WIXLIB

WHICH METHOD DO YOU CHOOSE?Checkall t h e m e t h o d s that y o u w i l l a d o pt .N I C OT I N E R E P L A C E M E N T T H E R A P Y ( N R T ) ( O ve r - t h e -C o u nte r )N i co t i n e Pa tc h e s deliver s te a d y a m o u n t s of nicotine to t h e b o d yt h ro u g h t h e skin. Available OTC in t h re e strengths: 2 1 m g , 1 4 m g a n d 7 m g .N i co t i n e G u m delivers nicotine to t h e bra i n m o r e quickly t h a n t h epatch. Available OTC in 2 m g a n d 4 m g do s es .N i co t i n e L o ze n ge releases nicotine a s it dissolves in t h e m o u t h . Ea c hl oze n g e lasts a b o u t 2 0 - 3 0 m i n u te s . Available OTC in 2 m g a n d 4 m g do s es .N I C OT I N E R E P L A C E M E N T T H E R A P Y ( N R T ) (Re q u i res Prescription)Ni co t i n e N a s a l Sp ray is a p u m p bottle that co ntai ns nicotine. Yousquirt it in yo ur n o s e w h e n y o u h av e a n u rg e to s m o ke . This is t h e fastestw a y to deliver nicotine to t h e b l o o d st re a m. Available by prescription only.N i co t i n e Inhaler (also k n o w n a s “puffer ”) delivers a va p o r i ze d fo r m ofnicotine in yo ur m o u t h t h ro u g h a m o u t h p i e c e a tta c h e d to a plastic cartridge.Available by prescription only.N ON -NICOT INE PH A R M ACOT H E R A PY (N N P)B u p r o p i o n ( Zy b a n ) is a m e d i ca t i o n that hel ps re d u c e nicotinew i t h d ra wa l s y m p t o m s a n d t h e u rg e to s m o ke . Treatment b e g i n s w h i l ey o u a re still s m o k i n g , a b o u t o n e w e e k prior to quit date. Available byprescription only.Varenicline (Chantix) g o e s directly to t h e brai n a n d bl o cks t h e effectsof nicotine. You start Varenicline w h i l e y o u a re still s m o k i n g . Available byprescription only.Living Independent From Tobacco 18

DID YOU K N O W THAT Tobacco u s e is t h e leading p rev e nta b l e ca u s e of death, disease, a n ddisability in t h e U S . Ea c h year, a ro u n d 4 4 3 , 0 0 0 p e o p l e die f r o m s m o k i n g o r ex p o s u re tos e co n d h a n d s m o ke , a n d a n o t h e r 8.6 million suffer f r o m a serious illness f r o msmoking. It is e s t i m a te d that a b o u t half o f all s m o ke rs eventually die f r o m s m o k i n g related diseases. S m o k i n g increases t h e risk of h e a r t disease, h e a r t attacks, h i g h b l o o dpressure, brittle b o n e s , g u m disease, p o o r w o u n d healing , a l o we re d abilityto fight infection, arthritis, a n d certain eye p ro b l e m s (cataracts, m a c u l a rdegenerati o n).19 Living Independent From Tobacco

A L L T O B A C C O I S T O X IC !T h e re a re m o r e t h a n 7,000 c h e m i ca l s incigarette s m o ke . M o s t of t h e s e c h e m i ca l sa re toxic a n d m a n y of t h e m ca u s e cancer.In 2 0 0 4 , t h e U.S. S u rg e o n G e n e ra l re p o r te dt h e link b e t w e e n cigarette s m o k i n g a n d t h ed e v e l o p m e n t of va r i o us ca n c e rs includinglung , h e a d a n d neck, s to m a ch , kidney, colon,cervix, bl a dder, a n d l eukemi a . In addition,cigarette u s e h a s also b e e n a s s o ci ated w i t h avariety of chronic diseases including stroke,h e a r t attack, chro ni c obstructive p u l m o n a r ydisorder, chro ni c l u n g di s ea s e a n d a s t h m a ,h a rd e n i n g o f t h e arteries, a n d p n e u m o n i a .Living Independent From Tobacco 20

W O M E N A N D CIGARETTESM E N A N D CIGARETTES21 Living Independent From Tobacco

