Confident Conversations Confident Conversations

About TobaccoAbout Tobacco

1. Why is this important?

2. What is your role?

3. Maine Treatment Resources

Agenda for Today’s SessionAgenda for Today’s Session

1. Why Is It Important 1. Why Is It Important

To Discuss Tobacco Use?To Discuss Tobacco Use?

Health Impact of Tobacco UseHealth 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

Toxins in Tobacco Harmful to HealthToxins in Tobacco Harmful to Health

• Over 4,000 chemicals

• Over 50 are carcinogenic

Secondhand Smoke RisksSecondhand 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

Risk to the FetusRisk 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)

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

Tobacco Smoke and PetsTobacco Smoke and Pets

Thirdhand SmokeThirdhand 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, cyanideBabies and young children absorb, swallow or inhale

residue from clothes, upholstery, rugs, toys, skin & hairStudies are in process to measure the level of health

effects on babies and children

Thirdhand SmokeThirdhand 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

Secondhand & Thirdhand SmokeSecondhand & 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

New Tobacco ProductsNew 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

2. What is your role?2. What is your role?

Encourage ChangeEncourage Change• Begin with listening

• Seek to understand

• Serve as an ally

• Offer respect

• 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

Give Clear and Consistent MessagesGive Clear and Consistent Messages

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 A’s Describes approved Nicotine

Replacement Therapy (NRT) medications

Evidence-Based MethodsEvidence-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

The Five A’s, Recommended for Health Care The Five A’s, Recommended for Health Care ProvidersProviders

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

We recommend that you use the first We recommend that you use the first

three A’s:three A’s:

ASKASK

• Do you smoke or use other tobacco?

• Any use in the past 6 months?

ASSESSASSESS

Have you tried to stop in the past?

How did that go?

How do you feel about quitting?

ARRANGEARRANGE

• Provide appropriate resources

• Refer to the Maine Tobacco HelpLine

• Refer to local resources & support groups

Understanding Slips & RelapseUnderstanding 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!

3.3. Maine Treatment ResourcesMaine Treatment Resources

Maine Tobacco HelpLineMaine 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 informationA quit date is set and a quit plan createdCaller will receive 4 follow-up calls If eligible, the caller may have the opportunity to participate

in the medication program

Medication Voucher Program of the Medication Voucher Program of the Maine Tobacco HelpLineMaine Tobacco HelpLine

• Nicotine patch, gum or lozenge4 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

Build a RoutineBuild 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

Local ResourcesLocal Resources

Help for Your ClientsHelp 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)