Stopping smoking. Learning outcomes. n To understand the reasons for smoking and the reasons to stop smoking n To set targets for stopping smoking

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1 Topic 3 theme 1 Stopping smoking Learning outcomes n To understand the reasons for smoking and the reasons to stop smoking n To set targets for stopping smoking RESOURCES n Copies of Resources 1, 3, 4, 5, 7, and 8 n One copy per learner of the 16-page leaflet, Stop smoking. Start living! (printed as Resource 9: see important note below) n Discussion cards prepared from Resource 2 n Suggestions cards prepared from Resource 6 n Sticky notes n Audio equipment 3 A special note about Resource 9 The 16 pages of Resource 9 present a speciallycreated brochure about stopping smoking. Ideally, it will be reproduced on a colour printer (either by photocopying, or from the supplied pdf) such that it is a stapled,16-page, A3 folded to A4, self-cover A4 brochure, with page 1 as the front outer cover, and page 16 as the rear outer cover. Other options are possible! The brochure is used throughout the three smoking-related themes. RELATED THEMES Stop smoking for life (pages ) The cost of smoking (pages ) HEALTH SKILLS About 70% of smokers would like to stop. Stopping smoking is the single biggest thing people can do to improve their health. Because nicotine is an addictive drug, however, it is difficult to break the habit and stopping smoking requires determination as well as support. Some people may use cigarettes as a prop and may not be able to cut them out completely but may cut down. Most smokers will need substantial support to stop smoking, and there are many local services available that can be contacted and invited to join sessions. A list of local services can be found on the NHS website where learners can find information about support services for stopping smoking. SKILLS FOR LIFE People who prepare to stop smoking, for example by making a considered decision to stop and then setting realistic targets, are more successful in achieving their goal. Considering reasons for and against smoking may include reading information, discussing the issues and writing down action lists. In order to prepare and set their own achievable targets to stop smoking, learners need to: n listen and respond to the points of view of others n read and understand information from leaflets n write down personal feelings and targets. 140(new) Skilled for Health n Health and well-being n Topic 3: Substances

2 Related health information NHS leaflets or website information about stopping smoking Core curriculum Activities in this theme will contribute to learning in the following curriculum areas: n discuss and share points of view ( L SLlr/E3.5) n express and record own opinions honestly ( L SLc/E3.3) n note down targets for future use ( L Wt/L1.5). Engage n Start a discussion by asking learners to think of all the health risks of smoking. This could be done as a group or in pairs. Learners can give ideas about risks verbally or write them on separate sticky notes. Confirm that they do not need to worry about spelling of medical terms. Post the notes on a flipchart or board and share the information with the group. They could include: lung cancer (also cancer of the mouth, nose and throat, larynx (voice-box), oesophagus, pancreas, bladder) bronchitis and other lung diseases such as emphysema shortness of breath heart disease and stroke or other circulation problems increased risk of miscarriage or problems during pregnancy impotence in men. n You can use Resource 8: Smoking facts to check for any health risks missed. Note that the detail of these facts is subject to change as new research is published. You may want to check facts on the internet. The resource was based on information from the following websites: ; (British Heart Foundation); (British Medical Association); info.cancerresearchuk.org ; (Midwives Information and Resource Service); (NHS Information Centre); n To ensure understanding, discuss the meaning of the health conditions in the list, such as bronchitis, emphysema, lung cancer. Learners may not be familiar with all the medical conditions, their symptoms and impacts on health, so expect to spend some time on this. n The effects of smoking on health are expressed in terms of increased risk, for example smokers are twice as likely as nonsmokers to die prematurely, or a 1 in 2 risk, or that smokers on average die 10 years earlier than non-smokers. This risk is expressed in a number of different ways, which is in itself confusing. To try and make it more meaningful, it might be helpful to model the risk with a group of learners. For example if there are 12 learners, half smokers and half non-smokers, the smokers will die on average 10 years earlier than the non-smokers, half the smokers (i.e. 3 of the group of 6 smokers) will die of a disease related to smoking. We all know smoking is bad for you, but what exactly are the risks to health caused by smoking? TIP Model the pronunciation of medical vocabulary, especially of words that sound different from the way they are written, e.g. bronchitis, oesophagus, emphysema. Point out that medical terms are very technical. If necessary it would be helpful to point to a model of a body to show where organs and other body parts are located. You may need to discuss the functions of these organs. 141(new) Skilled for Health n Health and well-being n Topic 3: Substances