D e c r e a s i n g Your Risk:Smoking and Diabetes S m o k i n g ca n ag gravate m a n y p ro b l e m s that p e o p l e w i t h d i a b ete s a l rea dyface, s u c h a s h e a r t a n d b l o o d vessel disease. S m o k i n g increases yo ur cholesterol levels a n d t h e levels of s o m e o t h e r fatsin yo ur bl o o d, raising yo ur risk of a h e a r t attack. S m o k i n g d a m a g e s a n d constricts t h e b l o o d vessels. This d a m a g e ca nw o r s e n fo o t ulcers a n d l ea d to b l o o d vessel di s ea s e a n d leg a n d footinfections. S m o ke rs w i t h di a betes a re m o r e likely to g et n e r v e d a m a g e a n d k i d n eydisease. Pe o p l e w i t h d i a b ete s w h o s m o ke a re t h re e t i m e s a s likely to die ofcardiovascular di s ea s e t h a n o t h e r p e o p l e w i t h d i a b ete s w h o d o n o t s m o ke . S m o k i n g increases yo ur b l o o d pressure. S m o k i n g raises yo ur b l o o d s u ga r level, m a k i n g it h a rd e r to control yo urdiabetes.Ohio Di ab etes Res o u rc es :Opportunities for Ohioans with Disabilitieshttp://www.ood.ohio.gov/ Ohio iabetes/odpcpresource.aspxColumbus Area Diabetes Support Grouphttp://diabetesohio.org/Home.aspxColumbus Diabetes Management mbus.org/diabetes-educationLiving Independent From Tobacco 22

D e c r e a s i n g Y o u r Risk:Smoking and Lung Disease Cigarette s m o k i n g is t h e m o s t c o m m o n ca u s e of l u n g disease. It affects all a s p ec t s of health, a n d in particular t h e u p p e r respirator y a n dt h e lungs, w h i c h a re t h e first parts of t h e b o d y to feel t h e direct effects o fsmoking. W i t h p ro l o n g e d ex p o s u re to s m o k i n g , di s ea s e o ccurs leading to chro ni cair f l o w obstruction a n d a further a n d ra pi d deterioration in t h e ability tobreathe. Smoking decreases the elasticity of the tiny air sacs in your lungs. In orderto get enough oxygen, a chronic smoker has to take m o re breaths than thenon-smoker. Cigarette s m o k i n g is a s s o ci ated w i t h a n i ncrea s ed i nci dence of respirator yinfections a n d d e a t h s f ro m p n e u m o n i a a n d influenza.Ohio L u n g D i s e ase R e s o ur c e s:Ohio Lung Disease ryCall 614-293-4925 to schedule an appointmentCleveland Clinic—Lung Disease disease#health-information-tabCall 216-444-3386 to schedule for an appointmentPulmonary Medicine Services—UC cal-care/23 Living Independent From Tobacco

D e c r e a s i n g Y o u r Risk:S m o k i n g a n d Sp in a l C o r d Injury S m o k i n g ca n re d u c e l ung capacity, w h i c h is a l re a d y re d u c e d after a SCIespecially if t h e d i a p h ra g m is paralyzed. S m o k i n g also i ncrea s es m u c u s pro ducti o n, w h i c h ca n b e difficult for ap e rs o n w i t h a SCI to expel. S m o k i n g ca u s e s p re s s u re ulcers to a p p e a r m o r e quickly, a n d also increasest h e h e a l i n gt i m e . S m o k i n g increases a n a l rea dy elevated risk for b l a d d e r cancer.Tobacco u s e n o t o nl y affects a n individual’s physical level d u r i n grehabilitation b u t also their level of c o m m u n i t y participation a n d mobility.Several limiting factors dur i ng t h e rehabilitation p h a s e for a n individual w i t hSCI w h o u s e s to ba cco are: Li mi ted access into public buildings d u e to n o n s m o k i n g regulations. Li mi ted access to certain m o d e s of transportation. D e c re a s e d l ung ca pa ci ty for leisure a n d fitness participation. I n c re a s e d risk fo rchi l dren. At risk for s e co n d a r y illnesses related to to ba ccoOhio Spi nal C o r d Injury R e s o u r c es:Spinal Cord Injury Rehabilitation n-programResource Directory, d.org/rehab-directory/ohio/Cleveland FES Center—Resources Spinal Cord s Stokes Cleveland VA Medical Center—Brain and Spinal Cord Injuryhttps://www.cleveland.va.gov/services/Spinal Cord Injury.aspOhio Support Groups for Spinal Cord oups-spinal-cord-injury-ohio/Living Independent From Tobacco 24

