YOU CAN DO IT!

Quitting is hard, but…

Tips to help you stop smoking

Tips to help you stop smoking (Chinese)

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If you’re thinking of quitting, you’re heading in the right direction. Here are just a few of the facts that show how smoking damages your health and that of your family.

Smoking kills

Research shows that one out of every two people who have smoked for nearly all their life will die from smoking. And half of them will die in middle age.1

Tobacco smoke contains over 4,000 deadly poisons,2 including tar (which coats your lungs like soot and causes cancer), arsenic (used in rat poison) and acetone (used in paint stripper).

Many of the chemicals in tobacco smoke cause cancer – of the lung, throat, mouth, bladder, kidneys, pancreas and stomach. Smoking also contributes to acute myeloid leukaemia.1, 2

Other health problems caused by smoking include coronary heart disease, stroke, premature ageing of the skin, eye damage, shortness of breath, coughing, emphysema, pneumonia and impotence (in men).

“One time while smoking, I saw the smoke coming in and out through my nose and I felt really silly being dominated by a thing which does not belong to my own. Since then, I was determined to quit and gain back control of my life.”

Mr Lo, ex-smoker

WHY QUIT?

Smoking harms nearly every organ of your body.

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Passive smoking harms your family

Passive smoking – also called environmental tobacco smoke (ETS) or ‘second hand smoke’ – occurs when you breathe in someone else’s exhaled smoke or smoke from a burning cigarette.

For adults, passive smoking increases the risk of lung cancer and heart disease. But it is especially harmful to children because their lungs are smaller.

If you smoke around your children, they are more likely to suffer from pneumonia, bronchitis, asthma, sudden infant death syndrome (SIDS) and ear, nose, throat and chest infections.

It’s important to remember that the harmful substances in environmental tobacco smoke remain in the air long after the smoke is no longer visible.

Also, children who live in a smoke free home are less likely to become smokers themselves. Remember: Car and home – smoke free zone!

A baby living with someone who smokes in their car and home will have inhaled the

smoke of 80 cigarettes by the age of one.

“My family means everything to me.

I never let anyone smoke near my

children because I know it’s so harmful

to their health.”

Siu Lam, father of two

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Smoking is more than a habit – it’s an addiction to nicotine. It’s your dependence on nicotine that makes quitting hard. Nevertheless, many people quit successfully every year. Here are some steps that can increase your chances of quitting for good.

STEP 1 – GET READY

Try these things as you prepare to quit:

• Set a ‘quit day’.

• Get rid of all cigarettes and ashtrays.

• Don’t let people smoke in your home.

Review what worked for you and what didn’t in past attempts.

STEP 2 – QUIT!

When you are ready to quit, remember:

• Get support and encouragement.

• Tell your friends and family about your decision to quit.

• Talk to your GP, pharmacist or Quitline counsellor.

• Be prepared to cope with cravings – use the checklist in this brochure as a guide.

• Get medication that will help (see overleaf).

STEP 3 – STAY OFF CIGARETTES

Once you’ve quit, be very determined – don’t smoke even one puff. Over time, you’ll feel the urge to smoke less and begin to enjoy the benefits of being a non-smoker.

STEPS TO HELP YOU QUIT

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Nicotine, which is found in cigarettes, is a highly addictive substance.

FACT: nicotine is as addictive as heroin and cocaine.

When you stop smoking you can experience a variety of uncomfortable symptoms (withdrawal symptoms). These symptoms are your body’s way of adjusting to being free of nicotine and other chemicals in tobacco.

You may have headaches, be tired, feel anxious or depressed or irritable, have hunger cravings, and find it hard to concentrate or sleep.

Nicotine replacement therapies (NRT) are products that can help reduce your addiction to nicotine and the discomfort of nicotine withdrawal.

They work by giving your body a low but constant dose of nicotine. As the doses of nicotine become progressively smaller, you gradually wean yourself off nicotine.

The NRT products listed on the next three pages are generally available in your local pharmacy without a prescription. Talk to your GP or pharmacist about the best product and dosage for you.

But be careful:

• If you’ve recently had a heart attack, are pregnant or breastfeeding, talk to your doctor before using these products.

