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Your Pathway to Better Health

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					      Diary



Your Pathway to Better Health
CONGRATULATIONS
    You are a deadly member of
             NCACCH‟s
     „No Durri For This Murri‟
              program


    North Coast Aboriginal Corporation for
  Community Health and the Sunshine Coast
 Division of General Practice want to wish you
              well on your journey.

   We are working in partnership to provide
support and information to help you quit smoking
    and hope this guide will be useful to you.

  Let us know if you have any feedback and/or
   suggestions for this and future programs.




                                                   2
Why Did Our Mob Start Smoking?




  •Dry leaves of pituri and native tobacco (Nicotania
  gossei) were traditionally harvested, prepared,
  traded and chewed by Aboriginals.

  •Tobacco, and the practice of smoking, first
  reached the shores of Northern Australia over 400
  years ago with Macassan (Indonesian) fishermen.
  They acknowledged Aboriginal ownership of the
  land and offered pipes, tobacco and other valued
  goods in return for access to the coastal waters.
  Macassan style pipes and tobacco still play a role in
  traditional ceremonies today.

  •Europeans offered tobacco and pipes to Aboriginal
  people as a token of goodwill and later in exchange
  for labour and goods and services.



   Smoking rates are between 50-80%
     in communities across Australia,
    compared to under 20% smoking in
      the non-Indigenous population.                      3
What is involved?

1. Register and sign up to Quit smoking


2. Regular contact with your „Quit Coach‟ is a
    must.


3. Free products and services to help you
    quit (to a certain limit)


4. Agree to visit your GP and let her/him
   know you are registered with NCACCH’s
   program to quit smoking. Say you want a
   ‘long consult for a Quit Visit’.


5. Return to your GP at least every 3
    months to monitor your health and
    progress

                                                 4
             NCACCH CARD HOLDER

               Attend “Smoking Cessation Program”
                 Information / Registration Session


     Discuss your
 smoking and quitting
                               Quit
                                               Ongoing contact to
   history, and what                           support you and to
                              Coach
  support is right for                          see how you are
 you eg. Acupuncture,                                going
    Hypnosis, NRT,
    Counselling etc


  Must visit GP                                           Is the link
after registration                                         between
                                        NCACCH
 and Quit coach                                           NCACCH,
   discussion.
Ask for a „LONG
                           GP           Support
                                                           GP‟s and
                                                           the Quit
CONSULT‟ for a                           Worker             Coach
    Quit visit.
 Bring your new
 card and diary.




                               If         Program      Organise and
         You must        prescribed     support eg.      facilitate
          see your        Champix,       questions,       support
         GP at least      you must         don‟t          groups,
           every 3        visit your    understand     phone/internet
          months         GP after 4    something etc    support etc
                           weeks
                   82% of all
                  drug related
                   deaths are
                   caused by
                    tobacco
                                   There are
    Is more
                                     4,000
 addictive than
                                  chemicals in
     heroin
                                   cigarettes



                  Nicotine


Most smokers begin to crave their next cigarette
  every 45 - 90mins (Tobacco companies have
 designed a pack of 20-25 cigarettes for these
                time intervals).




                                                                6
                                       Painting by Dale Manns
About Nicotine
   Causes a rapid release of adrenaline which
   makes your heart beat faster, raises blood
    pressure and makes your blood vessels
                     narrow

     Causes more calories to burn (without
    exercise) but over time will increase bad
    cholesterol (LDL) which will damage your
                    arteries


    May block the release of insulin so you will
     have more sugar than usual in your body


  Once you decide to quit smoking, it only takes a
      few hours for most people to experience
  withdrawal symptoms. It takes only 12 hours for
        almost all nicotine to leave the body


   80% of nicotine in the body is broken down by
    enzymes in the liver. If you have a slow liver
    metabolism, it will take longer for nicotine to
                  leave your body


   Once you quit smoking, the effects of caffeine,
    insulin and many medications will affect you
     more strongly – you may need to cut down


   Withdrawal symptoms are a sign your body is
   adjusting and regaining health. You are on the     7
   road to improved blood pressure, circulation,
     immunity, taste, smell, sleep, breath, life!
     What kind of relationship do you
          have with smoking?
     The short test below can help you to
        understand the way you relate to
                    smoking.                           Yes No
Tick either yes or no to all of the questions.
                                                       1.
1.    Do you smoke within half an hour of waking
      up?
                                                       2.

2.    Is it extremely difficult for you to go for
      half a day without smoking?                      3.



3.    Do you have a frequent craving for               4.
      cigarettes?

4.    Do you feel a need to smoke a minimum            5.

      number of cigarettes each day?
                                                       6.