D e c r e a s i n g Y o u r Risk:S m o k in g a n d C e re b r a l P a lsy (C P ) Individuals ca n a g e m o r e rapidly b e ca u s e of t h e extra stress a n d strain t h edi s ea s e p u ts o n th e b o d y internally a n d externally, affecting p u l m o n a r y a n dcardiovascular systems t h e m o s t . Smoking worsens asthma, and other respiratory issues associated with CPworsening the inflammation of the airways. S m o k i n g ca n exacerbate cardiovascular issues a s s o ci ated w i t h CP, s u c ha s raising b l o o d pressure; therefore, increasing t h e risk o f h e a r t attack a n dstroke. H e av y s m o ke rs a re t w i c e a s likely to get m a c u l a r d e g e n e ra t i o n , resulting int h e g ra dua l loss of eyesight. S m o ke r s also r u n a n i n c re a s e d risk of cataracts. S m o k i n g ca n i ncrea s e t h e loss of s ens ati o n as s o ci ated w i t h C P by caus i ngconstriction of b l o o d vessels. Individuals w i t h C P a re c o m m o n l y m o r e susceptible to denta l deteriorationthat ca n b e w o r s e n e d by s m o k i n g . S m o k i n g stains yo ur te et h a n d g u m s , a n d increases yo ur risk ofper i o do nta l disease, w h i c h ca u s e s s w o l l e n g u m s , b a d b re a t h a n d loss ofteeth. Tobacco ca n increase behav i o ra l p ro b l e m s a n d intensify irritability.O h i o Cer ebr al Pal sy R e s o u r c es :Stepping Stones & United Cerebral Palsy of Greater 31-4660United Cerebral Palsy of Greater Clevelandhttps://www.ucpcleveland.org/Nation al Cer eb r al Palsy Resou r ces:Un ited Cereb ral Palsy: h ttp ://www.u cp .o r g/25 Living Independent From Tobacco

D e c r e a s i n g Y o u r Risk:Smoking and Sensory Loss“ S m o k i n g Affects M y H e a r i n g Loss?” S m o ke rs ca n lose h e a r i n g u p to 1 6 y e a rs s o o n e r a n d a re m o r e susceptibleto h e a r i n g loss ca u s e d by e a r infections. S m o ke rs a re 7 0 % m o r e likely t h a n n o n - s m o ke rs to suffer h e a r i n g loss. O n c e d a m a g e is d o n e , it ca n n o t b e re p a i re d . H e a r i n g loss b e g i n s w h e n you’ve s m o ke d regularly for m o r e t h a n a year. S m o k i n g affects t h e structure of t h e d ev e l o p i n g brain affecting ability tofo c u s a n d identify s o u n d . A g i n g w i t h tinnitus ca n w o r s e n w i t h s m o k i n g . T h e risk of b e c o m i n g h e a r i n g i mp a i re d o f ten increas es w i t h t h e n u m b e r ofcigarettes s m o ke d , a s wel l a s w i t h t h e intensity a n d t h e duratio n of ex p o s ureto s m o ke .“ S m o k i n g Affects M y Vision L o s s Too?” S m o k i n g h a s b e e n linked to d e c re a s e d n e a r a n d far s i g hted vision. S m o k i n g is also linked to cataracts a n d a g e related m a c u l a r d e g e n e ra t i o n . S m o k i n g m a y ca u s e blindness! This is a big d e a l for t h o s e relying o n their vision! You m a y lose it! Ev i d e n c e s h o w s that there is a relationship b e t w e e n cigarette s m o k i n g a n di ncrea s ed diagnosis of g l a u c o m a a n d Graves’ o phtha l mo pathy.Ohio H e a r i ng & Vi si on Loss Services:Bureau of Services for Visually Hearing Loss Association of America – Ohio Chapterhttp://www.hearingloss.org/support resources/find-localhlaa-chapter#ohioHearing, Speech, and Deaf Center of Greater Cincinnatihttp://hearingspeechdeaf.org/Living Independent From Tobacco 26