3 Enable n Introduce the Stop smoking. Start living! leaflet (Resource 9). Look through it briefly, and say that you will be referring to it throughout the sessions on smoking. Explain that the leaflet supports people who are trying to stop smoking, with facts, ideas, checklists, sources of support and a planned approach to stopping smoking. Point out that people who think carefully and plan how they will stop smoking are more likely to be successful. n Explain to learners that they are going to consider their own smoking habits, the reasons for smoking (or not) and the type of help available to them if they want to to stop smoking. Any non- or ex-smokers in the group should consider how they might support friends and family who want to to stop smoking. ACTIVITY 1 3 Share and think about reasons people give for smoking n Explain to learners that they are going to listen to people talking about why they smoke or have stopped. n Give learners Resource 1 so they can follow the audio extracts. n Play the extracts one at a time, stopping after each extract to discuss what learners think about the views expressed. Ask learners to identify the particular issues raised by each extract, for instance smoking and pregnancy, the cost of smoking and long-term smoking. Give opportunities to discuss each of these issues briefly and confirm that there will be opportunities later to discuss them in more detail. n Give learners the discussion cards prepared from Resource 2. Encourage learners to discuss them in pairs and decide whether they are true or false. These cards deal with some of the myths about smoking, for example that it keeps you slim. If appropriate, you might want to extend the activity to ask learners for some other ideas about beliefs to do with smoking or not smoking. n Go through the answers and information on page 5 of the leaflet ( The truth about smoking ). If relevant, point out the suggestions about finding out further information at the bottom of page 5. n Ask learners to suggest reasons other than health for stopping smoking. This might include pressure from partners or work, concerns about personal/oral hygiene, cost, and so on. n Discuss the barriers that people face in stopping smoking. For example, what may make it difficult for a young person in their teens to stop? Make a list of these barriers and keep them for later referral. You can extend the discussion to consider the impact of the Smokefree legislation introduced in 2007 (2006 in Scotland), using page 3 of the leaflet ( First step ). Learners may want to share their personal experience of the change in the law. Confirm that there has been a significant fall in the number of smokers since the law came into effect and that many ex-smokers have reported that it made it easier to stop smoking. I am going to play you some short recordings of people about smoking. Listen carefully to each one and think about the main point. For instance in this one (extract 1), what s the main point? He talks about not being hooked, and it not being like drugs. So the point of this one is to relate smoking to drugs and addiction. What reasons do people have for stopping smoking, apart from improving their health? 142(new) Skilled for Health n Health and well-being n Topic 3: Substances

4 Support n Be aware that any activity involving writing, particularly where technical terms are required, will be stressful for many learners. Do the activity verbally, or offer to write the words for learners. n Learners with short-term memory problems will be challenged by listening activities. Break each listening extract into smaller parts so that learners can focus on one main point at a time. n Ask direct questions to check understanding, such as Why did this person start smoking? n Read through the statements on the cards and reword them as direct and personal questions to learners. For example: Do you think cigarettes are a type of drug? Encourage learners to give reasons for their answers. esol n Learners may need to listen to the extracts several times. First, play all the extracts through, providing questions to help learners focus on the gist (e.g. Has anyone stopped smoking?, Has anyone tried to stop?, Does anyone want to stop? ). n Then play the extracts one by one, pausing to discuss the reasons given for smoking or stopping smoking and the attitude to smoking. n After listening, go through the speech-bubbles and discuss the meaning of unfamiliar idioms (e.g. hooked on it, mates, put on weight ). ACTIVITY 2 Find out more about personal reasons for smoking n Hand out Resource 3 and introduce the Why do you smoke? questionnaire; explain how to score it. Each section has three statements and learners must ask themselves if each one applies to them and reflects their experience. Each statement is scored 1 5 and learners need to total each section. Note that there may be some learners who will need support for completing the questionnaire and adding up the scores. You may need to discuss the meaning of the word crave. n Support learners in interpreting their scores using the scoring feedback sheet on Resource 4. Spend some time considering the different reasons for smoking, e.g. stimulation, or coping with tension. Learners may not have considered this before. n Note: the results will also be needed for Activity 4. n Discuss whether the results are what learners expected. n Point out that for many of them there will be more than one reason why they smoke and that the reasons don t fit neatly into one box. Learners may be able to add other reasons to the list. Why do people smoke? What reasons do they give? Support n Cut the quiz up into separate boxes and give these to learners one at a time. n Make the statements into direct questions, e.g. Do you smoke to make yourself relaxed? Always? Mostly?. n Support learners in noting their scores and adding them up. esol n Before learners do the quiz, go through the questions discussing the meaning of expressions, for example keep me going, cheers me up, can t cope, calms me down, light up, moody. Provide other examples to help learners understand when and how the expressions are used. n Encourage learners to try out the expressions in their own sentences. 143(new) Skilled for Health n Health and well-being n Topic 3: Substances

