6 Tips for Tobacco Reduction During the Holidays

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As another holiday season approaches, it’s important to take time to consider how this time of year can impact your tobacco reduction goals. For many, this time of year can be incredibly motivating when it comes to commercial tobacco reduction due to weather changes, time spent with friends and family, and the feeling of a “fresh start” as we ring in a new year. However, like any holiday, a variety of emotions are in play including joy, love, stress, sadness, loneliness, nostalgia, and more. These feelings can often be exacerbated by established traditions and the media putting additional pressure on us to have the “perfect holiday”. 

We know when it comes to smoking cessation that emotions can play a major role in both successes and challenges faced. We also know that having a plan and preparing for challenges when reducing can help people feel more ready to stick to their reduction goals. But what are some ways you can prepare for the holiday when reducing your use?

Tips for Tobacco Reduction and the Holidays

  1. Get enough rest. Exhaustion will only leave you feeling more stressed which may increase the urge to smoke. Do your best to make sure you are getting enough sleep at night or schedule out times to have a nap during the day when needed. This will leave you feeling refreshed and ready to participate in events and gatherings.

  2. Set boundaries – it’s okay to say no! To extra visits, events, financial commitments, or other stressors. The holidays can be a nostalgic time for many of us, and that can often lead to pressure to make sure things are a certain way or are exactly the same as previous years. But sometimes this can lead to over-exertion and increased stress. Sit down with your loved ones to discuss plans and responsibilities and suggest changes that might need to be made ahead of time. Making sure everyone is on the same page can go a long way in preventing unexpected stressors.

  3. Have a replacement method on hand. Cravings are tough, and sometimes can occur at unexpected moments. Plan to have something on hand like a snack, a fidget toy or stress ball, a puzzle book, gum, or anything else that has been helpful in coping with cravings. Make sure you always know where it is so you can easily access it when you are dealing with a challenging moment. 

  4. Stay hydrated. Staying hydrated can help improve your mood and leave you feeling more energetic, especially when activities and events are keeping you busy. Additionally, a glass of water can be a great way to cope with cravings without picking up tobacco.

  5. Don’t beat yourself up IF things don’t go your way. Like any other major event in our lives, the holidays are prone to not having everything go exactly as planned. This is also true for plans surrounding reduction and cessation efforts. While it is important to plan to help yourself succeed in your goals, it’s equally important to extend yourself grace IF things don’t turn out the way you planned. Remember: small slip ups do not have to impact or prevent your long term success. Give yourself the chance to get back on track with your goals rather talking yourself into abandoning them.

  6. Take time to enjoy the season. Regardless of your plans or traditions, the end of the year can be a great time to reconnect with loved ones and find joy. Both of which can support your goals with reduction. Take time to enjoy everything you love about this time of year OR find opportunities to make new happy memories to look back on next year. Remember, regardless of where you are with your reduction plans: you deserve the chance to relax and enjoy time with the ones you love.

Tobacco Reduction resources and supports 

When developing a quit or reduction plan, we often discuss the importance of having support whether it comes from a TTS, a friend, a coworker, or anyone else in your life. But the holidays can impact availability and your access to them. Because of this, it’s good to have additional resources prepared to fall back on when you’re facing a challenging moment. Such resources might include:

  1. A Quitline service: the Michigan Quitlink has available services for support including online and phone-based support and available 24/7.

  2. Check out the Quit Plan Builder at Smokefree.gov for an easy option to develop or alter your quit or reduction plan.

  3. Phone applications can offer assistance in tracking your days quit and motivation reminders, as well as tips and other resources when facing tough moments.

  4. Have a designated friend/family member that you can reach out to when you’re in need of support. Having this set up in advance allows you to know who is going to be available for a check in and when. 

The holidays can be a joyful yet tumultuous time for many. New or additional challenges or stressors DO NOT have to prevent you in reaching your goals. Take time now to make a plan so you can feel prepared and in control of your reduction efforts this season. 

For more tips you can check out our video for navigating reducing your tobacco use during the holidays and articles like this one.

