2017 HCHB_digital

Smoking Cessation
Almost 5000 New Zealanders die annually from smoking-related illnesses,
such as heart disease, lung cancer and stroke. The lifespan of people who
smoke is shortened, on average, by about 15 years, and children exposed to
passive cigarette smoke (second-hand smoke) have a higher incidence of croup,
pneumonia, bronchiolitis and asthma. Smoking also contributes to socioeconomic
and ethnic inequalities in health.
Maori are over-represented in smoking statistics. Research has shown almost 38%
of Maori people aged 15 to 64 years smoke cigarettes, compared with just 15% of
New Zealanders of European ethnicity. The New Zealand Government is committed
to the goal of New Zealand becoming auahi kore (smoke-free) by 2025. Promotion
of the auahi kore message (www.smokefree.org.nz) throughout community and
whanau groups aims to change attitudes towards smoking, encouraging Maori to
either stop smoking or not to start.
There is never a bad time to quit smoking. Within one year of stopping the risk
of a heart attack or stroke significantly decreases, reaching that of a non-smoker
within three to five years. The risk of lung cancer can also be reversed, but this
may take 10–15 years.
Once someone has started smoking, quitting can be challenging because
smoking is so addictive.
Initial assessment
If you suspect a customer smokes, tactfully enquire as to their smoking status.
Pharmacy staff are in an ideal position to deliver personalised, empathic
smoking cessation advice, since there is good evidence that even brief advice
from health professionals has a significant effect on smoking cessation rates.
Success is increased when repeated interventions are delivered from several
different sources over a long period of time. This may be as little as saying the
words “If you ever want to stop smoking, we can help” to a customer who you
know smokes. Smokers cycle through the stages of contemplation, quitting and
relapse an average of 14 times before achieving permanent success. A free online
smoking cessation training course for health professionals (Helping people to
stop smoking e-learning) is available at learnonline.health.nz. The most
important variable determining how smokers will respond to any intervention is
TREATMENT OPTIONS
Category Examples Comments
Nicotine replacement therapy
(NRT)
Natural / herbal products /
supplements
[GENERAL SALE]
eg, Habitrol Gum*, Habitrol Patches*, Habitrol
Lozenges*, Nicorette CoolDrops Lozenge*,
Nicorette Gum*, Nicorette 16hr InvisiPatch
Patch*, Nicorette QuickMist*
[PHARMACY ONLY MEDICINE]
Nicorette Inhalator*
L-tryptophan, Quit Smoke
NRT offers relief against nicotine withdrawal symptoms, including cravings, irritability,
excitability, anxiety, headaches, nausea, dizziness, lethargy, loss of concentration, insomnia,
gastric disturbance and respiratory problems. NRT is the preferred method for smoking
cessation, as recommended by the New Zealand Ministry of Health.
Ensure correct strength. Under-dosing leads to nicotine craving and loss of confidence.
Guidelines recommend staying on the same starting dose for at least eight weeks to allow
time to create new habits and routines. Do not exceed stated doses.
Keep out of reach of children and pets; poisoning has occurred from improperly discarded
patches. Fold sticky ends of the patch together, wrap and place in bin.
Patches may cause skin reactions. Always reapply on a new part of the skin. Use surgical tape
over the patch to hold in place if the patch does not stick well. Patches may be worn while
showering, exercising, or swimming. Remove patches overnight if they disturb sleep.
May help with smoking cessation.
Products with an asterisk have a detailed listing in the Smoking Cessation section of OTC Products, starting on page 260.
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Page 138 HEALTHCARE HANDBOOK 2017-2018 Common Disorders