Helping you quit smoking

By Assoc Prof Dr M. HANIKI NIK MOHAMED

How your neighbourhood pharmacist can help you quit smoking.

TOBACCO is the major cause of premature and preventable deaths in the world. It is currently responsible for the deaths of about 10,000 Malaysians each year and five million people worldwide.
If current smoking patterns continue, it will cause some 10 million deaths annually by 2020! Half the people that smoke today (about 650 million people) will eventually be killed by tobacco.
Hence, the importance of quitting smoking has been emphasised again and again, through various means.
In Malaysia, the Certified Smoking Cessation Service Provider (CSCSP) was set up in December 2003 with the full support of the Ministry of Health, the Clearinghouse for Tobacco Control (C-Tob) and the Malaysian Pharmaceutical Society.
The main objective of the CSCSP Programme is to train health professionals, starting with pharmacists, to assist smokers to quit by using behavioural and pharmacological approaches.
The programme aims to ensure that health professionals are equipped with the appropriate tools and counselling skills to help smokers quit the habit.
After going through training, the pharmacists will be able to manage tobacco smoking and dependence, armed with a thorough knowledge of the stages and processes of behavioural change. They would be able to provide brief and intensive clinical interventions, including practical demonstrations of nicotine replacement therapy (NRT), wherever appropriate.
In addition, pharmacists will learn their role and responsibilities in recruiting smokers to become helpers by sharing with other smokers on how to quit smoking.
Imagine this: A person comes into a pharmacy intending to buy some cough syrup. He speaks to the resident pharmacist and voices his concern about the cough, which never seems to go away.
The pharmacist probes further and asks for a social history: “Do you smoke?”, to which the person says yes. From there, the pharmacist uses the 5’s strategy (ASK, ADVISE, ASSESS, ASSIST, ARRANGE) to identify the level and method of intervention as well as follow-up with the would-be quitter. With that first question alone, the pharmacist is able to start that person on his quit smoking journey?
That’s the beauty and simplicity of the CSCSP programme. Just meet up regularly with your friendly neighbourhood pharmacist who will walk with you on your journey to a tobacco-free life.

Smoke-free tips

For those who are considering quitting, here are some effective ways that will help to make quitting easier for you:

1. Be proud of yourself for quitting – Quitting smoking is not an easy thing to do but is essential for living a long, healthy life. Acknowledge that what you are going through is challenging and be proud of yourself for recognising the dangers of smoking and doing something about it before it is too late.

2. Make an action plan – This plan can help you recognise what you need to do and how you will do it. Things to include on it are a list of the important benefits of quitting, a list of situations in which you smoke and the reasons why you smoke. This will help you identify what “triggers” you to light up. Finally, a list of fun and healthy activities to replace smoking should be included.

3. Set a quit date – Set a date that is good for you (for example, birthday, anniversary, etc). Try not to choose a date that may already be stressful due to social commitments or work deadlines. A quit date may signal the end of your smoking days, but it is also the beginning of enjoying all the benefits of your new, healthier life.

4. Stay clear of smoking “triggers” – Starting on the day you quit, try to remove or avoid your smoking triggers. For example, if you associate coffee with smoking, try drinking tea or water instead. If you usually smoke at parties, find other ways to socialise with friends.

5. Drink lots of water and eat healthy meals – Increasing your daily water intake (six to eight oz. glasses are ideal) will help you help flush tobacco-related toxins from your body. Eat plenty of fruits and vegetables and limit your fat intake. This would help in preventing the weight gain after quitting, as is often experienced by smokers.

6. Get support – It’s always a good idea to get the support of a close friend or family member, or someone else you respect who wants to see you succeed at quitting. When you need a helping hand, they can help you stick to your plan.

7. Use nicotine replacement therapy (NRT) – Nicotine replacement therapy (NRT) is one of the ways in which smokers are able to quit the tobacco addiction successfully. NRT replaces a small amount of nicotine that the body misses when a smoker quits, thus reduces withdrawal symptoms, for example, craving, irritability, etc. Only nicotine is substituted, without the other harmful constituents of tobacco smoke.

NRT comes in the form of patch, gum and inhaler. Ask your pharmacist to help you select and use the right NRT product for you.
For more information on the CSCSP Programme, NRT or how to quit smoking, please visit your local pharmacist for assistance.
Background Information on NRT
Nicotine replacement therapy or NRT consisting of nicotine gum, nicotine patch and nicotine inhaler are the main medications to aid smoking cessation in Malaysia.
Studies have demonstrated that NRT alone approximately doubles one’s chances of quitting smoking. Success is even greater when therapy includes counselling, as provided by the Certified Smoking Cessation Service Provider (CSCSP).
In addition, the Government provides more than 200 quit clinics located throughout the country for smokers who would want to quit smoking.
Smoking is an addiction that is difficult to stop. But with the CSCSP programme, cognitive behavioural therapy (CBT) from a trained health professional and support from family and friends, SMOKING CAN BE STOPPED. Check with your local community pharmacist today for more information on NRT and CBT.

Sources:

1. Source of information extracted from the website of World Health Organisation, at http://www.who.int/tobacco/en/, accessed on 15 December 2006
2. Source of information extracted from the website of American Lung Association at http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=33566, accessed on 15 December 2006
3. Help smokers quit smoking CSCSP manual by Dr. M. Haniki Nik Mohamed
4. Source of information extracted from the website of American Academy of Family Physicians, at http://familydoctor.org/161.xml, accessed on 15 December 2006
Assoc Prof Dr M. Haniki Nik Mohamed is chief coordinator of the Certified Smoking Cessation Service Provider Programme and representative of the Malaysian Pharmaceutical Society.