5.     Do you often find yourself smoking a
      cigarette when you aren't aware of lighting      7.
      one up?

6.    Do you link your smoking with other
                                                       8.


      activities, like drinking coffee or talking on
      the phone, drinking alcohol or getting           9.

      together with family or friends?
                                                       10.

7.    Do you sometimes unintentionally go a whole
      day without smoking?

8.    Do you smoke more after having an
      argument with someone?

9.    Is smoking one of the most important
      pleasures in your life?
                                                             8
10. Does the thought of never smoking again
    make you feel unhappy?
   Scoring The Test
   If you answered              Seek advice from a
„YES” to two or three             Doctor about
of questions 1,2,3 or            medications and
  4, you most likely                 Nicotine
   have a chemical                Replacement
       addiction                     Therapy


   If you answered
                                 Get a Referral for
„YES” to two or three
                               counselling or attend
of questions 5,6 or 7,
                                a support group to
    you most likely
                               help change how you
    smoke through
                                     do things
   habits or rituals


   If you answered
„YES” to two or three             Get a Referral for
  of questions 8,9 or          Counselling or attend
  10, you most likely            a support group to
     deal with your               find new ways to
 feelings by having a          relax in difficult times
       cigarette



           If you answered “YES” to all the
         questions, you may need to combine
                                                     9
                      the above
Getting the support you need...
1. Tell your Doctor you want to quit
      - Ask about Champix, Zyban and NRT
      - Ask for a referral for counselling
2.     At the Pharmacist
     - Ask about how to use medications correctly
     - Ask about how to use Nicotine Replacement
       Therapy
3.     Counsellors and Psychologists
      - Can help with putting your decision to quit into
        action
      - Discuss changes to lifestyle and relationships
      - Explore your smoking triggers
      - Help you work out ways of coping with withdrawal
      - Work on helping you prepare for relapses
      - Can help with finding your way (what works best
        for you)
      - Can help you stay clear about why you’re quitting

4. Websites to help you quit
     www.outsmartcigarettes.com.au
     www.quitnow.info.au
     www.howsyoursugar.com.au/#/smoking
     www.quit.org.au/browse.asp?ContainerID=1587
     www.ashaust.org.au
                                                            10
Getting the support you need...
  5. Special local Quit Providers
   ACUPUNCTURE
  Acupuncture treatments during this time will focus on calming the
  mind and alleviating anxiety and to help address physical symptoms
  of withdrawal. If you are very motivated and ready to quit
  smoking, acupuncture can help to empower you to take control of
  your life and begin a healthy smoke free life.

  HYPNOSIS
  Hypnotism to stop smoking is an excellent way to end your smoking
  habit because the success rates are possibly double that of the
  patch and gum. You can also use hypnosis together with other stop
  smoking programs like the patch to achieve even better results.

  Allen Carr‟s EASYWAY to Stop Smoking
  Allen Carr's Easyway® method is the only quit smoking method
  that removes the desire to smoke. By removing the desire, we can
  remove the conflict. With no conflict, the whole quit smoking
  process is easy and, for many people, extremely enjoyable and
  empowering.
  Allen Carr clinics are the most successful smoking cessation clinics
  in the world!

  6. Contact NCACCH about group sessions,
  web, SMS and community activities.
                                                 Most smokers try
                                                to quit many times
                                                 before success –
                                                try different ways
                                                   until you do!
                                                                         11
• How you’re coping with quitting –
  what gets you through the tough times

• The ups and downs of the journey

• Helpful hints and tips

• Why doing this matters to you. What
  difference is it making in your life

 NCACCH will send you details on each session



Painting by Dale Manns
                                                12
                          sport

          smell/taste                 health




 family                                        finances




education                                       time




          Children‟s
                                      teeth
           health
                        friendships



                                                       13
Thinking about quitting
I usually smoke with………
Smoking is easier when………
Not smoking is easier when……..
Smoking fools me into
 thinking…………..
Smoking plan for my life…….
My hopes for my life………..
 Why I want to quit……………
How will me quitting make a
 difference for?.............
When I quit I will be able to……….
Who might I inspire by
 quitting?........
          „Cold Turkey‟ can work
           for some smokers who
             are not chemically      14
            addicted to nicotine
Working on smoking triggers...
I smoke...               Is this okay?      What can I do instead?
when, where, how,        What are the
why or with....          effects of
                         doing this?
e.g. In my comfy chair   Not if I want to   Make sure I go outside onto
with the paper           quit               the footpath to smoke




                                                                             15

     “From little things, big things grow...”   Kev Carmody and Paul Kelly
What would make me take up
smoking again?


What needs to happen so I can
say no to smokes in crisis times...



Say no when I forget I already quit


Say no even if I drink...