• Don’t smoke while taking these products!

“I used to smoke low-tar/mild cigarettes thinking that they’re safer. My doctor explained that there is no safe way to smoke. When you smoke mild cigarettes, you tend to draw harder on them, so you end up smoking just as much cigarette junk.”

Mr Wong, ex-smoker

PRODUCTS TO HELP YOU QUIT

Correctly using nicotine replacement therapies

can double your chances of success.3

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PATCHESThese are adhesive patches that deliver nicotine slowly through the skin. It’s important to use them properly:

• Apply the patch to clean, dry, non-hairy skin on your arm or upper body and leave it in place for 16 hours or 24 hours, depending on which patch type you are using.

• Choose a different site each day to avoid skin rashes.

• Use only one patch per day.

How much should I have?

There are two types of patches, and each has different strengths (mg) of nicotine:

24-hour patch 16-hour patch

21mg (strong) 15mg (strong)

14mg (less strong) 10mg (less strong)

7mg (least strong) 5mg (least strong)

If you smoke more than 10 cigarettes a day, start on the strongest patches – 24-hour (21mg) or 16-hour (15mg). If you smoke less than this, or weigh less than 45kg, start on the less strong ones – 24-hour (14mg) or 16-hour (10mg).

Use the patches for a minimum of 8 weeks and do not use them for longer than 3 months. Wearing a patch for 16 hours per day is as effective as wearing one for 24 hours per day.

INHALERAn inhaler looks similar to a cigarette – it’s a small white ‘cartridge’ you place in your mouth. Nicotine in the inhaler is inhaled directly through the mouth. It may be useful for those who miss the hand-to-mouth action of smoking.

How much should I have?

Inhale air through the cartridge for 20 minutes. Decide on your own dose according to cravings or withdrawal symptoms and use according to the manufacturer’s information.

Use at least 6–12 cartridges a day for 12 weeks and then reduce your dose over 6–8 weeks to zero.

Using the inhaler for longer than 6 months is not recommended.

PRODUCTS TO HELP YOU QUIT

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GUMNicotine gum works by allowing nicotine to be absorbed into the bloodstream through the lining of the mouth. This type of gum is NOT to be used like regular gum:

• Have a piece before you get out of bed (so you don’t reach for a cigarette).

• When you put the gum in your mouth, chew it three to four times until you get a strong taste. Then flatten it, place it between your cheek and gum and leave it there (this way more nicotine is absorbed).

• When the taste has disappeared, then move the gum around your mouth and resume chewing slowly again to release more nicotine.

• Repeat the chewing routine for about 30 minutes then discard the gum.

• Don’t drink or eat anything 15 minutes before or after chewing.

If the gum is too bulky, pieces may be cut in half and used more often.

How much should I have?

Gum comes in 2mg and 4mg strengths. If you currently have more than 20 cigarettes a day try the 4mg strength, and if you smoke less try the 2mg strength. The maximum dose is 40mg a day, so do NOT chew more than 20 pieces of the 2mg gum or 10 pieces of the 4mg gum in a day.

Use the gum regularly. A typical dose is one piece every hour for a period of 1–3 months.

PRODUCTS TO HELP YOU QUIT

“Nicotine is as addictive as heroin so some people

need more than just determination or will power

to quit. For me, patches worked – they helped me

quit for good.”

Mr Lo, ex-smoker

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SUBLINGUAL TABLETA sublingual (‘under the tongue’) tablet is a small white round tablet that you place under your tongue. As the tablet dissolves, it releases nicotine. It’s similar to a lozenge but contains more nicotine. When using a sublingual tablet:

• Place it under your tongue and keep it there.

• It will take about 30 minutes to dissolve completely.

• Do not chew or swallow! Let it dissolve under your tongue.

• Do not use sublingual tablets for longer than 12 months.

How many should I have?

For low-dependence smokers or those who smoke less than 20 cigarettes per day:

Dissolve one 2mg sublingual tablet under the tongue every 1–2 hours (8–12 tablets per day).

For high-dependence smokers or those who smoke more than 20 cigarettes per day:

Dissolve two 2mg sublingual tablets under the tongue every 1–2 hours (16–24 tablets per day).