5 ACTIVITY 3 Note personal likes and dislikes about smoking n Hand out Resource 5. n Ask learners to discuss in pairs what they do and do not like about smoking and to make a list using the writing frame. Page 6 of the Stop smoking. Start living! leaflet Think about why you smoke has some ideas that may help learners to start thinking. n Discuss the lists as a whole group and note down the top like(s) and dislike(s). n Extend this discussion to consider smoking triggers, in other words situations or times when temptation is greatest to light up. Page 6 of the leaflet has some ideas about this What makes you carry on smoking? Confirm that knowing your own smoking triggers will help you to avoid them, or at least be in a better position to control them. What do you like and dislike about smoking? What do you dislike most? Support n Encourage learners to share ideas first. n Support them as they write the lists. Learners may want to add rules to help them keep their writing straight. n Encourage dyslexic learners to refer to other Resources for words. esol n As preparation for the discussion, ask learners to suggest some words they can use for talking about likes and dislikes (e.g. like, enjoy ; don t like, dislike, hate, loathe ). ACTIVITY 4 Consider appropriate strategies for stopping smoking, and begin planning to stop smoking n Refer learners to the results of the quiz they did in Activity 2. Explain that in order to stop smoking they will need a plan to overcome the difficult times. People who plan are more likely to be successful. n Give learners the first six suggestion cards prepared from Resource 6 (distinguished by coloured corners). Read through them and guide learners to find the ones that match the boxes where they scored 10 or more in the quiz. Ask learners to comment on the suggestions and to help one another. Explain that the cards give ideas for alternative activities that may help tackle the reasons people give for smoking. n Give learners the last two cards, Get support from others and Reward yourself. Read through the ideas and discuss them. Add more suggestions from the group. n Ask learners to think about what will work for them. They could use the cards to select an option, or make a list of their own ideas. Link this back to the earlier discussion on smoking triggers. Do you know anyone who has successfully stopped smoking? How did they do it? 144(new) Skilled for Health n Health and well-being n Topic 3: Substances

6 Support n Read through the information on the suggestions cards with the learners and support them to make a list, if they wish to do so at this point. Help learners to record information in a format they can understand, and help with spellings. n You may need to spend some time ensuring that learners understand the link between the titles on the Resource 6 cards and the categories in Resource 3 (e.g. to stimulate yourself, to keep going / Find other stimulation ). esol n Be prepared to explain phrases such as crush the craving, break the habit. n Look at patterns of word formation such as stimulate / stimulation / stimulating tense / tension relax / relaxation / relaxing. ACTIVITY 5 Consider SMART targets for stopping smoking, and begin planning to stop smoking n Hand out Resource 7 and go through the SMART targets. Explain the thinking behind SMART and reinforce the idea that planning to stop smoking is a positive approach that works. Explain what each stage means and ask learners to give examples. n Ask learners to think about the targets they will set themselves, using the suggestion cards from Resource 6 to help them. The first and most important target will be to identify the date on which they plan to stop smoking. n Learners can note down any ideas on the sheet if they wish to. Learners will need support and questioning to make their actions and targets specific rather than general, for example: I would like to play football next season is more specific than I would like to feel fitter. I would like to go to Spain this year is more specific than I want to be better off. Doing something else when I feel the need for a cigarette is too general. I will eat some fruit / take the dog out is more specific and more achievable. n If it s appropriate for your group, now might be a good time to complete a personal Stop smoking plan see page 12 of the leaflet. n It is a good idea to end this session on a positive note by considering information on the health benefits of stopping smoking, as described on the leaflet page 4: Know the facts. It s also worth noting that people who get help to stop smoking are much more likely to succeed. What targets will help you to stop smoking? It s important to set targets that are realistic, that you know you can do. There s no point in being unrealistic you risk setting yourself up to fail. 144a(new) Skilled for Health n Health and well-being n Topic 3: Substances

7 Support Read through the information about SMART targets with the learners, pointing out the relationship between the letters and the words (e.g. S = Small and specific). Support them as they fill in the sheet correctly, if they wish to do so at this point. Help learners to record information in a format they can understand, and help with spellings. esol As preparation for the writing activity, discuss: n the use of will for intentions, e.g. I will join a relaxation class. n the use of the prepositions on and by, e.g. I will stop on 1st June (a specific date), I will stop by 1st June (the latest date). n ways of finishing the introductory sentences in the writing frame (Resource 7). Action n Suggest that learners might find it helpful to complete the Why do you smoke? planner on page 8 of the leaflet. This will help to confirm smoking triggers and add to self-knowledge. It takes the form of a diary of smoking which ideally will be kept for a day or two. Some patterns should emerge about what triggers you to light up. n Ask learners to revisit the list of barriers made in Activity 1. Can they now suggest ways of overcoming each of these barriers? Widen this into a discussion about how individuals, groups and society in general can support people to overcome these barriers. n Suggest that learners find out about different kinds of support that the NHS provides for people who want to stop smoking. They can do this by visiting the GP s surgery, pharmacy or other health centre. They might also be able to search online for information. If possible, information can be brought to the next session. 144b(new) Skilled for Health n Health and well-being n Topic 3: Substances

8 Stopping smoking RESOURCE I just wanted to know what it was like, really. I m not hooked on it. It s not like drugs or anything. I could stop smoking tomorrow if I wanted to. 2 3 I stopped smoking when I was pregnant with Abi because I was told it can harm unborn babies. I feel much better for it and I want my second baby to be as healthy as Abi. I wish Liam would stop, though. I don t want to set a bad example to my children or risk my family s health through second hand smoking. The trouble is I enjoy smoking, especially in the evening when I m relaxing at home or at the pub with mates. 4 My family all smoke, so of course I started to smoke too. I d like to stop because it s costing a lot of money. The trouble is, when I ve stopped in the past I ve put on weight. Smoking helps me to keep slim. 5 No one s allowed to smoke in the office any more, so I ve had to cut down at work. It s ridiculous standing in the cold is surely just as bad for our health. Smokers have rights too. My job is very stressful and smoking calms me down. 6 I ve been smoking all my life. I can t remember why I started. I ve tried to stop a few times in my life. I ve tried cutting down as well, but now I m back up to 40 a day. I m too old to stop smoking now. 145(new) Skilled for Health n Health and well-being n Topic 3: Substances

