Transcript Nurses’ Role in Tobacco Use Control Kawkab Shishani, PhD

Nurses’ Role in Tobacco Use Control
Kawkab Shishani, PhD
[email protected]
Objectives
o Recognize that all tobacco forms are
hazardous to health
o Realize the emerging threat from the rapidly
growing smokeless tobacco industry globally
o Recognize the role of gender in tobacco use
o Apply smoking cessation counseling in practice
o Be actively involved in tobacco control
at all levels
Why Tobacco Use is Hazardous to Health
oSmoking is the chief avoidable risk factor for
chronic diseases
oSmoking affects progression of chronic diseases
oUnlike the other risk factors, smoking affects
smokers as well as those around them
Tobacco Forms
o Smoke
• cigarettes
• cigars
• pipe
• waterpipe
Tobacco Forms
o Smokeless
• Dip
• Snus
• Chewing
• Snuff
Myths Associated with Smokeless Tobacco
o Smokeless tobacco is a safe alternative for
smoking
• Smokeless tobacco IS NOT SAFE. It contains
NICOTINE
• Chemical compounds added to smokeless
tobacco include: Ammonium (chloride &
Carbonate); Proplyene Glycol; Ethyl Alcohol;
Sodium (Chloride, Carbonate, Saccharin &
Citrate); and many other chemical….
Myths Associated with Smokeless Tobacco
o Smokers can quit by switching to smokeless
tobacco
• Nicotine in all tobacco products causes
addiction
• Switching from smoke to smokeless tobacco
does not solve the problem
E-cigarettes
o A battery operated device
o Filled with solution that contains nicotine
o When a user inhales, the vaporizer turns the
liquid into a vapor
o Is not a safe alternative to cigarettes
o Poorly regulated; nicotine content in the
solution varies according to the manufacturer
Burden of Tobacco Use
o 1.3 billion smokers
• 20% in developed countries
• 80% in developing countries
o Insufficient tobacco policies in developing
countries lead to increase in:
• Tobacco leaf production
• Cigarette production
Women and Tobacco Use
o 250 million women smoke globally
o 22% of women in developed countries smoke
o 9% of women in developing countries smoke
o Male smoking rates are in slow decline
o Female smoking rates are still rising
o Tobacco industry target women through
deceptive images (e.g. slim, menthol
cigarettes)
Women and Tobacco Use
o Nicotine metabolism may differ in women
compared to men (Zeman, Hiraki, & Sellers, 2002).
o Women take more puffs to have the same
nicotine effect as men
o Women develop lung cancer with lower levels
of smoking
o Women are less successful in quit attempts
o Women face more difficulties in quitting
Passive Smoking
o Indoor
• Homes
• Schools
• Workplaces
• Hospitals, Primary care
o Public transportation
o Outdoor
• Parks
• Play grounds
Tobacco Dependence
From Benowitz N. Nicotine Addiction. Primary Care 1999; 26(3):611-31
Why it is Difficult to Quit
o Coping with withdrawal symptoms
• Urges to smoke
• Craving
• Anxiety
• Restlessness
• Nervousness
Why it is Difficult to Quit
o Adapting to withdrawal symptoms
• Headache
• Depressed mood
• Difficulty in concentrating
• Increased appetite
Benefits of Quitting
o Immediate effect:
• Breath smells better
• Food taste improves
• Yellow fingernails disappear
• Everyday activities become more enjoyable
• Teeth get whiter
o Improves lung functioning
Benefits of Quitting
o Lowers the risk of:
• Lung and other types of cancer
• Heart disease and stroke
• Respiratory diseases
o Women:
• Reduce the risk of infertility
• Reduce the risk of having a low
birth weight baby
Role of Nurses in Tobacco Use Control
o Nurses are in direct contact with
• Patients at acute care settings
• Primary care centers
• Public
Levels of Involvement in
Tobacco Use Control
o Individual
o National
o International
Individual level:
Providing Smoking Cessation Counseling
o Article # 14 FCTC
“Each country shall develop evidence based
guidelines to promote cessation of tobacco
use and adequate treatment for tobacco
dependence”
Smoking Cessation Counseling
Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008
Update. Quick Reference Guide for Clinicians. Rockville, MD: U.S. Department of Health
and Human Services. Public Health Service. April 2009.
5 A’s Model
o Ask—Systematically identify all tobacco users at
every visit
o Advise—Strongly urge all tobacco users to quit
o Assess—Determine willingness to make a quit
attempt
o Assist—Aid the patient in quitting (provide
counseling and medication)
o Arrange—Ensure follow-up contact
National Level
o Be actively involved in tobacco use control
activities
o Network between your own institution and
other national institutions that are involved
in tobacco control to strengthen the national
tobacco control efforts
o Be involved in developing and maintaining a
systematic approach to treat tobacco
dependence
National Level
o Raise awareness of high risk groups about the
dangers associated with tobacco use and
dependency
o Lobby for health policies that ban tobacco use
in public places
o Participate in putting into enforcement health
policies that are related to smoking
International Level
o Participate in international tobacco forums
o Collaborate with international scholars in
developing new venues in tobacco control in
your country
o Exchange expertise with tobacco use control
activists form around the world
Contact Information
Kawkab Shishani, PhD
[email protected]