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LivingTobacco

TOOLKIT

Welcome

Congratulations, you are taking the first step to quitting tobacco.

The activities and information in this workbook can be used to stop cigarette smoking or other tobacco use.

This program was created to help you live life tobacco free. It is designed to help you quit by:

Helping you better understand the power of nicotine and why you smoke or chew.

Teaching you how to handle withdrawal symptoms and stress.

Teaching you tips to resist the urge to smoke or chew.

The more support you get, the more likely you will quit for good.

This toolkit is just one part ofthe Living Tobacco Free program.

Work with your Health Coach to learn about all of the tools available to you.

Health Coaches are here to help you quit for good!

Quitting isn’t easy. It may take several tries. But you learn something

each time you try.

As you work through this program, think ofthe word

NOPE: Not One PuffEver. Remember, this is your goal!

Table of Contents

Getting Started...... 4

Smokeless Tobacco...... 5

WeighingtheProsandCons...... 6

GettingReadytoQuit...... 7

My Tobacco Use...... 8

Triggers...... 9

Creating Your Quit Plan...... 10

MyQuitPlan...... 11

Helpful Tips...... 12

Nicotine Replacement Therapy...... 13

Pack Wrap...... 15

PackTrack...... 17

AfterYou’veQuit...... 18

PreventingRelapse...... 20

Will I Gain Weight When I Stop Smoking?...... 21

Staying Tobacco Free...... 22

Additional Resources...... 23

You may feel uncomfortable not smoking or chewing at times or in places where you usually do. These times and

places are called “triggers” because they turn on your nicotine cravings. Not smoking at these times is the hardest

part of quitting for some smokers. Don’t give up too soon. You will feel good again. It takes time to break free

from nicotine.

Cigarettes—notjustnicotine

Your body gets more than nicotine when you smoke. There are more than 4,000 chemicals in cigarette smoke. Some

of them are also in wood varnish, the insect poison DDT, arsenic, nail polish remover, and rat poison. The ashes,

tar, gases, and other poisons in cigarettes harm your body over time. They damage your heart and lungs. They also

make it harder for you to taste and smell things, and fight infections.1

Thelong-termrewardsofquitting

By quitting, you will add healthy, full days to each year ofyour life. You will greatly lower your risk ofdeath from

cancer and diseases, including:

SmokelessTobacco

Quittingdip,chew,snuff,andbetel

You may already know ofthe health risks ofusing smokeless tobacco. In addition to the health risks, you may

already have personal reasons for quitting.

TheDangers of

Smokeless Tobacco

Smokeless tobacco can:

Lead to cancer of the mouth, throat, and pancreas.

Cause tooth decay.

Damage your gums.

Give you mouth sores that can lead to cancer.

Researchshowsthatsmokelesstobaccocancauseheartdiseaseandstrokeaswell.5

Smokelesstobaccoaddiction

Smokeless tobacco is not harmless. It contains nicotine, which makes it addictive. Not only is it bad for your health,

it stains your teeth and clothes, smells, and gives you bad breath. It’s expensive too!

It is important to have the support offriends and family to help you quit.

Quitplan

It is important to know why you want to quit and to make a quit plan and stick to it! This toolkit can help you make

a plan to quit for good. Health Coaches are also available to help. Read on to learn more.

U.S. Department of Health and Human Services. Reducing Tobacco Use: A Report of the Surgeon General. Centers for Disease Control and Prevention,2000.

U.S. Department of Health and Human Services. Women and Smoking: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, CDC, National Center for Chronic DiseasePrevention

and Health Promotion, Office on Smoking and Health; 2001.

Centers for Disease Control and Prevention. Annual Smoking–Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 1997–2001. Morbidity and Mortality Weekly Report[serial

online].2005.

Centers for Disease Control and Prevention. Health United States, 2005 With Chartbook on Trends in the Health of Americans. (PDF–119KB) Hyattsville, MD: U.S. Department of Health and Human Services,CDC, National

Center for Health Statistics;2006.