9 Stopping smoking RESOURCE 2 Cigarettes are a type of drug. Smoking can harm unborn babies. Second hand smoke does not affect nonsmokers. Smoking keeps you slim. Smoking stops you feeling stressed. You are never too old to stop smoking. 146(new) Skilled for Health n Health and well-being n Topic 3: Substances

10 Stopping smoking RESOURCE 3 Why do you smoke? Read each statement and ask yourself it this is your experience. Give each statement a score of 1 to 5. Add up your total scores for each section. 1 Never 2 Not very often 3 Sometimes 4 Mostly 5 Always Section 1 Score Section 2 Score Smoking helps to keep me going. Smoking cheers me up. Smoking helps me to think. I like to have a cigarette in my hand. I enjoy lighting up a cigarette. I like watching the smoke and blowing smoke rings. Total score for Section 1 Total score for Section 2 Section 3 Score Section 4 Score Smoking relaxes me. I like to have a cigarette when I am drinking. I smoke more when I am out with friends or on holiday. A cigarette calms me down when I am upset or angry. I have a cigarette when I am worried about something. I smoke more in situations that make me nervous or worried. Total score for Section 3 Total score for Section 4 Section 5 Score Section 6 Score I can t cope if I haven t got any cigarettes. I really crave a cigarette sometimes. I am anxious or moody when I am not smoking. I light up without even thinking. I smoke at regular times of the day. One of the first things I do in the morning is smoke a cigarette. Total score for Section 5 Total score for Section 6 147(new) Skilled for Health n Health and well-being n Topic 3: Substances

11 Stopping smoking RESOURCE 4 Why do you smoke? Scoring feedback Use the feedback to understand more about why you smoke. Find the sections where you have a high score. A score of 10 or more in a section is high. A score of 5 is low. Section 1 A high score means you smoke mainly to stimulate yourself, to keep going. To stop smoking, find other things to do instead. Section 2 A high score means you smoke mainly because you enjoy handling a cigarette. To stop smoking, find something else to keep your hands busy. Section 3 A high score means you smoke mainly to relax. To stop smoking, find other ways of relaxing. Section 4 A high score means you smoke mainly because you are tense. To stop smoking, find other ways to get rid of your tension or deal with worries. Section 5 A high score means you smoke mainly because you have a craving. To stop smoking, find a way to get rid of the craving. Section 6 A high score means you have developed a habit. To stop smoking, break the habit by changing your routine. 148(new) Skilled for Health n Health and well-being n Topic 3: Substances

12 Stopping smoking RESOURCE 5 Likes and dislikes list What I like about smoking What I don t like about smoking 149(new) Skilled for Health n Health and well-being n Topic 3: Substances

13 Stopping smoking RESOURCE 6 Find other stimulation You could: l go for a walk l do some exercise l take up a new hobby l join a club or group l do something else you enjoy l try a new routine, or do something differently. Keep your hands busy You could: l use a stop smoking medicine, such as a patch or gum l keep yourself busy by cooking, sewing. writing. drawing, reading magazines or doing DIY jobs l carry a pen, keys or small item for something to keep your hands busy. Relax You could: l take a long relaxing bath or shower l do some relaxation exercises l watch a film or TV programme l have an early night l distract your mind - read something, play a computer game. Crush the craving You could: l challenge yourself to see how long you can go without having a cigarette l drink plenty of water l when you get the craving to smoke, eat something healthy instead l use a stop smoking medicine, such as a patch or gum. Get rid of tension You could: l take deep breaths l do some exercise or take a walk l plan a relaxing evening l tell yourself that you are strong enough to cope and you re going to prove it l talk to others about what you are doing: your partner, friends, or family l write down your feelings, or make a note of your progress. Break the habit If possible try to: l change your normal routine l avoid places where you normally smoke l avoid people who might persuade you to have a cigarette l avoid things you link with smoking, such as a cup of coffee l plan to do something active at the times when you would normally smoke. Get support from others You could: l talk to someone you know who has successfully stopped smoking l talk to your doctor l call a helpline or contact your local NHS services l ask for support from a friend or family l join a support group in your area l tell everyone you know that you are stopping and ask for their support. Reward yourself You could: l put the money that you normally spend on cigarettes in a separate place l buy yourself a treat at the end of the week with the money you have saved l save enough to buy an expensive item that you have always wanted. 150(new) Skilled for Health n Health and well-being n Topic 3: Substances