D e c r e a s i n g Y o u r Risk:Smoking and StrokeH a d a stroke?Quit Smoking Stroke is essentially a p rev e nta b l e di s ea s e a n d s m o k i n g greatly increasesyo ur risk. T h e ra py ca n h e l p y o u rega i n functioning, b u t quitting s m o k i n g willsubstantially i mpro ve t h e o u tco m e ! S m o k i n g d o u b l e s o n e s risk of a stroke, b u t after b e i n g s m o ke free for ap e r i o d of ti me, t h e risk declines to that o f a n o n s m o ke r ! ! D i d y o u k n o w that t h e c h e m i ca l s in cigarettes ca n interfere w i t h s o m em e d i ca t i o n s !K n o w t h e signsO h i o S t r o k e R e s o ur c e s :Heart Disease and Stroke Prevention pxFinance Tips and Guide for After e/ucm489492.pdfN ati onal S t r o k e R e s o ur c e s :A m e r i c a n Stro ke Association:w w w . str o keasso ciatio n.o r gN ati onal S t r o k e A s s oci ation:www.stroke.org27 LivingIndependent FromTobacco

D e c r e a s i n g Your Risk:Smoking and HeartDisease S m o k i n g l ea ds to co mpl i cati o ns s u ch a s a h e a r t attack, stroke a n dh a rd e n i n g of t h e arteries. Cigarette s m o k i n g i ncrea s es t h e risk of co ro n a r y h e a r t di s ea s e byitself.W h e n it acts w i t h o t h e r factors, it greatly increases risk. S m o k i n g increases b l o o d pressure, d e c re a s e s exercise to l e ra n c e a n dincreases t h e te n d e n c y for b l o o d to clot. S m o k i n g also increases t h e risk o f recur rent co ro n a r y h e a r t di s ea s e afterby p a s s surgery. S m o k i n g d e c re a s e s H D L ( g o o d ) cholesterol. Cigarette s m o k i n g c o m b i n e dw i t h a family history o f h e a r t di s ea s e also s e e m s to greatly increase t h e risk. Cigarette s m o k i n g is t h e m o s t i m p o r ta nt risk factor for a h e a r t atta ck inyoung men and women.O h i o H e a r t D i s ease R e s o ur c es:Heart Disease and Stroke Prevention pxHeart Disease Fact Sheet for Menhttps://www.cdc.gov/dhdsp/data statistics/fact sheets/fs men heart.htmHeart Disease Fact Sheet for Womenhttps://www.cdc.gov/dhdsp/data statistics/fact sheets/fs women heart.htmNational Heart Disease Resources:A m e r i c a n H e a r t Association :www.heart.org/HEARTORG/Car d iovascu lar Disease F o u n d a t i o n :http://www.cvdf.org/Living Independent From Tobacco 28

D e c r e a s i n g Y o u r Risk:A g i n g w i t h DisabilityN a t u ra l A ge - Re l ate d D e c l i n e is E xa c e r b a t e d b y S m o k i n gA g e a n d to b a c co related decline ca n b e s e e n in d e c re a s e d functioning in: Res pi rator y system - i m p a c t s t h e ability of yo ur lungs to ta ke in oxygen. Smell/Taste - re d u c e s yo ur s e n s e of smell a n d d e c re a s e s t h e n u m b e r o ftaste b u d s in yo ur m o u t h . Ca rdi o va s cul a r system - build-up of fatty depo s i ts inside yo ur arteries,p o o r circulation, h i g h b l o o d pressure, a n d a hi g her h e a r t rate. Gastrointestinal system - affects yo ur b o d y ’s ability to p ro d u c e digestivee n z y m e s a n d saliva a s wel l a s increases yo ur risk of ulcers. M us cul o s kel eta l system - ca u s e s b o n e a n d m u s c l e loss.Effects o n Medications R e d u c e t h e effectiveness o f m e d i cat i o n s . M a ke drug therapy unpredictable. Increa s e t h e risk of possible side effects. M a ke the re co m me n d e d dosage invalid.B e ca uti o us if taking B eta blockers, anx i ety medi cati o n, H epar i n, Warfarin,Theophylline, Insulin, Lidocaine, Penta zo ci ne.O h i o A g i n g Resour c es:Ohio Department of bilityresourcenetwork/Council on Aging (Southwestern Ohio) http://www.help4seniors.org/Aging and Disability Resource gingAndDisabilityResourceCenterNation al A g i n g Resou r ces:Fed eral G o v e r n m e n t :h ttp ://www.u sa. gov / Top i c s/ S en io r s.sh t ml29 LivingIndependent FromTobacco