U.S. Department of Health and Human Services. Reducing Tobacco Use: A Report of the Surgeon General. Centers for Disease Control and Prevention,2000.

Weighing the Pros and Cons

Think about why you want to quit smoking or chew. Think of more than just health reasons. For example, think of

how much money you’ll save by not buying cigarettes or how you will be setting a good example for your children.

Weigh the pros and cons to help you identify your most important goals and possible obstacles. Write your thoughts

in each section.

THEPROSOFSMOKING:THECONSOFSMOKING:

What do you enjoy about smoking or chewing?What are some ofthe things about smoking or

chewing that you dislike?

THEPROSOFQUITTING:THECONSOFQUITTING:

Why would it be good to give up smoking or chew?What would be the down side ofquitting?

Getting Ready to Quit

It’s OK to have mixed feelings about quitting. Don’t let that stop you. There will be times every day that youdon’t

feel like quitting. Try to stick with it anyway.

Find reasons to quit that are important to you. Think ofmore than just health reasons. For example, think of:

The extra time you’ll have for yourselfby not taking cigarette breaks, rushing out to buy a pack, or searching

for a light.

Not being short ofbreath or coughing as much.

Your car, clothes, and breath will all smell better.

Think ofthe word NOPE: Not One PuffEver. Remember, this is your goal!

Keep your lists ofreasons to quit where you’ll see them often.

Goodplacesare:

My TobaccoUse

It is important for you to understand when and why you use tobacco. The chart below describes situations where

you might use tobacco. Think about how often (rarely, sometimes, often) you find yourself in each situation. Then,

put a check mark in the column that best describes how often you are in each situation.

Keep this list where you will see it often. Talk to your Health Coach about it too. Your Health Coach can help you

find healthier ways ofdealing with these situations.

Checkyourresponse:RarelySometimesOften

Smoking or chewing tobacco is something I do when I’m out

having a good time with friends.

I smoke or chew when I need a “lift.”

Instead ofhaving a snack when I’m hungry, I smoke or chew.

I smoke or chew after I’ve had an argument with someone.

I socialize with other people who smoke or chew.

I smoke or chew when I feel angry or upset, or need to relax.

When I feel “down” or want to forget about my worries, I smoke

or chew.

I skip meals and smoke cigarettes or chew instead.

I use tobacco more when I’m with my friends.

I smoke or chew to perk myselfup or boost my energy.

I light up a cigarette or chew when I feel uncomfortable or

nervous about something.

I smoke or chew when I start feeling sluggish during the day.

Healthwise disclaims any Liability for the decisions you make based on this information.

Triggers

Knowyourtriggers

Certain things trigger, or turn on, your need for tobacco. They can be moods, feelings, places, or things you do. Put

a check next to things that tempt you to smoke. Then, write down what you can do to fight the urge to smoke.

Triggers:WaysIcanfighttheurgetosmokeorchew:

Feelingstressed

Feelingdown

Talkingonthephone

Drinkingalcohol,likewineorbeer

WatchingTV

Drivingmycar

Finishingameal

Playingcards

Takingaworkbreak

Beingwithothersmokers

Drinkingcoffee

Seeingsomeoneelsesmoke

Coolingoffafterafight

Feelinglonely

Afterhavingsex

Other:

Facethesetriggers

Knowing your triggers is very important. Here are some tips to help you fight the urge to smoke:

Not everyone has all ofthese feelings ofwithdrawal. You may have one or many ofthese problems. And they may

last different amounts oftime. Talk to your doctor about medicines that may help.

Getsupport

Quitting tobacco is easier with the support of others. Tell your family, friends, and co-workers that you plan to quit.

Tell them how they can help. Here are some ideas:

Ask everyone to understand your change in mood. Remind them that this won’t last long. The worst will be

over within two weeks.

Does someone close to you smoke? Ask them to quit with you, or at least not to smoke around you.