14 Stopping smoking RESOURCE 7 Smart targets My ideas S Small and specific Set a specific target for stopping. Don t be too ambitious! I would like to: M Measurable Check your progress by keeping a diary, or contacting someone every day. I will keep a check on my progress by: A Achievable What will you do to help you to achieve your goal? Think about things that will work for you and your lifestyle. If I feel I need a cigarette I will: R Rewarding Go for it! Think of something you really want. I will reward myself by: T Time-based Plan for it. Let people know. Contact support services. I will stop smoking on: 151(new) Skilled for Health n Health and well-being n Topic 3: Substances

15 Stopping smoking RESOURCE 8 Smoking facts Smoking is bad for your health. It is also bad for the health of family and friends around you. Here are some facts. Find out more by searching the internet. Early death 106,000 people in the UK die every year due to smoking. About half of all smokers will die of smoking related causes. About half (5 out of 10) of all long-term smokers will not live beyond 70. Many smoking-related deaths are not quick deaths, and involve years of long-term illness before eventually dying. Cancer 3 out of 10 of all deaths from cancer are caused by smoking. More than 30,000 people per year, over 80 a day, die from lung cancer. About 8 in 10 of those are directly related to smoking. Lung cancer is the most common cause of cancer death. Other types of cancer can be caused by smoking: cancers of the throat, oesophagus (wind pipe), bladder, kidney, stomach, pancreas and blood. By the time lung cancer is diagnosed it is often too late to treat it. Heart disease In the UK, about 120,000 people die each year from heart disease. About 1 death in 7 is caused by smoking. Smokers are almost twice as likely to have a heart attack as people who have never smoked. Second hand smoke, babies and children There is a greater chance of complications occurring during pregnancy and labour, such as sickness, miscarriage, and bleeding. Smoking while pregnant can also increase the risk of premature birth by 1½ to 2 times, and about one in three of all stillbirths are caused by smoking. Babies exposed to cigarette smoke are 4 times more likely to die of cot death. Second hand smoke makes children 1½ times more likely to develop asthma and ear infections. In England and Wales, about 17,000 children under five are admitted to hospital each year with problems relating to the smoking of their carers or parents. Your risk of developing lung cancer increases by 20-30% if you regularly breathe in other people s cigarette smoke. Second hand smoking by people living with smokers causes around 2,700 deaths each year in people aged 20 to 64, and a further 8,000 in people over 65. Other effects of smoking Bad breath Infertility in men and women Impotence in men Wrinkly skin 152(new) Skilled for Health n Health and well-being n Topic 3: Substances

16 RESOURCE 9 Stop smoking. Start living! Make the break. Live your life without smoking. Contents Stop smoking 5 steps to success 2 step 1: Think about it First step 3 Know the facts 4 The truth about smoking 5 Think about why you smoke 6 How much does smoking cost you? 7 Step 2: Get ready to stop Planning how to stop smoking 8 Top tips 9 Step 3: Stop smoking Stop smoking medicines 10 Stop smoking plan 12 Step 4: Keep on stopping Coping with withdrawal 13 Handling stress 14 Step 5: Keep on trying! Staying stopped 15 Information page 16 1(new)

17 Stop smoking Start the 5 steps to success Step 1 Think about it Why do you smoke? How much does it cost? Find out the truth about smoking. First step Know the facts The truth about smoking Think about why you smoke What are the costs? Are you ready to stop smoking? Stop smoking! follow these five steps to success! Step 2 Get ready to stop What are your smoking triggers? How will you cope? What will help to make it easier? Who can help me? Planning how to stop smoking Top tips Step 3 Stop smoking Help with missing nicotine. Make a plan: set a date, tell people, get the help you need. Stop smoking medicines Stop smoking plan Step 4 Keep on stopping Keep to your plan. Ideas to help. Coping with withdrawal Handling stress Step 5 Keep on trying! Many people need a few goes to stay smoke free successfully. So if you do start again Ask yourself: Did you prepare yourself enough? Are there better ways to cope next time? What have you learnt? When you re ready, come back and follow the steps again. Congratulations! If at any point you feel tempted to start smoking again, think back to why you stopped. Celebrate how well you have done so far. 2 Stop Smoking Start Living

18 step 1: Think about it Congratulations! You have made the first step to stopping smoking. You are thinking about stopping smoking. You know that smoking is bad for your health. It is also bad for the health of those around you. You want to stop, for all sorts of reasons. You CAN stop smoking. It is worth the effort. This guide gives you ideas about how to stop and how to stay smokefree. Smokefree UK! The whole of the UK is now smokefree in public places. England, Wales and Northern Ireland have been smokefree since Scotland went smokefree in This means that pubs and clubs are smokefree, as well as work places, shops and all transport. In fact anywhere that is a public place. Many people say that this has made it easier for them to stop smoking. Why go smokefree? Your health will improve. Your lifestyle will improve. Your friends and family will benefit. You will save money. Stop Smoking Start Living 3

