AFP HEALTH SERVICE COMMAND

AFP HEALTH SERVICE SOUTH

CAMP NAVARRO GENERAL HOSPITAL
NURSING SERVICE OFFICE
Camp Don Basilio Navarro
Upper Calarian, Zamboanga City

Topic: Smoking Cessation Time: 20 minutes

Terminal Learning Objective:

After 20 minutes of health teaching, the patients will be able to discuss the facts on quitting smoking.

Enabling Learning Objective:

At the end of this lecture, the patients will be able to:

1. Enumerate the benefits of quitting smoking.

2. Identify the challenges to quitting smoking.
3. Determine ways to cope with withdrawal symptoms.
4. Identify different behavioral coping skills to quitting smoking.

Instructional Materials/ Equipment: pamphlets, poster, tablet

Outline of Instruction Instructor Activity/ Activities
I. Introduction

Motivation  Establish rapport with the patients

Statement of Lesson Objectives
 State and explain the lesson for the day.
Policy/ House Rules
 State the policy/ house rules.
Overview of Lesson
 Emphasize the topics
II. Presentation

Introduction

The use of tobacco continues to be a major  Ask the patients, “What diseases are known to be
cause of health problems worldwide. There is caused by smoking?”
currently an estimated 1.3 billion smokers in the  Show the smoker’s body poster
world, with 4.9 million people dying because of  Emphasize the facts that smoking causes death,
tobacco use in a year. If this trend continues, the disease, and disability
number of deaths will increase to 10 million by the
year 2020, 70% of which will be coming from
countries like the Philippines. (The Role of Health
Professionals in Tobacco Control, WHO, 2005)

1. Benefits of quitting smoking  Ask patients what they think their benefits of
quitting would be.
Some reasons smokers give for quitting:
 Reduced risk of heart attack, cancer, and
stroke
 Feeling more in control of life
  Better smelling hair, breath, clothes, house
 More stamina when walking or exercising
 Less coughing, colds, and flu

Benefits to people around smokers who quit

 Children with mothers/fathers who do not
smoke have half the bronchitis, pneumonia,
ear and lower respiratory tract infections as
do children with parents who smoke,
 Spouses of non-smokers have half the lung
cancer risk of spouses living with smokers.

Benefits of quitting start within days

 As the carbon monoxide level in the blood
decreases, the oxygen level increases to
normal.
 The heartbeat slows to normal.
 The lungs begin to clear and repair
themselves.

Long-term benefits of quitting

 After 1-2 years of not smoking, the ex-
smoker’s risk of a heart attack drops sharply
and gradually returns to normal after 10
years.
 After quitting smoking, the risk of cancer is
reduced when compared with continued
smoking. However, cessation may not
reduce the former smoker’s risk level to that
of an individual who never smoked.

2. Challenges to quitting smoking

 Discuss
 Address any concerns about weight gain.
 Addiction
Most smokers are addicted to nicotine and
will crave cigarettes.
 Habit
Smokers smoke automatically in specific
situations every day.
 Reward
Some smokers relax or obtain pleasure
from smoking.
 Stimulant
Some smoker when they are tired and want
to feel more energetic.
 Weight gain
Many smokers gain weight after quitting.
 Social
Most smokers have friends or relatives who
smoke
 Time filler
Many smokers smoke when they are bored
or have nothing to do.

 Coping
 Most smokers smoke when they feel
worried, upset, sad, or mad.

3. Coping with withdrawal symptoms  Emphasize the fact that these symptoms are
signs that the body is recovering from smoking.
 There will be withdrawal symptoms after  Refer to Figure 1. (List of withdrawal symptoms
quitting. Give examples such as lack of and tips to address these issues)
concentration, feeling tired, or being
restless.
 The withdrawal symptoms may come and
go, get stronger or weaker, or remain the
same. Tell the smoker to be prepared for
these changes.
 The withdrawal symptoms should last 2 to 4
weeks. Symptoms usually occur within 24
hours of stopping or reducing the number of
cigarettes smoked per day.