Have any questions or are looking to reduce commercial tobacco use?
Reach out to our tobacco reduction team:

Caitlyn Clock
Tobacco Treatment Coordinator
cclock@miunified.org
313-316-7561

Changes to Celebrate When Quitting Tobacco

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Clients involved in our tobacco use reduction program generally have the same goal– becoming tobacco free. When you quit tobacco, your body and brain experience physical changes as they adapt to the lack of nicotine and tobacco. Quitting tobacco also involves starting new habits and changing your overall lifestyle. The process of quitting tobacco can feel overwhelming and frustrating, especially when you haven’t achieved your end goal yet.

However, it is important to give yourself credit for everything you’ve achieved so far. Even if you are still in the process of becoming tobacco free, your health has likely benefited from the changes in your routine and mindset. Recognizing and giving yourself credit for these accomplishments is important and can help you stay motivated in your journey. So what changes can you expect to see when quitting tobacco?

You’re developing healthier coping skills

Smoking can become an automatic response to stress, anger, and other unpleasant emotions. Between tobacco’s addictive nature and the way it easily becomes a habit, it is not uncommon for smoking to become an unhealthy coping mechanism. When quitting tobacco, it is important to identify situations where you are using tobacco as a coping skill. The next step is replacing the habit of smoking with other healthier behaviors. Discovering and implementing healthy coping skills is a huge victory when quitting tobacco. Not only can these skills help with reducing smoking, but they also help with stress management and living an overall healthier lifestyle.

You can go longer without smoking your first cigarette

One of the ways nicotine dependence is measured is by how soon after waking up you have your first cigarette. Since you are not using tobacco while you sleep, your body tends to go into withdrawal overnight. This is the reason people tend to crave a cigarette as soon as they wake up. Being able to go longer without your first cigarette of the day is a sign that you are becoming less dependent on nicotine. Even being able to go a few minutes longer without reaching for a cigarette is worth celebrating.

You know when to walk away from triggering situations

Learning to accept and cope with difficult situations is important, but there is also value in knowing when to walk away. Quitting tobacco might involve saying no to or leaving situations where you’ll have to urge to smoke. For example, the smell or sight of a cigarette is a common trigger. Learning to remove yourself from these situations can not only help you with tobacco cessation, but it can also teach you how to better manage situations that could damage your general health. The way you manage your triggers may also change over time. You might initially need to walk away from a situation, but with time you might learn how to better manage said trigger.

You can prevent slips from becoming relapses

When discussing quitting tobacco, a ‘slip’ refers to a singular incident of smoking whereas a ‘relapse’ refers to going back to your previous habits . Slips are very common, but they don’t always have to lead to relapsing. Instead of beating yourself up over a slip, focus on what you can learn from it. Reflecting on your slip– where were you, what were you doing, and how were you feeling– can help you better understand your triggers along with what is and isn’t a helpful strategy to manage them.

You’re able to accept yourself and your life as they are

Accepting what you can and can not control is key to making lifestyle changes, such as quitting tobacco. Triggering situations may be out of your control, and life may not go as expected even when we feel in control. Radical acceptance is a term that refers to accepting yourself and your life as they are rather than dwelling on what could be different. Learning acceptance takes practice, but feeling unable to accept reality can increase the pain in distressing situations. On the other hand, radical acceptance also involves giving yourself credit and accepting positive situations. It may be difficult to accept that you haven’t been able to completely quit tobacco, but there is also value in accepting the progress that you’ve made.

Image from Pexels

Becoming tobacco free can feel overwhelming as the process takes time and patience. Breaking it down into smaller steps and learning to recognize the small victories can make cessation feel more achievable. Realizing what you’re gaining from quitting smoking can help you stay motivated. If you’re feeling stuck in your cessation efforts, UNIFIED’s tobacco reduction program can help you create a plan to keep moving forward.

If you would like to learn more about tobacco reduction and cessation, please contact our team:

Caitlyn Clock (313)-316-7561

5 Tips for Setting Boundaries While Quitting

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In my personal and professional life, it is not uncommon to hear about tension between those trying to quit tobacco and others in their lives. Friends and family can serve as a great support system, but they can also unintentionally become a barrier to quitting. It can be difficult to navigate your reduction journey when those around you continue to smoke or be unsupportive. Common advice, such as ‘get new friends’ or ‘just avoid smokers’, tends falls flat for folks who have deeper relationships with people who are unable to support them on their quit journey. So how do you balance quitting tobacco while maintaining relationships with others?