19 Know the facts Fact: your body begins to heal itself after you smoke your last cigarette. After 20 minutes your blood pressure and pulse get back to normal. After 8 hours, the level of oxygen in your blood gets back to normal. You have less chance of having a heart attack. Your body starts to heal itself as soon as you stop smoking. After 24 hours, carbon monoxide leaves your body. Your lungs start to clear. After 48 hours 2 days your body is free of nicotine. Your sense of taste and smell start to get back to normal. After 72 hours 3 days your breathing starts to get better. You have more energy. From 2 to 12 weeks, your blood circulation gets better. It is easier to walk and exercise. From 3 to 9 months, your lungs get better. Breathing problems get better. You don t cough so much or get short of breath. After 5 years of not smoking, a smoker is twice as likely to have a heart attack as you are. After 10 years of not smoking, a smoker is twice as likely to get lung cancer as you are. And you have the same chance of having a heart attack as someone who has never smoked. Go smokefree and let your body start to mend itself. Two days after stopping smoking, your body is free of nicotine. 4 Stop Smoking Start Living

20 The truth about smoking Here are some of the statements people make about smoking. Are they true... or false? Find out the real facts. Cigarettes are a type of drug. True: cigarettes contain nicotine which is an addictive drug. This is not good for you but the poisons and tar you breathe in are the most damaging things about smoking cigarettes. Smoking can harm unborn babies. True: women who smoke are more likely to have a miscarriage. Their babies are more likely to be born early or have a low birth weight. There is also a greater risk of the baby dying at birth or in the first month of its life. Second hand smoke does not affect non-smokers. False: if non-smokers are in the same room as smokers, they are breathing in the cigarette smoke. This can damage the health of the non-smokers as well as those who are smoking. This applies to children and babies too. Smoking keeps you slim. False: nicotine in cigarettes does suppress your natural appetite and makes your body burn calories faster. But smoking does not make you slim. Think of the people you know who smoke and are overweight as well! It is true that some people who stop smoking may put on a small amount of weight. This is mainly because food tastes and smells so much better once you stop smoking. If you eat sensibly, you will avoid putting on weight. Smoking stops you feeling stressed. False: the effect of nicotine is to make you feel better but the effect wears off quickly. As it wears off, it makes you feel worse so you may feel more tense or stressed. So you reach for another cigarette. This is the addictive effect of nicotine. If you are stressed, then there are better ways of tackling this than being a smoker. You are never too old to stop smoking. True: if you stop smoking even well into middle age, you will avoid most of the risk of developing cancer. Within five years of stopping smoking the risk of having a heart attack falls to about half that of a smoker and by ten years it falls to about the same as someone who has never smoked. Find out for yourself Use some of these words or phrases to search for information on the web. When you read the information, take note of who has made the website. A tobacco company might have a different message than the NHS, for instance. Tip: it is best to stick to UK websites. Nicotine Smoking and pregnancy Smoking and stress Age to stop smoking Second hand smoking Stop Smoking Start Living 5

21 Think about why you smoke Why did you start smoking? It is a good idea to think about what made you start smoking. If you understand why you started, this can help you to stop. These are some reasons smokers give for why they started. Do they sound familiar? It made me look older It made me look cool It made me feel grown up I copied my family or friends It made me feel tough I did it to be accepted I did it because I wondered what it would be like I just felt like it Did you have any other reasons for starting smoking? Looking at all the reasons, do any of them still apply to you now? Are they good reasons for keeping on smoking? What makes you carry on smoking? Smoking is a habit. There are probably triggers that make you light up after a meal, on your way to work, certain times of day. It is a good idea to know the triggers, so you can think about ways to deal with them. When do you most need to light up? When you wake up When you talk on the phone When you have a drink When you watch TV When you are with friends At social events, such as parties, matches After a meal When you are with family When you read the paper In work breaks Any other triggers? 6 Stop Smoking Start Living

22 How much does smoking cost you? Now is a good time to work out just how much you spend on smoking. Try this rough calculation. What you spend on smoking in a week per week Multiply by 52 to work out the cost for one year per year Multiply this by 3 to give the cost for 3 years for 3 years Multiply the one year cost by 10 to give the cost for 10 years for 10 years It s surprising how it adds up! Use this ready reckoner to work out the cost more accurately. Time If you smoke 10 a day If you smoke 20 a day If you smoke 40 a day One day week (7 days) year (52 weeks) 1,092 2,184 4,368 3 years 3,276 6,552 13, years 10,920 21,840 43,680 This is based on a packet of 20 cigarettes costing 6. Think about what else you could spend this money on. Write down some ideas here. Stop Smoking Start Living 7

23 step 2: Get ready to stop Plan how to stop smoking Planning includes knowing why you smoke and managing your triggers. Why do you smoke? Fill in this planner for a day or two before you stop. It will help you work out when you smoke and why you smoke at that time. The time you smoked How many you smoked What you were doing How much you wanted to smoke (for example, just after breakfast, or 6pm) (for example, less than 1 cigarette, 1, 2, 3) (for example getting ready to go out, relaxing after a meal) 1=not much 2=quite a bit 3=desperate Manage your triggers You know what your triggers are (see page 6). How can you manage them? Here are some ideas. Stay busy Think about something else Go for a walk, or just into another room Drink a glass of water Talk to a friend about it Look back at your reasons for stopping Try using stop smoking medicines You probably have your own ways of dealing with triggers as well. 8 Stop Smoking Start Living

