are at the forefront of Smoking Cessation Advice. Consultations are available in English, Bengali or Spanish at selected branches.

The consultation is conducted by a sit down, one to one (although partners and friends, if attending, can be very beneficial) appointment usually of half hour duration. The consultation is carried out in the private Green Light consulting room.

Champix, Zyban and Nicotine Replacement Therapy(NRT) have to be used with advice and other coping strategies. This is all part of the personalised Quit Plan. NRT is now able to be prescribed on the NHS by the Pharmacist.
We as counselors will recommend the course of NRT that is most appropriate for yourself.
Weekly follow up and support is provided as long as it is required. Firstly to maintain motivation and secondly if the first attempt has failed to trigger a second attempt addressing the reason(s). We prefer to see people again to blow in the Smokerlyser which demonstrates the gains already achieved by quitting.

What we do

A special 'Quitters Plan' will be designed. The importance of such a tailor made approach is that quitting is more a lifestyle change than merely giving up the habit. History, contributing factors and past quit attempts all have to be taken into account.

The 'Smokerlyser' will be used to obtain a carbon monoxide(CO) reading. This is a high precision apparatus that accurately determines the CO load on the cardiovascular system, and hence is very useful in physically demonstrating the damage smoking is doing, CO stops Oxygen binding to the red blood cells therefore making less oxygen available to the organs, and increases the stickiness of the blood leading to clot formation. Up to 15% of your red blood cells can be bound to CO. The 'Smokerlyser' is also a useful self motivating tool as CO levels rapidly drop upon quitting - after 24 hours.

All Quit Plans will include a 'Quit date'. This is vitally important as any Quit attempt has to be at a time when there is relatively little stress. Also prior preparation for life as a non smoker has to be carried out.

When

Appointment times are very flexible, during the opening hours of the pharmacy incl. Saturdays
This flexibility allows convenience outside of a busy work schedule.

What next

The benefits of quitting at any stage of life are immense. Quitting will always enhance your quality of life.

After 20 minutes: Blood Pressure returns to normal
... 8 hours: Nicotine and CO level are halved
... 24 hours: CO eliminated and tar started to being cleared from lungs
... 48 hours: No nicotine left in body. Sense of taste and smell return
... 72 hours: Energy (and breathing) levels return
... 2 weeks: Skin improves
... 2 to 12 weeks: Circulation improves
... 3 to 9 months: any coughs, wheezing and breathing problems improves. Lung function increased by up to 10%.
... 1 year: risk of heart attack halved
... 1 year: you have saved around UKP1620 (based on 20/day previously) ... how about a holiday
... 10 years: risk of lung cancer halved.

Finally, if you are ready to Quit we want to hear from you!

Nicotine in NRT

Nicotine is the addictive component in cigarettes but does not cause cancer (it is as harmful as caffeine), it is the other components in cigarettes that cause the problems. Because Nicotine is addictive it is one of the things (the other being behavioural) you miss when you quit smoking, so using a NRT product is a good way to wean your body off nicotine without doing any further harm.

New advice for people with special conditions

Pregnancy

Giving up smoking as soon as possible (ideally before conception) is very important for the health of the baby. Ideally you should try to give up "cold turkey" without NRT, but if you can't then use NRT as the benefits of giving up with NRT far outweighs the risks of continuing to smoke. Ideally intermittent forms of NRT are preferable like lozenges or gum, but patches can be used if you feel nauseous or sick.

Heart Disease

While in hospital after a heart attack, stroke or irregular heartbeat then you will be encouraged to quit without NRT, however once discharged and well you can use NRT to quit if willpower alone is not enough.

Financial Benefits

Have you thought how much smoking costs you (besides quality years off your life) ...
If you smoke a pack a day (20 cigarettes) that's £4.50 per day ... £31.50 per week ... £135 per month ... £1620 per year !!!
and if you smoke more ... you save more when you quit !

Combing NRT products

New advice now recommends a combination dual therapy if a single NRT product has failed, eg try a patch for background nicotine levels, supplemented with a gum when needed to counteract breakthrough cravings.

Cutting down with NRT, then stopping

The PCT subsidised program that Green Light Pharmacy provides with counselling is based on total abstinence and this is ideally the best way. However for some people this is not possible or feasible so new advice suggests for those people to cut down with NRT as follows:
Start cutting down to at least 50% of current levels, aiming for a complete stop at 6 months or at the most 9 months. Then gradually reduce your NRT over the 3 months after stopping smoking. The whole process takes up to 12 months.

Camden PCT 2007 Smoking Cessation Awards.

Green Light Pharmacy Euston was awarded 1st place (Gold) in the 'Highest Pharmacy Stop Smoking Success Rate' category (3rd place (Bronze) in the Number of Stop Smoking Clients Seen category; and 1st place (Gold) in the Highest Number of Quitters category) at the Camden PCT Smoking Cessation Awards 2007.