SMOKING

CESSATION
Presented by: Group 5.
SMOKING CESSATION
PROGRAM
Tobacco use has been widely recognized as one
of the commonly shared behavioral risk factors
that lead to the 4 major non-communicable
diseases (NCDs) which are cardiovascular
diseases, cancer, chronic respiratory diseases
and diabetes mellitus. It is one of the most
serious avoidable risk factors for premature
death and chronic illness from tobacco-related
diseases that needs to be addressed.
The Smoking Cessation
Program of DOH
the program helps creating an enabling
environment to help current tobacco users to
quit, protect people from secondhand smoke
and prevent young people from taking up the
habit .
SMOKING CESATION
PROGRAM
The Tobacco Control component of the Lifestyle Related
Diseases Prevention and Control Program primarily aims
to reduce non-communicable diseases caused by
cigarette smoking. It implements the World Health
Organization (WHO) MPOWER measures which monitors
tobacco use and policies, protects people from exposure
to second-hand smoke, offers help to quit tobacco use,
warns people of its dangers, enforces bans on tobacco
advertising, and reduces the affordability of tobacco
products. This program helps create an enabling
environment to help current tobacco users quit, protect
people from secondhand smoke and prevent young
people from taking up the habit.
SMOKING CESSATION
PROGRAM
VISION MISSION OBJECTIVES
Tobacco Free Guarantee the design The program aims to:
Philippines: and Implementation 1. Promote and advocate
Healthier People, of an Integrated smoking cessation in the
Communities and Comprehensive and Philippines; and
Environment. Whole System of
Government - Society 2. Provide smoking cessation
Response services to current smokers
interested in quitting the
habit.
 Republic Act 10351 An Act Restructuring the
1
Excise Tax on Alcohol & Tobacco

POLICIES 2
Republic Act No. 10643 An act to effectively instill
health consciousness through graphic health warnings on
tobacco products

3 Executive Order No. 26 Providing for the Establishment of

Smoke-Free Environments in Public and Enclosed Places

4 Republic Act No. 11467

5 Executive Order No. 106

TYPES OF SERVICE

PhilHealth Circular PhilHealth

PhilHealth Circular PhilHealth Circular PhilHealth
No. 17, s. 2014: Circular No. 2, s.
No. 20 s. 2013: No. 31 s. 2013: All Circular No.
Implementing 2015: Governing
Adoption of the Case Rates (ACR) 15 s. 2014: Guidelines for the Policies on the
Philippine Package Policy No. 1 – Primary Care Primary Care Benefit Expanded
of Essential Non- Governing Policies Benefit 1 2 (PCB2) Package Coverage of the
Communicable in the Shift of
(PCB1) Now (Out-patient Primary Care
Disease (NCD) Provider Payment Medicines for
Called Benefit Package:
Interventions Mechanism from Hypertension,
“Tsekap” “Tamang
(PhilPEN) in the Fee-for-Service to Diabetes, and
Package Serbisyo sa
Implementation of Case-based Dyslipidemia) at
Guidelines for Kalusugan ng
PhilHealth’s Payment Selected Innovation Pamilya”
Primary Care
CY 2014 Sites
Benefit Package
(Tsekap)

TRAININGS
Training on Brief Tobacco Intervention
 PARTNER ORGANIZATIONS

Framework Convention on
Psychological Lung Center of the Philippines
Tobacco Control
Association of the
Philippines

Philippine Psychiatric Philippine College of Chest

Association Physician
Philippine General Hospital

Seventh Day Adventist

Metropolitan Manila
Development Authority World Health Organization

Philippine Academy of
Philippine Ambulatory
Philippine Medical Family Physicians
Pediatric Association
Association
 Smoking, the act of inhaling and exhaling the fumes of
burning plant material. A variety of plant materials are
smoked, including marijuana and hashish, but the act is
most commonly associated with tobacco as smoked in a
cigarette, cigar, or pipe. Tobacco contains nicotine, an
alkaloid that is addictive and can have both stimulating
and tranquilizing psychoactive effects. The smoking of
tobacco, long practiced by American Indians, was
introduced to Europe by Christopher Columbus and other
explorers. Smoking soon spread to other areas and today is
widely practiced around the world despite medical, social,
and religious arguments against it.