4. Behavioral coping skills  Discuss and demonstrate deep breathing

technique
Behavioral coping skills are actions that you do to  Invite questions from the patients
avoid smoking, such as:  Ask patients what coping skills they will utilize.

 Deep breathing
Deep breathing advantages:
>Quick and can be done anywhere.
>Helps cravings pass.
>Promotes feelings of relaxation.
>Helps to relieve feelings of tension,
nervousness, anxiety, and impatience
>Increases the flow of blood and oxygen to the
brain, helping to improve memory, alertness,
thinking, problem-solving, and decision-
making skills.

Deep breathing technique:

>Place 1 hand on your upper chest.
>Place your other hand on your abdomen
>Inhale through your nose.
>Take a slow, deep breath.
>Feel your belly expand outward.
>Breathe in for 3 seconds.
>Hold the breath for 3 seconds.
>Purse your lips.
>Breathe out slowly and evenly.
>Feel your belly move back inward.
>Breathe out for 6 seconds.
>Repeat 3 to 5 times.

 Oral substitutes
Oral substitutes are ways to keep your mouth busy.
When you smoke a pack of cigarettes a day, you
put your hand to your mouth several hundred times
a day. Your mouth gets a lot of attention. When you
stop smoking, your mouth still craves that attention.
Using oral substitutes can help you to quit smoking.
When choosing oral substitutes, look for low or no-
calorie items. Substituting highcalorie, high-fat
items can lead to weight gain. (e.g. Lollipops,
Cinnamon sticks, Toothpicks, Fresh fruits, Hard
candy, Gum, Brushing teeth, mouthwash, breath
spray, Fresh vegetables)

 Handling substitutes
Handling substitutes will give you something else to
do with your hands. (e.g. Rubber band, Paper clip,
Small ball, Pen, Doodling, Pencil, Ring, Coin, Straw
or coffee stirrer, Smooth stone, Wash hands,
Hobbies)

 Busy work
Busy work: Keep your hands busy and focus on
tasks. This will help you to fight the urge to light up.
Once you stop smoking, you will have more time to
give to other activities and people. Extra time can
become a problem if you do not find something to
fill this time. Choose activities that will mean
something to you and add enjoyment to your life.

 Exercise
Exercise increases chances of long-term success.
Exercise will:
>Help to prevent or slow any weight gain when
you quit smoking.
>Produce hormones to make you feel good.
>Help to reduce stress and relieve feelings of
tension, nervousness, anxiety, and anger.

 Relax and unwind

You may feel that smoking a cigarette helps you
to beat stress. Nicotine in cigarettes is actually a
stimulant that makes the heart beat faster and
increases blood pressure. You may think that you
are more calm and relaxed when you smoke. This
belief may be caused by a combination of three
things:

1. Your body has become used to a certain

amount of nicotine. When the amount of
nicotine in your body drops, you feel
uncomfortable. You then smoke another
cigarette, hoping to feel better.
2. You have probably smoked a cigarette
many times during stressful situations. Now
you connect smoking with feeling more
relaxed and in control of your problems.
Have you trained yourself to believe that
smoking calms you and makes you feel in
control?
3. Think about how you smoke a cigarette.
Perhaps you take deep, slow breaths. In
fact, it is deep breathing, not the cigarette
that actually calms you. It is important to
 understand that you, not the cigarette, have
been doing the calming and relaxing.
Cigarettes cannot pay bills, make traffic go
faster, or help you to deal with your boss.
Smoking has been your way of “setting the
stage” mentally to prepare yourself to relax.
As you focus on your journey to a smoke-
free life, you will learn new ways to relax.

 Medicine  Briefly discuss the available aids in smoking

(e.g. nicotine patch, gum, nasal spray, lozenge cessation.
and non-nicotine tablets like Chantix, and Zyban)

Journey to a Smoke-free Life (2014). UPMC Retrieved from

www.upmc.com/patients-
visitors/education/smoking/Documents/journey-to-a-
smoke-free-life.pdf

III. Review and Consolidation

 Summarize the important points.
Major Teaching Point

1. Benefits of quitting smoking

2. Challenges to quitting smoking
3. Coping with withdrawal symptoms
4. Behavioral coping skills