Working towards a smoke free workplace.

May 31st is World No Tobacco Day. This may be the perfect time for your workplace to launch a quit smoking initiative.

Why smoking?

Smoking is currently the greatest risk to the health and wellness of Australians. It is the leading cause of death and disease. The average smoker loses 15 years of life span compared to non-smokers.

What smoking does?

Smoking releases nicotine which has a broad effect on the body. It releases a burst of dopamine in the brain, releases adrenaline, increases heart rate, respiratory rate and blood pressure. Blood sugars increase whilst making the mind feel relaxed and content. It causes many health and wellness problems.

Why is it so hard to quit?

Nicotine is thought to be as addictive as heroin and crack cocaine. Unfortunately, over time tolerance of nicotine increases which requires a larger dose to get the same pleasurable effects. When someone does try and quit there are a barrage of withdrawal effects to deal with;

• Cravings
• Anxiety
• A sense of emptiness
• Depression
• Moodiness
• Irritability
• Lack of focus

1 in 33 conversations with a physician that recommends a patient quits smoking results in successful cessation. 1 in 33! Ideally, we need to have more conversations, more often.

Current thoughts on E-cigs/Vaping

These devices are relatively new so more research is needed. In Australia it is currently illegal to purchase, possess or consume e-fluid with nicotine in it. However, nicotine additives are easily obtained.

Current research:

• They are thought to be a safer way of getting a hit of nicotine than smoking.
• It may help quitting because it mimics the behaviour of smoking, hand to mouth, inhaling, and allows breaks at work.
• They are not recommended for anyone who doesn’t smoke as it can lead to nicotine addiction.
• They appear to be especially dangerous to school aged children.
• A common chemical additive, diacetyl, has been implicated in causing severe respiratory problems called ‘popcorn lung’ as it is a common ingredient used in microwave popcorn factories.

Best quitting methods:

• Nicotine Replacement Therapy (NRT)
• Doubles the chances of quitting.
• No difference between delivery methods: sprays, patches, inhalers etc. Counselling and psychological support
• Are very effective when used in conjunction with NRT.
• Can be many methods; group, phone, or individual.

Quitting Tips:

First off you will need to find out if they are a current smoker. Instead of asking a person “Are you a smoker?”, ask “Do you smoke?”. This will capture occasional smokers as well.

Let them know that the single greatest effect they can have on their health and wellness is to quit. They can quit if they are ready and they choose to do so. Gauge their readiness to quit, then ask. “Are you ready to quit?”

Ask them why they want to quit, then reinforce the supporting facts, such as;

• Lifespan, they are afraid to miss out on their grandchildren.
• On average a smoker loses 15 years of life 1 .
• Cancer, they are afraid that they will develop it.
• In Australia lung cancer is the 5 th most common cancer, 5-year survival rates are only 13% for males and 17% for females. 90% of deaths from lung cancer are estimated to be caused by smoking 2 .
• Cost, smoking is very expensive.
• A pack a day smoker spends $8800 per year on cigarettes.

Guidance

Show that you care! Let them know that you are there for them if they need any help or guidance.

Remember you don’t need to know everything. Just offer some pointers in the right direction.

• Do they know about the support that quit.org.au offers?
• Have they spoken with their GP?
• Have they spoken with their onsite Physiotherapist?

If they say no, they are not ready, don’t lose hope. Let them know you are there for them if they choose to quit or reduce at a later time.

Support

Quitting is incredibly hard, staying smoke free is just as tough! Unfortunately, people will relapse. The Australian Cancer Council suggests that it can take between 12–14 attempts to succeed 3 .

Make sure that you:

• Congratulate and reaffirm any positive action 4
• Support them during relapses

Remember that smokers already know a lot about the negative health outcomes of smoking. They have had it drilled into them by friends, family, health care providers, workplaces, cigarette packaging, posters etc. Don’t badger, insult, shame, or call them out on their habit. They have to be ready to quit on their own terms. Research has shown that small input from a health professional over a period of time is more effective than a single high intensity session.

Referring to quit.org.au?

Send them here:

https://www.quit.org.au/referral-form/

Your Call to Action:

• Review your companies smoking policy.
• Phone quit and request resources.
• Train your HSR’s, RTW and WHS team to be quit ready.
• Discuss with your Employ Health contact for further resources and suggestions.

1 United States National Cancer Institute, World Health Organization. The economics of tobacco and tobacco control. Bethesda (MD): United States Department of Health and Human Services,National Institutes of Health, National Cancer Institute/Geneva: World Health Organization; 2016 (National Cancer Institute Tobacco Control Monograph 21. NIH Publication No. 16-CA-8029A).

2 Australian Institute of Health and Welfare. Cancer in Australia 2010: An overview ISSN: 1039-3307.16 Dec 2010

3 Scollo M et al. Smoking cessation 7.7: personal factors associates with quitting. Tobacco in Australia facts and issues. 3rd edn. Carlton, VIC: Cancer Council Victoria, 2008:52

4 Chaiton M, Diemert L, Cohen JE, et al Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers BMJ Open 2016;6:e011045. doi: 10.1136/bmjopen-2016-011045