Say no even if I take other drugs..

                                           16

    Anytime: Phone the Quitline 13 78 48
Think about:
• where you smoke - in the
 home/car/workplace
Do you live with a smoker?
Are more than 50% of your friends
smokers?
Try to do these:
• Smoke outside (it is the gateway to
 quitting)
• Smoke outside car (it is also the gateway
 to quitting)
• Get everyone to smoke outside
• Don’t avoid your usual friends/family,
  places and cues – but be smoke-free
• Avoid people smoking around and near
  you                                  17
                   (Garvey, 1992) (Gilpin, 1999) (Thewissen, 2008)
Medications that may help you to quit...
                    CHAMPIX helps reduce craving and withdrawal
                      symptoms, and takes the enjoyment out of
                      smoking cigarettes.

                    Start Champix 7-14 days before your quit date.

                    Take a white tablet daily for 3 days.

                    On days 4-7 take one in the morning and one in
                       the evening




                                               From day 8: take light
                                               blue tablets - morning
                                               and evening - until the
                                               end of the script.




                                   At 4 weeks, visit your Doctor
                                   again for a check-up and
                                   prescription for the next 8 wks


Take Champix with a full glass of water
and with food (as it may cause nausea).

Try not to take Champix close to your
bedtime as it may cause sleep disturbance.
                                                                18

Take Champix for the full 12 weeks – no less.
Zyban and
Nicotine Replacement Therapy...
 Zyban is an antidepressant medication, found to be good for
 helping people to quit.

 Zyban is not often prescribed as seizures or fits are a possible
 side-effect.

 Zyban helps with cravings and unpleasant withdrawal symptoms.
 You would need to take Zyban for about 7 weeks

 About „Nicotine Replacement Therapy‟ (NRT)...

 NRT delivers a smaller and slower dose of nicotine to the brain
 to decrease the urge to smoke.

 Try a patch and see what happens! Wearing NRT patches can
 help you reduce smoking and reduce the harm it does to your
 body.

 Use full strength NRT patches for 24 hours a day for at least
 6-8 weeks.

 NRT is free of the cigarette’s poisonous gases and chemicals,
 and safe for pregnant women (except for patches) and
 children.

 Use NRT patches with medications and other NRT products as
 directed by your doctor.

 Gum, lozenges and microtabs can be used when you get a bad
                                                            19
 urge to smoke. Keep them handy in the car or pocket.
How to use NRT products...


    NRT patches
                        Press onto hairless area of skin
                        above the waist.

                        Change this place for every
                        patch to avoid skin problems.

                        If patch falls off with sweating
                        – use a medical adhesive tape.
                       Suggest using 21mg NRT patch
                       24hrs/day apply nightly before sleep.
                       Seek advice if more is needed.

    NRT gum
                         Chew slowly until you feel tingling.

                         Place the gum in cheek or under
                         tongue until tingling goes.

                         Chew again to get tingling, then
                         park again in mouth.
                         After 30mins throw gum away and
                         use a fresh piece – repeat as
                         above.
                         Do not eat or drink with gum.

                             Suggest using 4mg Gum
                             for extra help with cravings 20
                             – use as much as needed.
How to use NRT products...

                                  NRT microtab
 Press out a tablet and place
 under the tongue.

 Allow to dissolve – do not
 chew or swallow.
 Use as much as needed

  Do not eat or drink with
  microtab in mouth


                                   NRT lozenge
 Place in mouth and allow to
 dissolve slowly.
 Do not suck or chew.
 Do not eat or drink with
 lozenge in the mouth.
 Use as much as needed to stop
 cravings.
  Suggest using 4mg lozenge


                                  NRT inhaler

  Take a shallow puff every 2
  seconds, or 4 deeps puffs
  every minute for 20 minutes

  Helps with cravings – good to
  keep in car, office or for
  social occasions.                              21
22
                 Appointments
Date        Provider Name                               Time
            eg. other GP, Counsellor, Acupuncture etc




   My usual GP‟s Name:
   Medical Centre:                                             23
   Quit Coach:
               Special thanks to:

       Aunty Olive Bennet, Corey Czok,
       Gordon Browning, Brett Windeatt,
       David McNamara, Renee Bittoun,
      Cancer Council (Qld), Quit Victoria,
           Jane Hutton, Judy Venn

We would like to acknowledge Gordon Browning
 for the cover painting and Rick Roser (unless
 otherwise indicated) for the Aboriginal artwork
                   used inside


Thanks to the Department of Health & Ageing
     (DOHA) for funding the program

              Designed and compiled by
       Sharelle Eggmolesse and Renate Millonig



Indigenous Smoking Cessation Pilot Program




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