Do you take any medicines? Tell your doctor and pharmacist you are quitting. Nicotine changes how some

drugs work. You may need to change your prescriptions after you quit.

My quit date:

______

Who can help me?

______

SkillsandtipsIcanuse:

______

Mymedicineplan:

Medicine:______

Instructions:______

______

HowI’llhandletoughsituations:

______

Helpful Tips

Remove cigarettes and othertobacco

from your home, car, andwork

Getting rid ofthings that remind you ofsmoking will

also help you get ready to quit. Try these ideas:

Make things clean and fresh at work, in your car,

and at home. Clean your curtains and clothes. Wash

your car. Buy yourself flowers. You will enjoy their

scent as your sense ofsmell returns.

Have your dentist clean your teeth to get rid of

smoking stains. See how great they look. Try to

keep them that way.

Throw away all of your cigarettes and matches. Get

rid ofyour lighters and ashtrays.

Keepbusy

Be active. Take long walks. Go bike riding. Start a

new hobby.

Spend as much free time as you can where smoking

isn’t allowed. Some good places are malls, libraries,

museums, theaters, and places of worship.

Ifyou miss having a cigarette in your hand, hold

something else. Try a pen or a paper clip. Ifthe

craving gets bad, take a shower—you don’t smoke

in the shower.

Ifyou miss having something in your mouth, try

toothpicks, cinnamon sticks, lollipops, hard candy,

sugarfree gum, or carrot sticks.

Stay away from what temptsyou

Ifyou always smoke while driving, try something

new. Listen to a new radio station or take a

different route. Take the train or bus for a while, if

you can.

Instead ofsmoking after meals, get up from the

table. Brush your teeth or go for a walk.

Stay away from things that you connect with

smoking or chew. These may include:

Watching your favorite TV show.

Sitting in your favorite chair.

Having a drink before dinner.

Be patient. Using NRT the right way can take some getting used to. Follow the instructions and give it

some time.

Don’t mix tobacco and NRT. Having one or two cigarettes while you use the gum, patch, nasal spray, inhaler,

or lozenge is not dangerous, but your goal is to quit smoking for good. Use NRT only when you are ready to

stop smoking. If you do slip up and smoke a cigarette or two, don’t give up on NRT. Keep trying.

Take enough medicine. Use the full amount of NRT in the instructions. Don’t skip or forget to use NRT

after you first stop smoking.

Slowly use less and less medicine. Don’t stop completely until you’re ready. You can set up a schedule with

your doctor, pharmacist, or other health care provider.

Wait 30 minutes after using the gum, lozenge, or inhaler before you eat or drink:

Coffee

Soda

Tomatoes, tomato sauce, or tomato juice

Oranges or orange juice

Lemons or lemonade

Grapefruit or grapefruit juice

These acidic foods and drinks can keep nicotine gums and inhalers from working.

Keep some ofthe medicine with you after you stop using it. This way you’ll be ready ifyou have a craving.

Many large drug stores or pharmacies also sell their own brands ofnicotine gum and nicotine patches.

Using these medicines can double your chances ofquitting. Talk to your doctor or pharmacist for more

information. But remember: medicine can help with cravings and withdrawal, but quitting will still be hard at times.

Othermedicines

Zyban®, Wellbutrin®, and Chantix™ are medicines that have no nicotine. You need a prescription to get these pills.

They help with withdrawal and the urge to smoke so that you’re more likely to quit. Some people have side effects

when using bupropion SR or Varenicline Tartrate pills. Side effects may include dry mouth and trouble sleeping.

PackWrap

Wrapyourpackwithremindersofwhy

youwanttoquit.

Try placing a wallet size photo ofa loved one on the pack, so you

remember why you want to quit. You could even write your reasons

for wanting to quit on the back ofthe photo. Or, put a picture of

your reward for quitting on the package to help you stick to your

quitplan.

CutoutthePackWrapbelow.

