It s never too late to quit smoking

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3 It s never too late to quit smoking In as little as 20 minutes of not smoking, your body already begins to heal from the damage of smoking. TIME DURATION HEALTH BENEFIT 20 minutes Your blood pressure and pulse rate drops 8 hours Carbon monoxide (poisonous gas) level in your blood and blood pressure drop to normal. The oxygen level in your blood goes up to normal. 24 hours Your lungs starts to work better, and you fell less out of breath. Your chance of a heart attack goes down. 2 days You may be coughing as your lungs work to clean out some of the poisons left by smoking. You can taste and smell things better than before. 2 weeks to 3 months Your blood flow improves. Walking or exercising becomes easier. Lung function can go up by 30%. 1 to 9 months You may notice less coughing, sinus congestion, fatigue and shortness or breath. 1 year Your risk of dying from a heart attack goes down by 50% compared to that of a smoker who smokes 1 pack per day. 5 years or more Your risk of a stroke goes down to that of a non-smoker. Your risk of dying from lung cancer goes down by almost 50% compared to that of a smoker who smokes 1 pack per day. 15 years Your risk of dying from a heart attack is the same as a non-smoker. December 2012

4 Frequently Asked Questions about Nicotine Replacement Therapy (NRT) Is NRT safe? NRT is safe. When you smoke a cigarette, you are getting nicotine and over 4000 other chemicals. When you use a NRT, you are getting only nicotine. Disease related to smoking is caused by cigarette smoke and not nicotine. Can anyone use NRT? Almost anyone can safely use NRT but it might not be the right choice for you. If you are pregnant, breastfeeding or have any other medical condition, it is important to consult with your healthcare provider before starting to take NRT. How does NRT work? NRT works by giving your body some of the nicotine it used to get when you smoked cigarettes. The nicotine from NRT will lessen the effects of nicotine withdrawal. This means that NRT will lessen symptoms like headaches and cravings. NRT will make you more comfortable so you can concentrate on quitting smoking. Over time, you will be able to reduce the amount of NRT, until you are completely free of nicotine. Will NRT help me quit smoking? There are over a hundred scientific research studies showing that NRT helps smokers quit. NRT does not guarantee that you will quit smoking for good. Quitting smoking can be difficult and it might take a few tries to quit. How long can I take NRT? That depends on you. Sometimes, NRT needs to be used longer than what it says on the package. It is better for your health to keep using NRT than to go back to smoking. Please consult with your healthcare provider before using NRT longer than the manufacturer s recommendation. Is NRT expensive? It depends on which product and how much you need. NRT costs about the same as smoking a pack of cigarettes per day. The B.C. Smoking Cessation program helps B.C. residents stop smoking by assisting them with accessing free or subsidized smoking cessation aids. Call for more information. Will I become addicted to NRT? No. Cigarettes are highly addictive because they deliver nicotine to the brain very quickly. NRT delivers nicotine more slowly and in smaller amounts. Can I combine NRT? Gum, inhalers or lozenges can be used with the patch. The faster acting gum, inhaler or lozenges can be used as needed to manage cravings. Consult with your healthcare provider before combining NRT. Can I smoke while using NRT? Nicotine gum can be used to cut back on cigarettes. You will gradually decrease the number of cigarettes smoked in a day by replacing cigarettes with nicotine gum. Ideally, you should not smoke while on the patch but if you do, it probably means your nicotine cravings are not satisfied. Consider increasing your patch dose, adding gum, lozenges or inhalers to manage cravings. Please consult with your healthcare provider before combining or increasing your dose of NRT over the manufacturer recommendation. Based on the OMA Position Paper Rethinking Stop Smoking Medications: Treatment Myths and Medical Realities. January Reviewed by Dr.. M. Khara, MBChB., CCFP., cert.asam. Stop Smoking Medications Nicotine Replacement Therapies (NRT) & Prescription Medications PHEM Catalogue N0. DB.422.S76 December 2012