No more than 40 sublingual tablets per day should be used.

The duration of treatment is different for each individual, but should normally continue for 2–3 months, with the dose gradually reducing to zero.

LOZENGEA lozenge is like a sweet that you suck. Nicotine is absorbed through the lining of the mouth, as with gum. As you suck the lozenge it dissolves completely, whereas with gum you throw some away. Because of this, a lozenge may be up to 25 percent more effective than gum of the same strength.

When using lozenges:

• Use only one lozenge at a time. Do not chew or swallow!

• Move it around the mouth from time to time and suck until it dissolves completely (takes 20–30 minutes).

• Don’t eat or drink 15 minutes before using a lozenge or while it is in your mouth.

How many should I have?

Lozenges come in two strengths – 4mg and 2mg. If you usually reach for your first cigarette of the day within 30 minutes of waking, use the 4mg. If you usually wait longer than that, use the 2mg.

For the initial treatment period, take one lozenge every 1–2 hours from weeks 1 to 6. For the step-down treatment period, take one lozenge every 2–4 hours from weeks 7 to 9, and one lozenge every 4–8 hours from weeks 10 to 12. Do not exceed 15 lozenges per day.

PRODUCTS TO HELP YOU QUIT

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BUPROPION (ZYBAN) TABLETSBupropion is a non-nicotine medication that helps people stop smoking. It’s available only by prescription from a doctor and can be combined with gum, patches, etc, to help with quitting. Talk to your doctor about whether it’s suitable for you. Your doctor will explain how it is used.

But be careful…

Bupropion may not be appropriate for all smokers and it is not recommended for people with seizure disorders, those who are on certain medications for depression, or those who have a history of manic depressive illness.

PRODUCTS TO HELP YOU QUIT

“I tried a medical product before, but it didn’t work, so I lost confidence.

But my doctor said that using a NRT product could double my chances of

success, so I tried another product and this time I was successful.”

Mr Xiao, ex-smoker

Chemicals in cigarettes change

the way some medications work.

See your doctor before quitting if

you take any medication.

Stopping smoking can

be stressful.

If you have suffered from

depression, anxiety or other

mental illness, ask your doctor's

advice before quitting.

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¸ Keep your mouth and hands busy with sugar-free gum or palm seed, or use a pen or stress ball.

¸ Get enough sleep – avoid stimulants like tea or coffee before bed.

¸ Remind yourself every day why you want to quit: carry a list of your reasons and read them whenever you feel the urge to smoke. REWARD yourself when you overcome the urge.

“Fear of becoming fat put me off any quit attempts until I talked to my doctor about it. He advised me on how to avoid weight gain after quitting by regular exercise and healthy eating habits. I ended up only gaining about 2kg.”

Mr Yu, ex-smoker

Quitting takes hard work and a lot of effort, but you can do it. Physically, your body is reacting to the absence of nicotine. Psychologically, giving up an old habit means a major change in behaviour. You must be able to deal with both if your attempt to quit is to be successful.

Here are some tips to help:

¸ DRINK lots of fluids such as water and fresh juice. AVOID coffee or alcohol as these increase your desire to smoke.

¸ Have a balanced diet and regular meals. Eat plenty of low-calorie, high-fibre foods such as fruit and vegetables. AVOID fatty foods such as cake and ice-cream.

¸ Exercise regularly: use stairs instead of lifts, join an exercise club or walk to work.

¸ Change your daily routine: have lunch at a different place and leave the table straight after lunch. AVOID places where people smoke or situations you associate with smoking.

¸ Help yourself to relax and plan enjoyable things (instead of smoking) to help you cope with stress. Try a new hobby.

CHECKLIST – COPING WITH CRAVINGS

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After 20 minutes your heart rate drops (which means less strain on your heart).

After 12 hours the carbon monoxide level in your blood drops to normal.

After 2 weeks to 3 months your risk of heart attack begins to drop. Your lung function begins to improve.

After 1-9 months you will have less coughing and shortness of breath.

After 1 year your added risk of coronary heart disease is half that of a smoker’s.