WHAT IS SMOKING?
WHAT ARE THE
HARMFUL
SUBSTANCES IN
TOBACCO?
HARMFUL SUBSTANCES IN
TOBACCO
Cigarette smoke contains compounds that separate into gas and particulate. Three of
these compounds are known to be harmful to health: tar, nicotine, and carbon
monoxide.
TAR, the particulate matter left when water and nicotine are removed from cigarette
smoke, contains hydrocarbons and other carcinogenic substances. Tar is deposited in
lung passages, paralyzes the cleaning mechanisms (cilia) and damages the air sacs
(alveoli). It is responsible for many of the cancers and lung diseases.

NICOTINE, also a particulate, causes release of epinephrine and norepinephrine,

resulting in arrhythmia, increased heart rate, blood pressure, cardiac output, stroke
volume, contractility, oxygen consumption, and coronary blood flow. It also exerts a
toxic effect on the endothelium. It is also an addicting substance.

CARBON MONOXIDE may produce hypoxia of the intima and increase Endothelial
permeability. It also reduces the oxygen-carrying capacity of hemoglobin.

WHAT ARE THE

EFFECTS OF
SMOKING AND
TOBACCO?
 PUFF ME MORE!
Within 10 seconds of your first puff, the toxic
chemicals in tobacco smoke reach your brain,
heart and other organs. Smoking harms almost
every part of your body and increases your risk
of many diseases. Smoking also affects how you
look and feel, your finances and the people
close to you.
 Why do people
smoke?
Peer influence
Environment Social
Curiosity
image Stress Influenced by tobacco industry
Perception of being sexy tough,
sophisticated and attractive


Why does Tobacco use is

prevalent in the
Philippines?

Tobacco is legal
Easy access
Low price Lack of awareness
about it’s danger Weakness of
implementation
 HEALTH EFFECTS OF
SMOKING
Smoking leads to disease and disability and harms nearly
every organ of the body. More than 16 million Americans
are living with a disease caused by smoking. For every
person who dies because of smoking, at least 30 people
live with a serious smoking-related illness. Smoking
causes cancer, heart disease, stroke, lung diseases,
diabetes, and chronic obstructive pulmonary disease
(COPD), which includes emphysema and chronic
bronchitis. Smoking also increases risk for tuberculosis,
certain eye diseases, and problems of the immune
system, including rheumatoid arthritis.
 HEALTH EFFECTS OF
SMOKING
Secondhand smoke exposure contributes to
approximately 41,000 deaths among nonsmoking adults
and 400 deaths in infants each year. Secondhand smoke
causes stroke, lung cancer, and coronary heart disease in
adults. Children who are exposed to secondhand smoke
are at increased risk for sudden infant death syndrome,
acute respiratory infections, middle ear disease, more
severe asthma, respiratory symptoms, and slowed lung
growth.
WHAT HAPPENS IN
YOUR BODY?
When you smoke, harmful chemicals enter your
lungs and spread through your body. They can:
reach your brain, heart and other organs
within 10 seconds of your first puff
go everywhere your blood flows, harming
every part of your body.

How you become

addicted
ADDICTION
As the nicotine levels in your body fade, your
The nicotine in tobacco is highly brain craves more dopamine. The longer you
addictive. It makes your brain release have been smoking, the more dopamine you
a chemical called dopamine. need to feel good. You become dependent on
Dopamine is a ‘feel good’ chemical nicotine.
that: Once you are dependent on nicotine, without
makes you feel happy it you will have withdrawal symptoms. You may
find it difficult to concentrate or feel nervous,
helps you to concentrate
restless, irritable or anxious.
gives you more energy.
These two things — nicotine dependence and
But this effect doesn’t last long. nicotine withdrawal — make you want to smoke

more. You become addicted to tobacco.

How tobacco
affects the way
you look
Smoking tobacco can:
cause yellow-brown stains on your fingers,
tongue and teeth
increase your risk of tooth loss and bad
breath
make your skin saggy and give you early
wrinkles
make your hair lose its natural shine.

SMOKING IN
PREGNANCY
The nicotine, hydrogen cyanide, and carbon monoxide in a
smoking mother’s blood also reach the developing fetus
and have significant negative consequences there

• The more the woman smokes during pregnancy, the greater the reduction in
birth weight. The infants of smokers are normally proportioned, shorter, smaller
and half pound lighter than the infants of non-smokers, and have smaller head
circumference.