24 Top tips These top tips have helped other smokers to stop smoking. Try them out yourself. 1 Contact your local NHS Stop Smoking Service. They are trained advisors. They have practical ideas to help you stop smoking, including Stop Smoking Groups. Page 16 has more information and contact details 2 Know the triggers that make you smoke. Page 6 helps you find your triggers 3 Keep away from situations where you will be tempted to smoke again. Page 12 helps you plan to do this 4 Use stop smoking medicines to cope with the withdrawal symptoms. Page 11 has information about stop smoking medicines 5 Keep a check on how much money you save by not smoking. Plan treats with the money you save. Page 7 has some ideas to help work this out 6 Get a friend to stop smoking at the same time. You can support each other. 7 Take it one day at a time and reward yourself every day. 8 Keep telling yourself you can do it. Getting ready to stop smoking is about having a plan. Understand why you smoke. Know how to avoid smoking triggers. Choose a day to stop smoking. Choose the best way for you to stop smoking. Make sure you have people to support you. Plan treats and rewards for yourself. What s your plan? Tip Find your local Stop Smoking Service by contacting your doctor, phone or go to Stop Smoking Start Living 9

25 step 3: Stop smoking Stop smoking medicines The first few days of stopping smoking can be the hardest time. This is when your body misses the nicotine most. Stop smoking medicines can help. What are stop smoking medicines? This is a kind of treatment that gives your body the nicotine it wants. It only gives you nicotine and not the tar and other chemicals in smoke that cause cancer. So stop smoking medicines do not cause cancer. It helps you get over the early part of stopping smoking. Where do I get stop smoking medicines from? You can buy stop smoking medicines in most chemists and large supermarkets. You can also get them on prescription from your doctor. Can anyone use stop smoking medicines? If you are pregnant, you have to check with your doctor or midwife first. You also have to check with your doctor if you have a heart or blood problem or if you take regular medication. Always check first if you are at all worried. Where can I get more information? Ask the Stop Smoking advisor (for more information see page 16). Or you can ask your doctor or the chemist. The NHS Choices website has more information or try searching the web. Type in stop smoking medicine for some good links. 10 Stop Smoking Start Living

26 What kind of stop smoking medicines are there? Gum When you chew nicotine gum, the nicotine is absorbed through the lining of your mouth. Microtabs These are small tablets containing nicotine which dissolve quickly under your tongue. Inhalator Inhalators look like a plastic cigarette. The inhalator releases nicotine vapour which gets absorbed through your mouth and throat. If you miss the hand to mouth part of smoking, these may suit you. Patches Nicotine patches work well for most regular smokers and can be worn round the clock (24 hour patches) or just during the day (16 hour patches). Lozenges Lozenges are sucked slowly to release the nicotine and take about minutes to dissolve. Nasal spray The spray gives a quick dose of nicotine through the lining of your nose. Prescription drugs, such as Zyban or Champix Zyban works by changing the way your body reacts to nicotine. Champix works by reducing your craving for cigarettes. Both drugs have to be prescribed by a doctor and not everyone is allowed to take them. Stop Smoking Start Living 11

27 Make a Stop smoking plan The day you stop smoking, you will change your life for the better. Use this plan to help you prepare and help you to succeed. Avoid temptation Choose the date carefully. Make sure it is a day which isn t stressful. Don t have any cigarettes, matches or a lighter with you. Don t drink alcohol on that day. Get support Call your local NHS Stop Smoking Service. Page 16 has information about this. Talk to friends and family. Make sure they support you. Talk to someone who has already stopped smoking. Team up with someone else who is stopping at the same time. Call the NHS Smoking Helpline on Remind yourself why you are stopping For your health. For the health of your family and friends. Because you want to be in control. Because you want to spend the money on other things. To improve your lifestyle. In the first week... Keep busy. Change your routine to avoid triggers. Stick to no-smoking places. Get plenty of fresh air. Plan a reward for your success. Stop smoking planner The day I stopped smoking Day Date Month Year 12 Stop Smoking Start Living