After 10 years your lung cancer death rate is about half that of a smoker’s, and your risk of getting cancers of the mouth, throat, oesophagus, bladder, kidney and pancreas decreases.

Your family will benefit too:

• Your family and kids will be healthier.

• You and your family will enjoy better air inside your car and home.

• You’ll enjoy cleaner-smelling breath and clothes.

• You’ll save up to $3,000 a year – think what you could do with that!

FEEL THE BENEFITS – IN 20 MINUTES!

It’s never too late to quit. In fact, the

benefits of quitting begin immediately. Here are just a few

positive effects on your body from quitting.

11 Produced by Social Change Media. www.media.socialchange.net.au

• Talk to your doctor or pharmacist.

• Call the Quitline 137 848 (English). If you need a Chinese interpreter, call 131 450.

• For quit information in Chinese call The Cancer Council NSW 1300 300 935.

USEFUL WEBSITES

Car and home smoke free zone

www.smokefreezone.org

CASSCARE

www.cass.org.au

Chinese Association on Smoking and Health

www.cash-prc.com

Hong Kong Council on Smoking & Health

www.smokefree.hk/cosh/ccs/index.xml?lang=tw

Hong Kong Tobacco Control Office

http://sc.info.gov.hk/gb/

www.tobaccocontrol.gov.hk/chi

John Tung Foundation

www.jtf.org.tw

NSW Multicultural Health Communication

Service

www.mhcs.health.nsw.gov.au/health-public-

affairs/mhcs/publications/Tobacco.html

Notes

1. Doll R, Peto R, Wheatley K, Gray R and Sutherland I. (1994) ‘Mortality in relation to smoking: 40 years observation on male British doctors’. BMJ; 309, 901-911.

2. Report of the Surgeon General. U.S. Dept of Health and Human Services, Centre for Disease Control and Prevention, National Centre for Chronic Disease Prevention, Office on Smoking and Health, 2004.

3. Silagy C, Lancaster T, Stead L, Mant D and Fowler G (2004) ‘Nicotine replacement therapy for smoking cessation (Cochrane Review)’, in The Cochrane Library, Issue 1, Chichester, UK: John Wiley & Sons, Ltd.

Other references

Peto R, Lopez AD, Boreham J, Thun M and Health Jr C. (1994) Mortality from Smoking in Developed Countries 1950-2000: Indirect Estimates from National Vital Statistics, Oxford: Oxford University Press.

Asian Americans for Equality, Quitting Smoking Is Hard, But … You Can Do It!

Australian Government Department of Health and Ageing (2004) Smoking Cessation Guidelines for Australian General Practice, Desktop guidelines and patient education materials.

Department of Health and Human Services Public Health Service (2000) You Can Quit Smoking, Consumer guide.

John Tung Foundation, How to Quit, www.quitandwin.org.tw, Taiwan.

NSW Health (1997) Quit Because You Can, Sydney, Australia.

NSW Multicultural Health Communication Service (2001) Products to Help You Stop Smoking (Chinese Edition), Sydney, Australia and NSW Health (2004) Quit Online ‘Products to help you quit smoking’, Sydney.

Quit Victoria (1993) You Can Quit (Chinese Edition), Victoria, Australia.

Bittoun, Renee, Tips for Using Nicotine Patches/Gum.

Tobacco Control Office, Department of Health (2001) Seven Steps to Quit: Nicotine Pharmacotherapy, Hong Kong.

This booklet is for information purposes only. The information contained in this booklet is not a substitute for, and is not intended to replace, independent professional advice. Users should consider the need to obtain any appropriate professional advice relevant to their own particular circumstances.

Thankyou to the John Tung Foundation for the use of the Jackie Chan photographs, and to members of the Sydney Chinese community for their support.

We thank Dr Stephen Li (Area Medical Director of the Institute of Clinical Pathology and Medical Research and Chairman of the Community Health Subcommittee of the Australian Chinese Medical Association), Mr Peter Yu (Pharmacist, Westmead Hospital and CHS) and Sydney West Area Health Service for their valuable comments.

FOR MORE HELP

Published by the Chinese Australian Tobacco and Health Network (CATHN) representing Area Health Services across the Sydney Metropolitan area and The Cancer Council NSW. September 2005.