• If a woman smoker discovers herself to be pregnant, that should be a clear

signal to quit smoking. Women who give up smoking early in pregnancy (by forth
month) have similar weight to those of non-smokers.
 THE
GOODNEWS
The Good News: Quitting Can Reduce Risk
When a smoker quits smoking, the risk is reduced. For
smoking-related deaths from CAD, lower death rates
are reported in persons who quit smoking than in
persons who continue to smoke. Men under age 65
years who stopped smoking reduced their risk by
50%. In fact, after 10 years of not smoking, the risk of
death from CAD approaches that of a nonsmoker

 WHAT WOULD BE THE

ROLE OF A PUBLIC
NURSE?
1. Assisting smokers to quit

Research has shown that a single advice to quit

smoking coming from the doctor or health worker
can produce significant outcome in motivating a
person to quit. For active smokers, motivate and
assist them to quit smoking. Advise them also to
avoid smoking inside the house or enclosed areas to
prevent exposing people from second-hand smoke.

Smoking Intervention
Guidelines
Every person who smokes should be counseled on
smoking on every visit to the physician's office.
Maintenance of cessation should be frequently discussed
with patients who have quit.
Every patient should be ask about tobacco use; smoking
status should be recorded and updated at regular
intervals.
Cessation interventions as brief as 3 minutes are effective,
with more intensive intervention being more effective. -
Clinicians should receive training on patient-centered
counseling methods.
Office systems that facilitate delivery of smoking cessation
intervention should be established. -Links with other
personnel and organizations should be established to
provide smoking cessation intervention (nurses, smoking
cessation specialists, multiple risk factor intervention
programs, community resources).
Smoking Intervention
Guidelines

Successful smoking cessation often

requires both behavioral clinics and
pharmacological management. For
this purpose, smoking cessation
clinics have already been
established in some parts of the
country.
Strategies in Helping
Smokers to Quit
ASK ASSIST ARRANGE FOLLOW UP

A - ASK Step 1 - Assess A - ASSIST Step 5 - A - ARRANGE FOLLOW-UP Realizing that health
smoking status. Identify all Develop a quit plan with Step 8 - Set follow-up sessions to workers in most
tobacco users at every visit. the smoker. Set a QUIT monitor progress and prevent communities do not
A - ADVISE TO STOP DATE relapses. Be a role model. Filipino have much time nor
SMOKING AND THAT Step 6 -. Provide clients generally regard health resources, WHO has a
SMOKING CAN CAUSE supplementary workers with respect and high simplified
DISEASE, EVEN DEATH materials to assist the regard. So if they see you recommendation that
smoker. smoking, they will not take you any health worker can
Step 2 - Target clients' Step 7 - Develop a plan seriously when you advise them to apply readily to any
motivation to quit. to prevent relapse. quit smoking. Even if you don't say client and in any
Step3 - Encourage anything, your actions will speak setting. This involves
complete cessation. louder than words. If you are a the four "As" in helping
Step 4 - Discuss smoker yourself, the most smokers to quit.
alternatives and responsible thing to do is not to
substitutes to smoking. smoke in front of patients and to
comply with policies regarding no
smoking areas.
2. Promoting a Smoke-
free Environment
Success rate of smoking cessation WHO established four pillars for successful anti-tobacco
programs. These four pillars may be categorized into two simple
techniques for individuals is limited. words: education and legislation.

Pharmacological treatment is also 1. Aggressive health information dissemination combined with

expensive and inaccessible to many. comprehensive advertising bans on tobacco products;

Other interventions directed at 2. Government-supported and multisectoral programs to

promoting a smoke-free environment encourage and help smokers break free of their addiction to
smoking;
are needed particularly advocacy for 3.Building anti-tobacco coalitions to help governments,
the establishment and enforcement individuals, and sectors to rid tobacco from their systems; and
4.The taxation of tobacco products to create an economic
of supportive policies. disincentive for the buying of higher priced cigarettes.
 The passage of the Tobacco Regulations Act in 2003
is a landmark legislation in the country against
tobacco use. It declared enclosed places and public
Roadmap to utilities as no smoking area, limiting access of
children and youths to cigarettes (prohibiting sale of
Tobacco Control cigarettes to minors and selling of cigarettes within
Legislation 50 meters of schools), prominent labeling of
cigarettes warning users of the danger of smoking,

and limiting/banning tobacco advertisements and
sponsorships of activities directed to children and
youths.
ROADMAP TO Republic Act No. 9211, also known as the Tobacco
Regulation Act of 2003, is an omnibus law regulating
TOBACCO smoking in public places, tobacco advertising,
promotion and sponsorship, and sales restrictions,
CONTROL
among other requirements.
LEGISLATION
SMOKING
 T O P
S OKING!
M
SM