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FROM SMOKING ® Freedom Participant Workbook

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Page 1: 2904 2905 mech 1012 - Staywell · Participant Workbook ... Please answer these questions by circling YES or NO. ... Do your friends, family, or co-workers smoke?

FROM SMOKING®

Freedom

Participant Workbook

Page 2: 2904 2905 mech 1012 - Staywell · Participant Workbook ... Please answer these questions by circling YES or NO. ... Do your friends, family, or co-workers smoke?

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©2010 American Lung Association.

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Questionnaire 1 Are You Ready to Quit Smoking?

Please answer questions by circling YES or NO.

Question

1. Do I want to quit smoking for myself? YES NO

2. Is quitting smoking a #1 priority for me? YES NO

3. Have I tried to quit smoking before? YES NO

4. Do I believe that smoking is dangerous to my health? YES NO

5. Am I committed to trying to quit even though

it may be tough at first?YES NO

6. Are my family, friends, and co-workers willing to help

me quit smoking?YES NO

7. Besides health reasons, do I have other personal

reasons for quitting smoking?YES NO

8. Will I be patient with myself and keep trying

if I slip or backslide?YES NO

If you answered YES to 4 or more of these questions,

you are ready to quit smoking. GOOD LUCK!

If you scored under 4, please talk to

your Freedom From Smoking Clinic Facilitator.

SESSION 1: Thinking About Quitting

Are You Ready to Quit Smoking?

SAMPLE

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Questionnaire 2 Preparing to Quit

Listed below are questions about skills, techniques, and attitudes that are often used

to quit smoking. Please answer these questions by circling YES or NO.

Question

1. Have you identified your reasons for wanting to stop smoking? YES NO

2. Do you feel you are addicted to nicotine? YES NO

3. Do you know how to cope with withdrawal symptoms? YES NO

4. Do you want information on nicotine gum, the nicotine patch, or other quit-smoking medications?

YES NO

5. Do you know how to use deep breathing as a technique to stay free of smoking?

YES NO

6. Do you know how to develop social support to help you stay free from smoking?

YES NO

7. Have you planned strategies for dealing with temptations to start smoking again?

YES NO

8. Have you planned a reward for yourself once you have quit smoking?

YES NO

9. Do you know how to manage weight gain, which sometimes occurs when people stop smoking?

YES NO

10. Do you have ways to handle stress without smoking? YES NO

11. Is stopping smoking your top health priority? YES NO

Your Name: ____________________________________________________________________

Preparing to Quit

SAMPLE

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©2010 American Lung Association.

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Finding Freedom From Smoking

Like most smokers, you probably have many different feelings about smoking.

You’ve heard all the reasons why you should quit. And by joining this

program, you’ve indicated that you’re willing to change—ready to quit.

How does change happen? Like most people, you’ll go through a series of

stages. You might even experience certain stages more than once. That’s okay.

The Freedom From Smoking program is built to help you pass through the

stages and learn from any setbacks so you can keep moving ahead.

What to ExpectIf you’re ready to quit, Freedom From Smoking can offer you a step-by-step process

to quit for good. During each session, activities and assignments will provide you

with skills and techniques to support quitting. All of the exercises are intended to

help you gain control over your behavior. You will work through the quit process

individually and in a group.

Making a PlanThe first three sessions are part of the preparation stage. You’re getting ready to take

action. The more prepared, the better. Each skill you master, each urge you prepare

for is another step toward being a nonsmoker.

Taking ActionSession 4 is Quit Day. It’s a very big deal, and that’s okay. You have a plan and

you have support. Smoking is an unhealthy addiction to kick, but being part of the

Freedom From Smoking program means you don’t have to go it alone. The Clinic

Facilitator and other program participants are there with you, making change happen!

Staying Smoke-FreeSessions 5 through 8 are the maintenance stage. Here’s where you really get the taste

of freedom from smoking. You’ll exercise your right to be proud, and you’ll learn

more ways to stay quit.

SESSION 1: Thinking About Quitting

SAMPLE

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Session 1: Thinking About Quitting