5 Choosing a stop smoking medication? Description Instructions Cost Possible Side Effects Nicotine Patch Nicotine from the patch is absorbed through the skin into the blood Nicotine patches come in 3 strengths - 7, 14 & 21 mg Takes up to four hours to reach peak levels of nicotine in the blood Provides a steady dose of nicotine Apply patch on to clean, dry skin Change patch every 24 hours If you have difficulty sleeping, remove before bedtime Regularly change location on the skin $25-30/wk Skin rash Sleep disturbance Headache Dizziness Nausea Stomach upset Nicotine Inhaler Nicotine from the inhaler is absorbed through the mouth into the blood The nicotine inhaler is a thin plastic tube containing a nicotine cartridge Takes 20 minutes to reach peak nicotine levels in the blood Do not puff on inhalers like a cigarette. Nicotine vapour is held in the mouth and not drawn into the lungs Puff as needed to manage cravings Take slow puffs to avoid throat burn Avoid eating and drinking 15 minutes before and after use Mouth pieces can be cleaned and reused $40/wk Itchy mouth/throat Headache Nausea Nicotine Gum Nicotine from the gum is absorbed through the mouth into the blood Nicotine gum comes in 2 strengths 2mg & 4mg Takes 30 minutes to reach peak nicotine levels in the blood Nicotine gum is not chewed like regular gum Chew until there is a peppery taste and then park between the teeth and inside of cheek $40-55/wk Clings to dentures Nausea Hiccups Jaw pain Itchy mouth Nicotine Lozenge Stop Smoking Prescription Medications Nicotine from the lozenge is absorbed through the mouth into the blood Nicotine lozenge comes in 3 strengths 1mg, 2mg & 4mg Takes 30 minutes to reach peak nicotine levels in the blood Bupropion SR (Zyban) Comes as a pill Also used as an anti-depressant Reduces nicotine withdrawal symptoms Varenicline (Champix) Comes as a pill Reduces nicotine withdrawal symptoms and smoking satisfaction Allow the lozenge to dissolve in the mouth $40-55/wk Nausea Headache Heartburn Coughing Hiccups To be taken one week before stopping smoking Not recommended for people with a history of seizures, eating disorders or using certain medications To be taken one week before stopping smoking $15-36/wk Sleep Disturbance Dry mouth Nausea Sleep disturbance Serious mood change (rare)

6 Want to stop smoking or using other types of tobacco? The BC Smoking Cessation Program helps with the cost of products that can make it easier to stop smoking What does the program cover? It covers 12 weeks (84 days in a row) of treatment once each calendar year for either Nicorette gum or lozenges or inhaler, or Nicoderm patches. These nicotine replacement products are available at no cost. Prescription smoking cessation drugs bupropion (Zyban ) or varenicline (Champix ): Covered by BC PharmaCare in the same way as other prescriptions. The actual cost depends on the rules of your PharmaCare plan, which may pay for all, part or none of the cost. Who can take part? Nicotine replacement therapy products are available to B.C. residents who smoke or use another tobacco product (e.g., takes snuff, chews tobacco), and has active Medical Services Plan coverage. PharmaCare covers the prescription drugs for any B.C. resident who smokes or uses another tobacco product (e.g., takes snuff, chews tobacco), has active Medical Services Plan coverage, and is covered by an eligible PharmaCare plan. PHARMCARE MINISTRY OF HEALTH January 2016

7 What are nicotine replacement products? Nicotine replacement products are non-prescription medications that contain nicotine. They can make quitting easier by letting you slowly reduce the amount of nicotine in your body. What are smoking cessation prescription drugs? Bupropion (Zyban ) and varenicline (Champix ) do not contain nicotine. They work on the brain to help make quitting easier and to reduce cravings. When you are already seeing your doctor for another reason, ask about these drugs. Your doctor can help you decide if a prescription for one of these drugs is right for you. How do I get the product? Nicotine gum, lozenges, inhaler or patch Bupropion (Zyban ) or varenicline (Champix ) Visit your local pharmacy. You do not need a prescription but you will need to sign a declaration form. When you next see your doctor, ask about your options. If you and your doctor agree on one of these drugs, take your doctor s prescription to your pharmacy. Other tools and resources Get more information about the Smoking Cessation Program, including the specific products covered... Find out how to succeed in quitting... Register for Fair PharmaCare or learn more about PharmaCare... Visit Speak to your doctor or pharmacist. Visit for 24-hour free counselling to help you quit smoking. Visit or Call Health Insurance BC: From Lower Mainland, call From the rest of B.C., call BC PharmaCare is the provincial drug insurance program. It helps British Columbians with the cost of eligible prescription drugs and certain medical supplies.

8 YOUR PLAN STEP 1: Reason(s) for quitting/cutting down: Set your Quit Date: Day Month Year Reduce to Quit Plan: Week 1 Week 2 Week 3 Week 4 STEP 2: Your Quit Smoking Medication(s) Call HealthLinkBC at and receive up to 12 continuous weeks of FREE nicotine replacement therapy (gum or patch) Nicotine Replacement Therapy (NRT) Patch Inhaler Gum Lozenges Mouth Spray Varenicline (Champix) Bupropion (Zyban) *Remember, if you are taking Varenicline or Bupropion, start the medication 8 days before your quit date. STEP 3: Your Follow-up Support Quit Smoking Automated Follow-up program QuitNowBC (by phone, TXT, online) Self-help Resources Community Programs: Family Doctor Support Buddy (friend, family member, coworker, etc.): YOUR PLAN: It is important to identify, and to be prepared for, situations in which you may feel tempted to smoke. SITUATION YOUR PLAN

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