28 STEP 4 Keep on stopping Coping with withdrawal This stage can be tough. There may be pressure to start smoking again. You may not feel too good. Lots of people start smoking again because they find it difficult to cope with the withdrawal symptoms. The first few days can be quite tough, but this is a sign that your body is starting to recover. Stop smoking medicines can help to make the symptoms of withdrawal a bit easier. They can help you get over this tough time. Symptoms What s happening How to cope Intense desire to smoke Coughing, dry mouth Hunger Constipation or diarrhoea Trouble sleeping Dizziness Poor concentration, moody Your body and brain are missing the nicotine. Your lungs are clearing of tar and poisons. Food tastes better when you stop smoking. Your body is returning to normal and it will settle down. This can be because of the nicotine leaving your body. More oxygen is getting to your brain, instead of carbon monoxide (which is poisonous). These are signs if nicotine withdrawal and will pass. This is worst in the first few days but it will get better after a few weeks. These symptoms will clears up quite quickly. Warm drinks can help. Go to your doctor if it s a big problem. Eat more fruit and vegetables, chew gum and drink lots of water. Don t eat sweets or chocolate instead of smoking. Fruit, vegetables and lots of water will help things get back to normal. This should not last for more than two or three weeks. Cut down on coffee and tea and get more exercise. This should go away after a few days. Warn everyone that you are stopping smoking! Ask for their help and support. Stop Smoking Start Living 13

29 Handling stress You may be someone who smokes to help deal with stress. If you are, then these are some useful tips to help deal with stressful situations at home or at work. Top stress-busting tips Problem solving Be honest with yourself about what is really upsetting you. Try different ways of doing things. Talk problems over with someone you can trust. Ask for help. Time management Sort out the things you have to do each day. Plan your time so you do the most important things first. Make realistic plans about what you can do. Put yourself first and relax Do one thing just for yourself every day. Take time out to relax. Get enough sleep. Be positive! Remember that as a non-smoker you will be less stressed and find it easier to cope. Put the money you spent on cigarettes in a jar count it each week. Keep a calendar and mark off each day you are smoke free. Congratulate yourself on being successful Stop Smoking Start Living

30 step 5: Keep on trying! Staying stopped Don t worry if you take a step back and start smoking again. Many people take four or five tries to stop for good. Next time you try, you will know more about what works for you and what does not work so well. Put this emergency advice somewhere you will see it if you have just that one cigarette. Emergency advice If you ve just had a cigarette... Remind yourself about why you decided to stop. Throw away any cigarettes you have even the secret store. Get yourself away from the situation that made you start smoking again. Go outside, or to a different room. Call a friend or phone the NHS Smoking Helpline on Don t let this one cigarette undo all the hard work you have done so far. Why do people start smoking again? There are lots of reasons people give up, but these are some of the most common. I thought I could have just one cigarette. I didn t plan enough. I didn t think carefully enough about my smoking triggers. I couldn t find other ways to deal with stress. I was having a really bad day. I started putting on weight. I didn t get the right kind of support. I thought about myself as an ex-smoker. I should have thought about myself as a non-smoker. Remember that you haven t failed, because you can still succeed. Don t give up giving up! Stop Smoking Start Living 15

31 Information page Smoking helplines Ring these numbers to find out about services in your area to support you to stop smoking. Calls are free of charge. Open 7am to 11pm. NHS Smoking Helpline Scotland Smoking Helpline Wales Smoking Helpline Northern Ireland Smoking Helpline NHS Asian tobacco helplines Open 1pm to 9pm Urdu Hindi Punjabi Gujarati Bengali NHS Pregnancy Smoking Helpline Open mid-day to 9pm Smoking websites If you have access to the internet, there are lots of sites that have information and advice about stopping smoking. Type words in the search box of your web home page. Stop smoking Tobacco Quit smoking Smokefree Some sites also have tools such as calculators to work out how much smoking costs you, addiction tests and Promise pages. They also have leaflets (in several languages), videos and DVDs you can download or send for. The NHS has a very good site: Important note All information was up to date in summer Note that web addresses and telephone numbers may change over time.

32 Stopping smoking ANSWERS AND AUDIO SCRIPTS ANSWERS ACTIVITY 1 / Resource 2 The answers for Activity 1 are incorporated into the leaflet back page. ACTIVITY 2 / Resource 3 See scoring feedback on Resource (new) Skilled for Health n Health and well-being n Topic 3: Substances

33 Stopping smoking ANSWERS AND AUDIO SCRIPTS audio scripts ACTIVITY 1 3 Extract 1 I just wanted to know what it was like, really. I m not hooked on it. It s not like drugs or anything. I could stop smoking tomorrow if I wanted to. Extract 2 I stopped smoking when I was pregnant with Abi because I was told it can harm unborn babies. I feel much better for it and I want my second baby to be as healthy as Abi. I wish Liam would stop, though. Extract 3 I don t want to set a bad example to my children or risk my family s health through second hand smoking. The trouble is I enjoy smoking, especially in the evening when I m relaxing at home or at the pub with mates. Extract 4 My family all smoke, so of course I started to smoke too. I d like to stop because it s costing a lot of money. The trouble is, when I ve tried stopping in the past I ve put on weight. Smoking helps me to keep slim. Extract 5 No one s allowed to smoke in the office any more, so I ve had to cut down at work. It s ridiculous standing in the cold is surely just as bad for our health. Smokers have rights too. My job is very stressful and smoking calms me down. Extract 6 I ve been smoking all my life. I can t remember why I started. I ve tried to stop smoking a few times in my life. I ve tried cutting down as well, but now I m back up to 40 a day. I m too old to stop now. 154(new) Skilled for Health n Health and well-being n Topic 3: Substances