• Program Overview

• Three-Link Chain

of Addiction

• Benefits of Quitting

• Registration

• Excuses to Keep Smoking

Session 2: On the Road to Freedom

• Self-Management

• Stress Management

• Relaxation

• Triggers and Coping

• Increasing Motivation

• Medication to

Help You Quit

• Assessing Nicotine

Dependence

Session 3: Wanting to Quit

• Your Quit Plan

• Social Support

• Relapse Prevention

Session 4: Quit Day

• Panel of Ex-Smokers

• Quitting Ceremony

• Contracts and Rewards

• Using a Buddy for Support

• Recovery Symptoms

• Overcoming Cravings

Session 5: Winning Strategies

• 48-Hour Report

• The Grief Cycle

• What to Do If You Slip

• Coping Strategies

• Refining Your Quit Plan

• Stress Management

Session 6: The New You

• Progress Review

• Lifestyle Changes

• Weight Management

• Staying Smoke-Free

• Social Situations

Session 7:Staying Off

• Physical Activity

• Changing Your Self-Image

• Assertive Communication

• End of Clinic Questionnaire

Session 8: Celebration

• Reviewing Your Progress

• Rewarding New

Behaviors

• Relapse Prevention

• Challenging Your

Thinking

• Completion Ceremony

Schedule of Sessions

SAMPLE

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©2010 American Lung Association.

Three-Link Chainof Addiction

Why is it so hard for many people to quit smoking? Most smokers know

that they’re addicted, but they may not realize that there are several aspects

to their addiction. We call this the Three-Link Chain of Addiction. Smokers

have a better chance of quitting and staying quit if they address all three

parts of the chain.

PhysicalSmokers become physically hooked on the chemical

nicotine in cigarettes. Nicotine is extremely addictive

and actually produces changes in a smoker’s brain.

As a result, having a cigarette decreases a smoker’s

anxiety level and can help improve mood. Nicotine

also stimulates the brain to release chemicals that

make the smoker feel more awake and alert.

MentalSmokers often have a cigarette at the same time

every day. This may be during the drive to work,

while talking on the telephone, or after finishing a

meal. Smoking becomes such an automatic behavior

that some smokers light up without even thinking

about it. Smokers also link emotions like pleasure

or relief with having a cigarette.

SocialSmoking plays a huge role in our society. Teenagers

often begin smoking to fit in with a group. Asking

“Got a light?” is a common way to break the ice

when meeting someone new. Social groups even

form when the same employees regularly go outside

to smoke during breaks.

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SAMPLE

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©2010 American Lung Association.

Reasons Why You SmokeEvery smoker has a reason to smoke. You know it harms your health, but you do

it anyway. Why? Maybe smoking helps you deal with stress. Maybe you like to

hold a cigarette. Maybe you like the little rush of the nicotine entering your system.

The more you know about why you smoke, the easier it will be to quit. Take a

few minutes and think about your life and your behaviors. Then make a list.

Why do you smoke?

SAMPLE

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©2010 American Lung Association.

Benefits of Quitting Smoking

As soon as you quit smoking, your body begins a series of healing

or recovery changes that continue for years.

20 Minutes After Quitting:

• Your heart rate drops to a normal level.

12 Hours After Quitting:

• The carbon monoxide level in your blood drops to normal.

2 Weeks to 3 Months After Quitting:

• Your risk of having a heart attack begins to drop.

• Your lung function begins to improve.

1 to 9 Months After Quitting:

• Your coughing and shortness of breath decrease.

1 Year After Quitting:

• Your added risk of coronary heart disease is half that of a smoker’s.

5 to 15 Years After Quitting:

• Your risk of having a stroke is reduced to that of a nonsmoker’s.

• Your risk of getting cancer of the mouth, throat, or esophagus is half that of a smoker’s.

10 Years After Quitting:

• Your risk of dying from lung cancer is about half that of a smoker’s.

• Your risk of getting bladder cancer is half that of a smoker’s.

• Your risk of getting cervical cancer or cancer of the larynx, kidney,

or pancreas decreases.

15 Years After Quitting:

• Your risk of coronary heart disease is the same as that of a nonsmoker.

Source: U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General . Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Off ice on Smoking and Health, 2004.

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How Would You Benefit by Quitting?On page 9, the health benefits of quitting smoking were listed. Now it’s your chance to

get personal. What’s in it for you? Many people quit smoking for health reasons or for

the people they love. Why do you want to change? Take a few minutes and start your

benefits list. You might want to add to it over time. Keep in mind, the act of quitting

smoking is one thing in life that really is all about you!

Benefits Today

Example: My breath will smell better.

Benefits in the Future

Example: I’ ll have more money to spend on vacation.

SAMPLE

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©2010 American Lung Association.

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Registration Form and Questionnaire

All information on this questionnaire will be kept confidential. Please print clearly.