Having and learning to set boundaries allows you to keep a healthy connection with friends and family. The term ‘boundary’ has become a buzz word recently, but what exactly does it mean? A boundary refers to that imaginary line between you and others; it separates your physical and emotional needs, feelings, and responsibilities from others. Boundaries exist in every aspect of our lives, whether it is needing privacy from roommates, being uncomfortable with certain sexual activities, or refusing to do certain tasks at work. Everyone has boundaries, but it takes time and practice to learn what yours are and how to express them.

Boundaries are a powerful tool for those attempting to reduce or quit tobacco. Your boundaries might look like refusing to buy cigarettes for others, being able to walk away from people who are smoking, or any other limits you have to maintain your quit. Setting boundaries is easier said than done, but with practice they are a great way to protect your needs and your relationships with others. So how do you actually use boundaries in real life?

1. Focus on what you can control

Setting boundaries allows you to express what you need from others. However, you can not control others’ behavior. When setting boundaries, it is important to focus on what you can control: yourself and your actions. Boundaries are a reflection of your own needs, values, and comfort. Though it can be difficult at first, it is up to you to learn what your boundaries are, how to communicate them to others, and how you can respond to them being crossed.

2. Set boundaries before they are crossed

Once you’ve realized the boundaries you need to set, it can be helpful to communicate them to others before they get crossed. Communicating what you need before you’re in a tough situation can allow you to express yourself with a clear mind and avoid resentment in your relationships. For example, you might consider letting friends know you’re working towards quitting and are currently uncomfortable being around others while they smoke. Communicating ahead of time can help you avoid triggering situations, whether that means your friends going outside to smoke or them knowing why you may need to walk away when they smoke.

3. Don’t assume others’ intentions

When others are unable to respect our boundaries, it is natural to feel frustrated and hurt. Boundaries exist to keep us emotionally and physically safe, and it is important to build relationships where you can respect each other’s boundaries. However, we also don’t know others’ intentions when they can’t respect our boundaries. Someone who continues to offer you cigarettes, doubt your ability to quit, or be unsupportive in other ways may be unaware of how hurtful their actions are. Their behavior is more likely a reflection of their beliefs and values; they may view smoking as a way to connect or might not understand how important quitting is. This does not excuse their actions, but being able to take a step back and avoid assumptions can help us avoid resentment.

4. Boundaries help save relationships

At first, having boundaries can seem like a wall between you and others. Setting boundaries can be uncomfortable and may change the dynamics of your personal relationships. However, everyone has personal boundaries and expressing them can actually strengthen relationships. Having relationships where you both can comfortably express what you need from one another can help create safety and respect between each other.

5. Learn how to respond when boundaries are crossed

After setting a boundary, it is your responsibility to stand firm in what you need and learn how to set consequences when others can’t respect that. Boundaries are an opportunity to teach others how to treat you. If someone continues to cross your boundaries, it is time to determine how to distance yourself from harmful situations. This might look like walking away from or refusing to be in situations where your boundaries to be crossed, but it can also be a chance to create spaces where your boundaries will be honored.

If you would like to learn more about tobacco reduction and cessation, please contact our team:

Melissa Small – Ypsilanti/Jackson Tobacco Treatment Specialist

(734) 329-9223

Monica Allen – Detroit Tobacco Treatment Specialist

(313) 949-2938

FDA Proposed Menthol Ban

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In April of 2022, the U.S. Food and Drug Administration proposed a ban on the manufacturing and sale of menthol cigarettes and cigars. The FDA hopes this ban will “help prevent children from becoming the next generation of smokers and help adult smokers quit” along with reducing health disparities. Previous legislation has banned flavors, with the exclusion of tobacco and menthol, in cigarettes and e-cigarettes. It is important to note that the ban would target those making and selling menthol cigarettes, but it would not punish those who possess menthol cigarettes. This distinction allows Big Tobacco to experience consequences without penalizing those struggling with addiction.

Menthol may be one of the most popular flavors for tobacco products, but people may not be familiar with what it actually is. A chemical naturally found in peppermint, menthol can be described as minty and cooling. This flavoring may make smoking feel less harsh and seem healthier, but menthol can actually make it easier to start smoking and make it more difficult to quit. Studies have found that those who smoke menthol are less likely to quit when compared to those who smoke non-menthols.