Living Independent From Tobacco 30

SESSION 3C o n t i n u i n g YourC o m m it m ent t oChange31 LivingIndependentFromTobacco

CONTINUING YOUR COMMITMENT TO CHANGESe s s i o n G o a l s : Discuss a ny potential w i t h d rawa l s y m p t o m s y o u m a y b e ex per i enci ng Discuss s o m e qui ck strategies to h e l p if y o u ex p e r i e n c e a ny w i t h d rawa lsymptoms E xa m a i n e s o m e of yo ur barriers to quitting to ba cco a s wel l a s exploringw h y y o u w a n t to quit us i ng to ba cco E x pl o re w h a t life will b e like in t h e f uture w h e n y o u quit us i ng to ba ccoLiving Independent From Tobacco 32

T H E 4 D’s: C O P I N G W I T H W I T H D R A W A LT h e 4 D’s listed b e l o w ca n b e a g o o d starting pl a ce t o h e l p y o u dea l w i t hcravings. Yo u ca n:T W O THINGS TO KEEP IN MIND: T h e l o nger y o u g o w i t h o u t tobacco, y o u will h av e less i ntens e a n d lessf re q u e nt cravings. Withdrawal symptoms typically peak at 2-3 days and then begin to goaway. All sy mpto ms are normal and temporary. If any of these conditionslast beyond a few weeks, or b e co m e very bothersome, please consult yourdoctor.33 LivingIndependent FromTobacco

Living Independent From Tobacco 34

BARRIERSTO QUITTINGA l m o s t A L L s m o ke rs h av e barriers to quitting. T h e s e a re b a c k d o o rs t h eyleave o p e n that ke e p t h e m f r o m quitting. H e re a re s o m e of t h e ro a d blocksthat ke e p p e o p l e f ro m q u i tt i n g : I’ll ga i n t o o m u c h we i g ht – o nl y a b o u t o n e in three p e o p l e ga i n w e i g htw h e n t h ey quit tobacco, a n d t h e average ga i n is o nl y a b o u t 5-7 p o u n d s .S m o k i n g a n d eati ng a re b o t h w ay s to m e e t certain n e e d s (stimulation,relaxation, p a m p e r i n g , t i m e out, co mfo rt, o r socialization), s o w h e n y o u quittobacco, y o u m a y e a t m o re . Eat fo o d s w i t h hi gh fiber a n d p ro te i n to stayfuller longer. I’ve c u t w a y d o w n - s m o k i n g in a ny a m o u n t h a r m s ever y pa r t o f yo ur body.Plus, m a n y s m o ke rs will m a ke u p for s m o k i n g fewer cigarettes by puffingh a rd e r a n d inhaling d e e p e r o n t h e o n e s t h ey D O s m o ke . You n e e d to s to pus i ng a ny tobacco. M y p a r t n e r will m a ke it h a r d for m e to quit – tell yo ur s po u s e that quittings m o k i n g is ver y i m po r ta nt to you. A s k h i m / h e r n o t to s m o ke a ro u n d y o u o roffer y o u cigarettes. M a ke h i m / h e r s m o ke o uts i de a n d d o n o t a l low s m o k i n gin t h e car. M a y b e y o u b o t h ca n quit together. M y friend will offer m e cigarettes – a s k y o u r friend n o t to s m o ke a ro u n dy o u o r offer y o u cigarettes. If t h ey d o n o t comply, avoid t h e m for a while. There is too m u c h stress in m y life to quit n o w – there is no per

Each year, around 443,000 people die from smoking or exposure to secondhand smoke, and another 8.6 million suffer from a serious illness from smoking. It is estimated that about half ofall smokers eventually die from smoking-related diseases. Smoking incre