2017 HCHB_digital

CONTINUING OTC EDUCATION
Advice for smokers ready to quit
••
Set a quit date, preferably within two weeks.
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Contact a local smoking cessation provider.
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Inform friends, family, and co-workers and ask for support to quit
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If the urge to smoke is strong then Delay (acting on the urge to smoke), Deep breathe, Drink
water, and Do something else.
••
Remove cigarettes from home, car and workplace and avoid smoking in these places for two
weeks before quitting.
••
Anticipate challenges, particularly during the first few weeks, including nicotine withdrawal.
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Focus on the benefits and rewards of quitting.
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Totally stopping is essential – not even a single puff.
••
Drinking alcohol is strongly associated with starting smoking again.
their readiness to change (ie, they have to want to stop).
Smoking cessation advice is based around the mnemonic ABC.
• Ask customers about their smoking status.
• Give specific Brief advice about stopping smoking to all smokers, eg, “making
a quit attempt will make a big difference to your health”.
• Strongly encourage every person who smokes to use Cessation support and
offer to help them access it.
Enquire about a customer's progress or problems when they buy or collect
their smoking cessation products and encourage continued abstinence.
Treatment
There are many effective treatments (some prescription only) that can produce
long-term abstinence, but evidence has shown the success rate is improved fivefold
when treatment is combined with personalised counselling and behaviour
modification. The Quit Group (www.quit.org.nz or 0800 778 778) offers free
smoking cessation advice and generously subsidised Nicotine Replacement
Therapy (NRT). NRT is also subsidised on a prescription and through many other
qualified smoking cessation providers. Some research suggests only 3%–7% of
people stop smoking by going “cold turkey” alone.
Hypnosis, acupuncture, and prescription medicines (eg, bupropion,
nortriptyline, varenicline) are also options for smoking cessation. Electronic
cigarettes mimic the look and feel of conventional cigarettes; however, evidence
does not currently support their use as an aid to stopping smoking.
Advice for customers
• Giving up smoking may take a number of attempts but this is normal.
• Planning a quit attempt, rather than just deciding to stop suddenly, has a
higher chance of success.
»»
Make a chart to identify why and when you smoke (your smoking triggers).
A key factor in quitting is changing your routines and habits.
»»
Register with a smoking cessation provider (eg, www.quit.org.nz) and
discuss coping with cravings before you quit.
Refer to
PHARMACIST
The following questions aim to identify customers who would
benefit from further input from a pharmacist. Your initial assessment
may have already provided some answers. Decide if any further
questions still need to be asked and refer any “yes” answers to a
pharmacist.
• Is the person pregnant or breastfeeding or underweight?
• Is the person elderly or do they have diabetes or heart disease?
• Does the person experience skin sensitivity reactions often?
• Is the person reluctant to totally abstain from smoking?
• Does the person have an irregular smoking habit?
• Has the person had a reaction to nicotine products in the past?
» » Review previous quit attempts – what helped, what did not help and any
reasons for relapse. Trying a different type of treatment may help.
» » Apply for subsidised nicotine replacement therapies – an eight-week supply
of nicotine patches costs around $5 compared with over $200 if bought.
• Make your home and car smokefree and get rid of ashtrays. Wash all your
smoky clothes and wash down furnishings.
• Brush your teeth with fresh minty toothpaste and book into a dentist to have
your teeth cleaned.
• Carry a water bottle with you and practise saying "I am a non-smoker" or
"I don't smoke".
• The correct way to use nicotine gum is the “chew and park” method.
» » Bite down slowly on a piece of gum six to 10 times, enough to soften it and
release the nicotine, which may tingle or impart a spicy taste.
» » Park the gum under the tongue or between the cheek and the gum,
allowing the nicotine to be absorbed through the lining of the mouth into
the bloodstream.
» » Avoid over-chewing the gum or drinking while chewing the gum as this
can wash nicotine into the stomach, causing side effects such as heartburn,
abdominal pain or hiccups.
» » An occasional bite will expose a fresh surface of gum and release more
nicotine.
» » Repeat the process around five or six times in 30 minutes if needed, until
the gum loses its effectiveness.
» » Wrap up the gum and dispose of in a rubbish bin.
• If using lozenges, follow the same process as for the gum, except the lozenge
should be sucked, not bitten.
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