Name:

Address:

City: State: Zip code:

Home Phone: Work Phone:

E-mail:

Education: elementary school technical school/training

high school college/university

Gender: Age:

Questionnaire 3 Your History of Tobacco Use

1. At what age did you begin to use tobacco?

2. How many cigarettes do you smoke each day?

3. How many times have you stopped smoking before?

4. What is the longest period of time you have

gone without smoking since you first started?SAM

PLE

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Questionnaire 3

(continued)Your History of Tobacco Use

5. Do you use tobacco in any form other than cigarettes?

If YES, please check the box below:

pipe cigar snuff chewing tobacco

Other:

6. Do your friends, family, or co-workers smoke?

family friends people at work none of these people

7. Are your family members or significant others supporting you to quit?

Supporting They don’t want They don’t They don’t

me me to quit care know

Husband/wife/partner

Children

Friends

Co-workers

8 . How did you learn about the American Lung Association’s

Freedom From Smoking Clinic?

newspaper radio word of mouth TV

Other:

9. Which of these best describes your race or ethnic group? (Check all that apply.)

White African American Hispanic Asian/Pacific Islander

Native American/Alaskan Native Other:

I prefer not to answer this question.

SAMPLE

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Using Pack TracksFor every cigarette you light:

Indicate how much you want

that smoke. Check “YES” if

you really want or need it,

“yes” if it’s a normal urge, or

“?” if the craving isn’t strong.

Then, indicate the mood

you’re in. Check a:

• Happy face if you’re

feeling good.

• Blah face if you’re bored.

• Unhappy face if you’re

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©2010 American Lung Association.

Are You Kidding Yourself About Smoking?

Are you using any of these excuses to keep smoking?

� ”Scientists still haven’t proven cigarettes cause cancer.”Thousands of research studies have shown a link between smoking and lung cancer. No

doubt remains. These studies also have shown that smoking causes chronic bronchitis and

emphysema. Smoking also is associated with heart disease, diseases of the circulation, and

ulcers. In addition, smoking impairs the developing fetuses of pregnant women. In fact,

the U.S. Surgeon General has stated that smoking harms virtually every organ in the body.

Smoking reduces the quality of life for smokers and can cause shortness of breath,

reduced energy, and more frequent colds. Smoking also pollutes the air for nonsmokers,

damaging their health.

Once you’ve stopped smoking, your mind and body will feel better. You’ll feel good

about doing something that improves your health and affects those around you in a

positive way.

� ”I don’t smoke enough to get the diseases that smoking causes.”Heavy smokers do have a greater chance of getting diseases such as emphysema.

But light smokers get them too. Light smokers have a much greater chance of health

problems such as heart attack and stroke than do nonsmokers.

� ”It’s too hard for me to stop smoking. I won’t make it.”It can be hard for some people to give up smoking. For others, it is much easier than

they expect. Over 46 million Americans have quit smoking. You can too! Each day that

you don’t smoke, you will be developing a stronger nonsmoking pattern. Your desire

to smoke will become less, and finally disappear. Anyone who really wants to quit can

do it if he or she keeps at it.

� ”I don’t have to worry about my health if I smoke light or low-tar cigarettes.”There is no safe cigarette. Light or low-tar cigarettes often produce higher levels of

chemicals such as carbon monoxide than regular cigarettes. Also, to get the amount

of nicotine you’re used to, you may inhale more deeply and more often.

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©2010 American Lung Association.

� ”Smoking relaxes me.”A cigarette may supply the nicotine your body has become used to, but this is not real

relaxation. It’s just temporary relief from the tension caused by your need for a nicotine

fix. Smoking actually increases heart rate and blood pressure. With the help of this

program, you can learn to relax in ways that are truly effective and much better for you.

� ”If I stop smoking, I’ll gain weight.”Some people do gain weight when they stop smoking. Others don’t. Some even lose

excess weight. In some people, quitting smoking causes their body chemistry to slow

down. So they may gain a few pounds. This small weight gain usually disappears

after the body adjusts to its new state of well-being.

After you have learned to stop smoking, this program will show you how to keep

from gaining weight. Weight gain is a problem that can be handled easily. Meanwhile,

try not to substitute food for cigarettes.

� ”Air pollution is just as dangerous as cigarettes.”No, it’s not. Air pollution is more dangerous only when there’s an accident, such as poison

gas escaping, or in a workplace where a dangerous substance is not properly controlled.

Smokers who live or work in heavily polluted areas have much higher rates of lung

diseases than do nonsmokers. Any way you look at it, breathing in poisons harms

your health, especially in the concentrated levels found in cigarette smoke.

� ”I’ve smoked so long that it won’t make any difference if I quit now.”Wrong! Research has proven that your body benefits from quitting, no matter how

long you’ve been smoking. Over time, your body can even repair most of the damage

that has been done by smoking. After you quit, your body will begin to function

more efficiently. You will feel better and look better, and you’ll be healthier.

Remember: You are not giving up something. You are gaining your freedom! Cigarette

smoking has become socially unacceptable. The people near you—at work, in public

places, at home—will be happier to be around you. Everyone will breathe cleaner air.SAM

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