Tobacco Cessation Toolkit

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Symptom Review (page 1) Name Date

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You notice physical s, like moments of dizziness, sweating, hands trembling or a mild headache. When using tobacco, nicotine increases your heart rate (by about 10 20 beats per minute) and blood pressure. After quitting, your body needs to adjust to these changes. A mild headache may be the result of a change in oxygen level, increased tension or anxiety (see also You re in a bad mood below). Dizziness should only last a few seconds at a time. Few days to several Take a mild painkiller medication for your headache. Drink plenty of caffeine-free, low-sugar fluids. Avoid high-paced activities and change your position (e.g., when you are getting up) slowly when experiencing dizziness. Stop and sit down for a moment and the dizziness should pass. 25% report a mild headache some time during their quitting attempt. 10% experience light headedness. Hand shakiness will subside as your body adjusts to having no nicotine. Up to several. You may experience more sweating. Up to several Bathe or shower more often. You re in a bad mood Your body is recovering and adjusting to being tobacco free. Up to 4 Anxiety, anger, frustration, restlessness and irritability are common s. Depression is a common. Evidence suggests nicotine has an anti-depressant effect, but it has also been reported to make depression worse. That s why quitting tobacco may increase the risk of depression in the short term. Talk to your health-care professional (e.g., doctor, mental health therapist), as well as family and friends, if you have any depression or negative feelings that won t go away. For irritability or aggression, try deep-breathing exercises or relaxation techniques. 50% experience irritability or aggression. 60% experience depression.

You re in a bad mood Find a buddy to quit with. This could be a supportive family or friend, or you could call the AlbertaQuits helpline, use online supports or attend QuitCore group cessation. Exercise helps release calming chemicals in your brain. Do relaxation exercises (e.g., stretches, yoga, walking, breathing exercises, get a massage or listen to some of your favourite music). If possible, delay or avoid stressful and difficult situations or activities. You have a smoker s cough, dry throat or mouth, or bad breath Some research has found an increase in coughing following quitting tobacco. Nicotine in tobacco causes more saliva and phlegm to occur, so when you quit you may experience dry throat or mouth and bad breath due to a new lack of saliva. The increase in saliva and phlegm are not believed to be the cause of coughing. At the same time, your airways and lungs are working hard to help remove tars, particulate and phlegm out of your system. This is a good thing! Several days to a few. Drink more water and other clear fluids to thin out your mucus and make it easier to bring up. Use sugar-free lozenges or gum to increase your saliva. Prevalence unknown. 2

You have difficulty Your body is recovering from the Peaks at 2-3 concentrating chemical stimulants in tobacco. days and Your brain was used to getting a lasts a few buzz (stimulation) from nicotine. Now it s learning to stay alert without it. Some research shows that quitting tobacco makes it difficult to concentrate by slowing down how long it takes to perform simple tasks. You feel hungrier When using tobacco, nicotine Up to 10 than usual suppressed your appetite and made you not want to eat as much food. Now that you are tobacco-free, you may feel hungrier. Consider using nicotine replacement therapy (NRT). If you can, work less. Take regular breaks. Think about what may be causing you to want to eat more, and think of ways to manage it. Does putting food in your mouth give you pleasure? How can you manage that desire in a healthy way? Snack on healthy foods that are low fat, low calorie and high in fibre. Consider chewing sugar-free gum or ice chips, or using a (cinnamon-flavoured) toothpick, to reduce calorie intake and keep your mouth satisfied. Choose and prepare balanced, healthy meals. Use healthy cooking methods, make healthy choices when eating out and choose healthy foods at the grocery store. Drink 6 8 glasses of water per day and limit drinks with added sugar. For more support, consult a health-care provider who can advise on healthy eating (e.g., a registered nutritionist or dietitian). 60% experience difficulty concentrating. 70% experience increased appetite. 3

You change your eating habits, such as what and how often you eat. Foods taste better now! You may also find that your mouth feels satisfied by eating a snack to fight a tobacco craving. This is an important time to watch and review your eating habits. Good or bad eating habits can be established in as little as 18 days. Eat more vegetables and fruit, choose whole grains and choose foods high in fibre. Get plenty of exercise. Consult a health-care provider who can advise on healthy eating (e.g., a registered nutritionist or dietitian). Prevalence unknown. You feel tired and have low energy When using tobacco, nicotine decreases fatigue from boring mental tasks. When you quit tobacco, your body must adjust itself, which can cause feelings of drowsiness and fatigue. Caffeine is a drug found in cola, coffee, tea, chocolate and energy drinks. After quitting tobacco, your body will metabolize caffeine more slowly and you may be at risk for caffeine toxicity, which causes s like irregular or rapid heartbeat, dizziness, trouble sleeping, fever, confusion and diarrhea. Quitting caffeine may cause fatigue for the first three days. Up to several First three days Get enough sleep, but don t oversleep. Make healthy food choices and keep your sugar intake to a healthy level. Consult with a health-care provider who can advise on healthy eating (e.g., a registered nutritionist or dietitian). Do not take on extra work. A leisurely walk or activity may give you more energy. Avoid caffeine as much as possible, especially while your body is adjusting to becoming tobacco-free. To avoid caffeine toxicity, reduce your caffeine intake at least by half your regular amount when trying to quit smoking. Common of drug withdrawal. 4

You re craving another cigarette Your body is recognizing that nicotine is no longer there, so your brain looks for another hit of nicotine. Triggers can also bring on cravings. For example, if you visit the store you always bought tobacco at, you may be tempted to add it to your bill. Up to 2-4 A craving will usually last a few minutes. Follow the 4Ds approach to fight cravings: distract yourself, delay until the craving passes, deep breathe until it passes and drink water. Try yoga, listen to relaxing music, write in a journal, take a walk, call a friend or make a cup of tea. 70% experience cravings to use tobacco again. Use oral substitutions (e.g., sugar-free gum, candy, sunflower seeds). Avoid triggers that may bring on a craving by planning ways to eliminate or reduce them. If you have strong cravings, consider using nicotine replacement therapy (NRT) like gum or lozenges. Consult your primary health-care provider (e.g., your doctor or pharmacist). You have gas, stomach pain and constipation Nicotine helps your body move food through the digestive track more quickly and stimulates your bowels. When you quit tobacco, this can slow down, which can lead to constipation, gas or bloating. Consult your family doctor if these s last longer than a few days. 3 4 days Choose healthy beverages Prevalence unknown. and stay hydrated. Drink water throughout the day. Introduce more fiber into your diet (e.g., whole-grain cereals, fruits and vegetables, and beans and lentils). 5

You have trouble sleeping, bad dreams or nightmares Nicotine affects your brain waves and sleep patterns. Now that you are tobacco free, you will have to adjust to new sleep patterns. You may be waking up because your body is looking for a fix of nicotine. Consult your health-care provider. Valid withdrawal s include insomnia and restlessness. You may also dream more. When using an NRT patch, the steady dose of nicotine may cause vivid dreams. Consult your health-care provider. Up to one week Avoid caffeine, especially in the four hours before bedtime. Take a warm bath or shower to relax. Drink plenty of water. If you are using a 24-hour NRT patch, either remove it before bed or switch to a 16-hour patch. Consult your health-care provider and follow up if the results are not satisfactory. Avoid naps during the day. 25% experience sleep disturbances. 6