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Start Again in 2010!

Thursday, 21 January 2010

Today we meet Billy again with his expert Pharmacist Kathy Maher. Kathy will be helping Billy to stop smoking with the aid of nicotine replacement therapy. Today Kathy will go into detail about the products she will be using with Billy and why. All our smokers stopped on Monday the 18th of Jan.

Expert - Kathy Maher - Pharmacist

Duleek & Donore Pharmacy, Co. Meath.

She has been a pharmacist for almost 13 years, having completed her training in 1997. She has worked in community pharmacy ever since. She is based in Duleek & Donore Pharmacies, having worked there for 10 years. Herself and her husband own these pharmacies.

She is very active in health promotion and patient education, having won an award in this field in 2005. She firmly believes that giving patients the information around their medicines/conditions empowers them to making choices to have a healthier lifestyle. Community pharmacists are the most accessible health care professionals, with most pharmacies open for 6/7 days a week, often with extended opening hours. People should be encouraged to make use of this free advice, and contact their pharmacists about any health query.

How addictive is nicotine?

Nicotine is highly addictive; when smoke is inhaled nicotine travels rapidly from lungs to blood. It reaches the brain very quickly and then triggers the pleasurable/comfortable feelings that make people continue to smoke. Once the brain gets used to nicotine and needs more to produce the same feelings. That is why some people find themselves smoking more cigarettes or inhaling more deeply to get the same effect.

What is nicotine replacement therapy?

Nicotine Replacement Therapy (NRT) such as patches, lozenges and gum replaces some of the nicotine you from cigarettes, but doesn't deliver the harmful chemicals and gases.

How does it work?

NRT is designed to be reduced gradually until the need for nicotine is gone, that is why it is usually over a 10 - 12 week treatment spell. The type of NRT is usually tailored to suit a person's specific needs, depending on various factors - how many they smoke per day, their smoking habits, and their individual preferences also.

How can it help someone to stop smoking?

NRT provides enough nicotine to help ease the feelings of CRAVING that some people get when they are trying to stop smoking. People are better equipped to utilise their willpower then - using NRT can almost double a person's chance of quitting successfully.

Is it possible to become addicted to nicotine replacement?

With regard to nicotine replacement, the aim is always to use them for a short time, gradually weaning down strength/use to withdraw from the nicotine addiction. There are some people who do use some of the products for longer periods of time, but pharmacists try and encourage them to stop. The chance of this happening is lower with patches, but the choice of product always depends on patient factors.

What are the success rates with Nicotine replacement?

Success in quitting with NRT is also greatly increased with the help and support of a healthcare professional such as a pharmacist or doctor.

What course of nicotine replacement have you decided on for Bill?

I have decided to go with a combination of Nicotine products - a patch that will give him a baseline amount so his body won't go into total withdrawal, and I've also recommended that he use an immediate-release product to treat cravings he may have. I've suggested that he use a tablet that he can pop under the tongue, this will release nicotine straight into the bloodstream.
Bill has said that any time he tried NRT, he failed so I think by treating both dependency and cravings we will succeed.

Why did you decide on these products? Can you explain how the will work together?

I decided on the 16hr patch (i.e. that is not worn through the night) as Bill had used a 24hr patch before and found that he had disturbed sleep - anything that improves compliance will increase chances of success. I've recommended the micro tab as he had tried gum before and didn't like it.

Should anyone who decides to use nicotine replacement consult with their pharmacist or doctor first?

It is recommended that anyone beginning NRT speak to their pharmacist or doctor - to ensure that they are going to use the correct product. Quite often people will say they tried nicotine before and it didn't work, but perhaps they used a type that wasn't most suited to them, or didn't know how to use it correctly. Also - anyone on prescribed or other medication should always speak to their Pharmacist before purchasing/using any medication across the counter.

How do you think Bill will cope with this method? Are you confident that you will be able to help Bill stop smoking?

I think Bill will cope with this method - I think he will find it difficult, given his high dependency but with the best support I would be confident that we can get him to quit for life.

What do you think are the main reasons that people fail to reach their goal of stopping smoking?

Some of the main reasons people don't succeed:

- incorrect NRT product or perhaps the method they used didn't suit them.

- didn't address the habitual actions that need broken.

- poor family/friend support.

- didn't seek support from healthcare professional.

- sometimes they have 'just one' and this leads them to back smoking.

- not ready

What advice would you have for anyone that is thinking of stopping smoking?

General advice to help them:

Seek support from a healthcare professional. Pharmacists are ideally placed - they are experts in the field, and extremely accessible without an appointment. They always have an open door - 6 or 7 days a week, sometimes for long hours. People will double their chances of success if they enlist the help & support from healthcare professional

. Think positively, you are more likely to succeed

. Eating a healthy and balanced diet

. Increasing physical exercise

. Learning to deal with cravings

Tips for Dealing with Cravings - THE 4 D's:

. DELAY - delay at least 3 minutes and the urge will pass.

. DRINK - drink a glass of water or juice.

. DISTRACT - distract yourself. Move away from the situation.

. DEEP - deep breath. Breathe slowly and deeply, it will help you to relax.

William Salinger - Smoker

What did you think when you heard that you would be using nicotine replacement as your method for stopping smoking?

I was a bit unsure as I have tried it all before and really thought I would fail.