Kool Your Throat

Not only are menthol cigarettes designed to be more addictive, but they have also historically targeted African Americans through their marketing tactics. Mentholated brands, such as KOOL and Newport, have been advertised in Black publications and other media. Big tobacco also has a history of sponsoring Black events and organizations. For example, Philip Morris (owner of Marlboro, Virginia Slims, and other brands) has sponsored the National Association for the Advancement of Colored People, the Urban League, and the United Negro College Fund. There are countless examples of Big Tobacco targeting African Americans and other minorities. Bans and regulations surrounding tobacco may prevent future generations from being impacted by the tobacco industry’s marketing, but decades of targeting have already damaged many individuals and communities.

By banning menthol, the FDA can work towards making tobacco less appealing and accessible. Not only could it prevent younger generations from using tobacco, but banning menthol could also act as an incentive to help those who currently smoke quit. As tobacco becomes more regulated and restricted, the tobacco industry loses its ability to influence more people to smoke. For more information on the proposed ban, you can check out the FDA’s official Press Announcement.

If you’re interested in learning more about tobacco reduction and cessation, please contact our team:

Monica Allen, Detroit Tobacco Treatment Specialist

(313)-949-2938

Melissa Small, Ypsilanti/Jackson Tobacco Treatment Specialist

(734)-329-9223

Unpacking Tobacco Use in the LGBT+ Community

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The decline of tobacco consumption throughout the previous decades is worth celebrating. Increased tobacco cessation programs, awareness surrounding the health effects of tobacco, and legislation to limit consumption have worked together to create an environment where more people can either quit tobacco or not start smoking at all. However, this decline has not affected all people and communities equally. Rates of tobacco use among the LGBT+ community have remained disproportionately higher than in the general population.

National data from 2016 shows that the rate of tobacco use among lesbian, gay, and bisexual adults is 20.5% compared to 15.3% in heterosexual adults. There are even larger disparities for transgender adults as 32.6% of transgender adults currently use tobacco compared to 23.6% of cisgender adults. For transgender youth, the rate of smoking cigarettes is nearly 4x compared to cisgender youth. These disproportionately high rates remain consistent among all tobacco products, and more information on how tobacco use compares within the LGBT+ community can be found here.

Big Tobacco and the LGBT+ Community

When we discuss differing rates of tobacco use, it is important to examine why these disparities exist. Big tobacco has strategically marketed to the LGBT+ community through LGBT+ publications and events. In particular, R. J. Reynolds (the parent company of Newport, Camel, Pall Mall, and Doral) launched Project SCUM (Subculture Urban Marketing) in the 1990’s. This campaign targeted the LGBT+ and homeless populations in hopes of increasing their tobacco use. R.J. Reynolds is not the only company to market cigarettes as a normal and exciting part of LGBT+ life. Other companies within big tobacco have exploited the community through targeted advertisements, sponsoring pride events, and funding LGBT+ and HIV/AIDS organizations. These marketing tactics may no longer exist today, but their impact on the health of the community remains.

How Health Inequities Impact Smoking Cessation

Beyond the history of what led more folks within the LGBT+ community to start using tobacco, there are also barriers that make quitting more difficult as well. LGBT+ individuals are more likely to experience discrimination or have negative experiences with healthcare providers. Providers may be ignorant or have preconceived notions regarding LGBT+ health issues, which can lead to inadequate care or a lack of care altogether. One study found that 18% of LGBT+ individuals reported avoiding seeking out healthcare due to fears of discrimination. When discrimination around one’s identity is combined with the stigma surrounding tobacco use, it can be challenging to find a provider who is empathetic and committed to addressing everyone’s unique needs.

LGBT+ folks are also more likely to experience financial barriers when seeking out healthcare. The Affordable Care Act and legalization of same-sex marriage have helped to provide health insurance to the LGBT+ community, but healthcare still remains unaffordable for many. Though data on LGBT+ health is limited, it is suggested that LGB adults are more likely to avoid necessary care due to cost. Transgender adults experience the same inequity when it comes to the cost of care, and they are also less likely to have insurance compared to cisgender adults. These inequities can make it more difficult for LGBT+ folks to receive nicotine replacement therapy, counseling, and other cessation support.

Tobacco Reduction and Cessation Resources

Learning about health disparities can be discouraging, but more people are taking the time to educate themselves on these inequities and work to change them in their personal and professional life. Southeast Michigan has various organizations that provide physical and behavioral healthcare to the LGBT+ community.