PackTrack

Keeptrackofwhenandwhyyousmoke

Pack tracks help you to become more aware of your smoking patterns. You can tape your “pack track” to your

package ofcigarettes, or carry it in your purse or wallet. When you feel the urge to smoke, but before you actually

put the cigarette in your mouth and light up, fill in the following information on your pack track.

Fillingoutyourpacktrack

1) Enter the time ofday.

2) Check the activity you are doing.

3) Check the word(s) that best describe your feeling at the time.

4) Mark how important that particular cigarette is to you in the “Level ofNeed Rating” column.

1 – VERY IMPORTANT2 – IMPORTANT3 – LEAST IMPORTANT

Fillout packtracks on differentdays of theweek (such as 2workdays and2 non-working days).When you smoke and

whereyousmoke may be different on daysyouwork comparedtodays off.You’lllearn aboutyoursmokingtriggers.

And you’lllearnwhichcigarettesare yourfavorites. These factswillhelpyouprepareto fightyoururgeto smoke.

PhotocopyandcutoutthePackTrackbelow.Foldittofitinyourpack,walletorpurse.

After You’ve Quit

Did you know your body begins to recover from the damage done by smoking within 20 minutes after your last

cigarette? The poisonous gas and nicotine start to leave your body. Your pulse rate goes back to normal.

Within a few days you may notice other things:

Your senses of taste and smell are better.

You can breathe easier.

Your “smoker’s hack” starts to go away. You may keep coughing for a while, though.

The nicotine leaves your body within three days. At first, you may feel worse instead of better. Withdrawal feelings

can be hard. But they are a sign that your body is healing. And don’t forget about the long-term benefits ofquitting

smoking. Quitting lowers your chances of heart disease, stroke, chronic bronchitis, emphysema, and several types

ofcancer.

Findnewthingstodo

Starting today you may want to create some new habits. Here are some things you might try:

Swimming, jogging, playing tennis, bike riding, or basketball. It’s hard to smoke and do these things at

the same time.

Keep your hands busy. Do crossword puzzles or needlework. Paint a room in your home. Do woodworking,

gardening, or household chores. You can also write a letter or paint your nails.

Enjoy having a clean-tasting mouth. Brush your teeth often and use mouthwash.

Take a stretch when you’re tempted to reach for a cigarette. Set aside time for the activities that satisfy you and

mean the most to you. There are natural breaks even during a busy day. After dinner, first thing in the morning,

or just before bed are good examples. You’ll also need plenty ofrest while you get used to your tobacco-free

lifestyle.

Remember once you quit smoking, you will have more energy and money to try new and interesting hobbies!

Rewardyourself

You are saving money by not buying cigarettes! Plan to buy yourselfa gift

after your quit date.

Buy a new CD.

Buy a piece ofjewelry.

Go to a sports event, movie, or play.

Get a manicure.

Buy a new couch or armchair—it won’t smell like cigarettes.

Buy new curtains for your home.

Stickwithit

Beating an addiction to nicotine takes a lot ofdetermination. Ifyou’ve quit, you’ve made it very far. Now’s the time

to focus on sticking with it!

Keepyourguardup

Preventing Relapse

Stayupbeat!

As you go through the first days and weeks without smoking, keep a positive outlook. Don’t blame or punish

yourselfifyou do have a cigarette. Instead, take it one day at a time. Remember that quitting is a learning process,

and remember to look at what you are gaining and not what you are giving up.

Ifyoudoslip,youhavenotfailed!

If you have a slip or relapse, don’t be too hard on yourself.

A slip is defined as smoking for an isolated period oftime that is not longer than six consecutive days,

following at least 24 hours ofnot smoking.

Relapse is defined as continuous smoking, at least one puff a day, beyond six consecutive days.

A slip or relapse doesn’t mean that you can’t be a non-smoker, but it’s important to get yourself back on the

non-smoking track RIGHT AWAY.

Relapse is not failure—it can take an average of10 tries before quitting for good.

Find the trigger. What was it that led you to smoke? Be aware ofthe trigger and decide NOW about how you’ll

cope with it when it comes up again.