After meeting with Kathy how confident are you that Kathy will be able to help you stop?

I feel great and very confident, the tablets (micro tabs) she gave me with the patches are working great, it gives me the same feeling as having a smoke. Any time I get a craving I can use one its like having a smoke and it lasts for about 5 or 10 mins I don't even feel like I am coming off them with the tablets. I am using the patches, not sure how good they are but the tablets are brilliant, the tablets are called micro tabs. 20 in a pack and up until today (Tuesday) I have used about 10.

Do you have good will power as that will be needed as well?

I do have ok willpower as I really want to stop smoking. The only problem I have is not having the smoke in my hand but really this micro tabs are doing the trick for me they are best thing I have ever taken.

How have you gotten on this first week?

So far so good, I really don't think I will touch a cigarette again. I really believe that.

How are you going to keep your self busy?

Have not started the puzzle ball yet, I'm just doing all my normal things because I don't feel I like I need a cig.

How do you family feel about you stopping smoking? Are they 100% behind you?

I am the only one who smokes I the house so they are over the moon, my wife got rid of all the ashtrays in the house and has declared it a smoke free house. Anyone that comes into the house is not allowed smoke inside. My kids are thrilled and they all are behind me 100%.

We gave you a project last week on the show; how are you getting on with it?

Have not started it yet as I don't need a distraction yet with the nicotine replacement methods that Kathy has given me, but I will do it.

Prices/Stockists/Relevant Information:

For details on the products William is using go to your local pharmacy or check with your GP.

Additional / Misc' Info:

To contact Kathy Maher - or

The benefits of giving up:

The health benefits start right away when you give up smoking:

. Within 20 minutes your circulation will improve, your heart rate and blood pressure will get lower. This reduces your risk of heart attack straight away.

. Within 8 hours the carbon monoxide level in your blood will drop and the oxygen level will go up.

. Within 24-48 hours all the carbon monoxide will have left your body.

. Within a few days your sense of smell and taste will start to improve.

. After 72 hours your breathing will improve and your energy levels will increase.

. Within 2 or 3 months your lung capacity can increase by up to 30%.

. Within 1 year your chance of heart attack drops by half and within 10 years the risk drops to almost the same as a non-smoker.

. Within 5 years the risk of smoking related cancers will be greatly reduced.

. Once you give up, your lungs start to fight back by coughing up tar. A mug full of tar builds up in the lungs of a 20 a day smoker over the period of a year. It is the toxic chemicals in tar that cause cancer.

These are just some benefits. No matter what age you give up smoking, you will:

. look and feel better

. have fresher breath and cleaner teeth, hair, skin and fingers

. have more control of your life

. be fitter and have more energy

. reduce your risk of illness

. reduce the complications of existing illnesses

. have a better quality of life

. be a good role model for your children or grandchildren

. have more money

. have a healthier family as they will not be exposed to your second-hand smoke

Smoking Facts:

. Most smokers (83%) regret that they ever started smoking and would not smoke if they had the choice again.

. Every 6.5 seconds someone in the world dies from tobacco use = 1.5 million people dying needlessly each year.

. Every cigarette a person smokes reduces his/her life by five and a half minutes.

. In Ireland, smoking is the leading cause of avoidable death. Nearly 7,000 people die each year from the effects of smoking and thousands of others are ill because of smoking-related diseases.

What is in a Cigarette:

There are around 4000 chemicals in cigarette smoke, here are just a handful of them.

Nicotine: Nicotine is a colourless, poisonous alkaloid, derived from the tobacco plant. It is a powerful drug, which affects the brain and quickly becomes addictive. It can also be found in weedkiller.

Tar: "Tar" is the term used to describe the toxic chemicals found in cigarettes. This is a sticky brown substance that forms when tobacco cools and condenses. It collects in the lungs and can cause cancer.

Carbon Monoxide: An odourless, colourless gas that is released from burning tobacco. When it is inhaled it enters the blood stream and interferes with the working of the heart and the blood vessels. Up to 15% of a smoker's blood can be carrying carbon monoxide instead of oxygen.

Arsenic: Arsenic-containing pesticides used in tobacco farming occur in small quantities in cigarette smoke. Arsenic is commonly found in rat poison.

Ammonia - floor cleaner: Ammonia is a toxic, colourless gas with a sharp odour. Ammonia compounds are commonly used in cleaning products and fertilizers. Also used to boost the impact of nicotine in manufactured cigarettes.

Acetone - Nail polish remover: Fragrant volatile liquid ketone, used as a solvent, for example, nail polish remover.

Toluene - Explosives: Toluene is a highly toxic chemical. The main uses of toluene in industry include rubbers, oils, resins, adhesives, inks, detergents, dyes and explosives.
Methylamine - tanning lotion: A chemical found in tanning lotion.

Pesticides - DDT: A number of pesticides (chemicals used to kill pests, usually insects) are present in cigarette smoke. - pesticides are toxic. These pesticides find their way into cigarettes because they're used on tobacco plants as they are growing.
Polonium -210: A radioactive element - used in nuclear weapons, also used as an atomic heat source.

Methanol : A fuel used in the aviation industry.

Formaldehyde: It causes cancer, and can damage your lungs, skin and digestive system. Embalmers use it to preserve dead bodies.

Lead: Lead poisoning stunts your growth, makes you vomit, and damages your brain.