  • Here at UHHB we provide inclusive care and resources to people living with HIV in the Detroit, Ypsilanti, and Jackson areas. This includes our tobacco reduction program that offers counseling, support groups, and other resources to individuals looking to reduce their tobacco use.
  • Ruth Ellis Center in Detroit has a variety of services for LGBT+ youth and young adults, including a Health and Wellness Center with behavioral health services.
  • The Corner Health Center in Ypsilanti offers physical and behavioral health services to LGBT+ youth, including support with tobacco reduction.
  • Ozone House provides shelter and support for at-risk youth. Some of their programs include LGBT+ support groups, counseling, and substance use support.
  • LGBT Detroit supports the Detroit LGBT+ community through advocacy and education. They offer various programs to provide a safe space and increase the wellbeing of Detroit’s community.

Commit to Quit: World No Tobacco Day 2021!

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What is World No Tobacco Day?

World No Tobacco Day (WNTD) is an annual global event sponsored by the World Health Organization (WHO). Falling on May 31st, WNTD’s purpose is to inform the public on “the dangers of using tobacco, the business practices of tobacco companies, what WHO is doing to fight the tobacco epidemic, and what people around the world can do to claim their right to health and healthy living and to protect future generations”.

WNTD was initially created in 1987, with the World Health Assembly passing a resolution that would declare April 7th 1988 a “world no-smoking day”. The goal was to encourage current tobacco users to abstain from using tobacco products for a 24-hour period. In 1988, a second resolution passed naming May 31st the official date for World No Tobacco Day and making it an annual event.  

Each year, WHO chooses a different theme to accompany the day. With the first theme being “Tobacco or Health: Choose Health”. Since then, we have seen various themes focused on health, tobacco industry tactics, and ways we can fight back. This year’s theme of “Commit to Quit” comes from the renewed commitment to quit many people who currently use tobacco products have found as a result of the COVID-19 pandemic. 

WNTD 2021: “Commit to Quit”

For many people, the COVID-19 pandemic has been a new reason to quit their tobacco use, but what does that look like for people who are unsure of quitting or for people who feel the pandemic has decreased their motivation to quit? Tobacco cessation is a different process for everyone, and there is no single guaranteed path to a successful quit. Similarly, the idea of “Commit to Quit” might look different from one person to the next.

Your “Commit to Quit” might be one hour, one day, one year, or maybe forever. Your “Commit to Quit” might not be for this year’s World No Tobacco Day event, but rather a new commitment to yourself to quit one day in the future. “Commit to Quit” might mean taking the time on May 31st to simply consider reducing your tobacco use, or it might mean taking time to explore the options and resources that are available to you. 

Ways to Get Involved

There are many ways to get involved with this year’s World No Tobacco Day event, including options to meet you wherever you’re at on your quit journey. You can:

Resources 

There are many resources available online when it comes to tobacco cessation. In addition to our counseling-based tobacco treatment services at UHHB we have our tobacco blog, a monthly live stream (every second Tuesday of the month at 2:00 PM) on Facebook and Youtube (livestreams recorded and saved to both websites),  and our World No Tobacco Day video series being posted this month leading up to the big day. You can also reach out to our Tobacco team for additional information and resources.

If you’re interested in other web- or phone-based resources you can check out Smokefree.gov and smartphone applications like “SmokeFree”, “myQuitTime”, and “quitStart”.These apps and websites can be helpful in setting up a plan, tracking your days quit, building motivation, and finding distractions or other coping strategies for cravings. 

Local quitlines are another great resource to utilize to build motivation and start your own reduction plan. You might also reach out to your doctor or another trusted healthcare provider if you are interested in quit medications or discussing the benefits of quitting or reducing your tobacco use. 

Commit to Quit? Maybe!

World No Tobacco Day can be a great day to either start or continue your quit journey. Wherever you are, or whatever “Commit to Quit” looks like for you, remember that tobacco cessation looks different for everyone. Any attempt you make in reducing your use whether it be a definitive quit, smoking one less cigarette a day or week, deciding to try again after a past attempt didn’t go like you hoped, or simply reading up on available resources for tobacco cessation is a step worth celebrating. Whether you’re planning to participate in this World No Tobacco Day or it’s just another day for you, any day, regardless of whether it’s a “tobacco holiday” or not, is a good day to “Commit to Quit”.

Want to learn more about this year’s World No Tobacco Day or just interested in tobacco reduction resources? Contact our tobacco reduction team:

Detroit

Amber Jager – (313) 316-6226

ajager@miunified.org

Ypsilanti/Jackson

Caitlyn Clock – (313) 316-7561

cclock@miunified.org

Breaking Up with Boredom

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“I’m just…bored” is something I’ve been hearing a lot lately. Whether it be from myself, clients, colleagues, or family members, it seems like everyone is struggling with increased boredom these last months. Though it has certainly been boosted by the COVID-19 pandemic, boredom is far from a new experience. This is especially true for people who are working to reduce or quit their tobacco use. 

What is boredom?

To me, boredom is one of those concepts that everyone seems to have an idea of what it is, but when we try to define it with words it’s suddenly difficult to explain. Because of this, having specific definitions can come in handy as we work to combat boredom. This month’s blog and livestream used a couple specifically:

  1. Boredom is “the state of being weary and restless through lack of interest…”
  2. “…attentional failure (i.e. being unable to successfully engage attention w/ an activity) and or perceived lack of meaning can lead to boredom…”

COVID-19 impact

“…perceived lack of meaning can lead to boredom…” is something I’ve been thinking about more often as we continue to find ways to deal with COVID-19 and public health responses. For nearly the last year, we’ve all been dealing with changes to our daily lives in one way or another due to the COVID-19 pandemic. Whether you’re staying home more, changing the ways you connect with others socially, have developed a new routine, or maybe even completely stopped having a routine, change as has been unavoidable. These changes have also had their hand in influencing the amount of boredom we face. While boredom was not created by the pandemic, the pandemic has certainly resulted in an increase in the amount of boredom one might experience daily or weekly. Additionally, it may leave many experiencing something similar to “Groundhog Day” syndrome given the lack of opportunities for new or exciting activities. Even with hopeful changes coming our way, increased boredom will likely continue for longer than we hope.

Boredom and tobacco reduction

While boredom is common and maybe in some cases welcome from time to time, too much boredom can be challenging, and this especially true for someone who is currently trying to quit or reduce their tobacco use. People often smoke when they’re bored and this is for a few different reasons including:

  1. Boredom is emotional trigger (i.e. people are used to smoking when they’re bored and therefor when they experience boredom it is the natural response to light a cigarette)
  2. Smoking gives people something to do when they’re bored
  3. They have no alternative distractions
  4. Smoking is already on their mind 

Because of this link, someone experiencing an increase in boredom in their daily life will likely also experience increased opportunities or urges to smoke. 

It’s also important to note that boredom is not only a trigger for people to smoke and can also be a result of reducing your tobacco use. Tobacco use is something that takes up a pretty decent amount of time throughout your day. On average, it takes someone 5-6 minutes to smoke a single cigarette, which opens up about an hour per day for those smoking ½ of a pack per day and two hours for those smoking a pack a day. Those who smoke cigars might be smoking anywhere between fifteen minutes to one hour per cigar depending on the type and brand. Tobacco use also takes up specific times of your day (i.e. post coffee, first thing in the morning, post meals, before/after activities, etc.). While this may not seem like much, having that much additional spare time suddenly can be challenging to deal with. This is why we try to work with our clients to find ideas for alternatives to smoking, distractions, and other ways to stay busy as a part of their quit plan as they work on their own tobacco reduction/cessation. 

Combating boredom 

This month’s blog and livestream tpoic is a result of clients dealing with boredom, and part of the hope was to offer both a deeper understanding of boredom as well as ideas to help people cope with and combat their boredom. For this I focused on two ideas: daily routines/structure and activities to keep the hands and/or mind busy.

In our very first livestream last year we discussed the idea of a “quarantine routine” and ways to help maintain structure in your daily life. Though it’s been nearly a year since I wrote the accompanying blog, the tips offered can definitely help support your daily routine – and also combat boredom by giving yourself consistency in your day to day life. It may even give you something to look forward to. 

You can also check out the ideas below for activities to incorporate into your daily or weekly routine:

  • Video games – a great way to keep your hands and mind occupied and potentially a way to connect with others if you have friends or family who also play the same games
  • Learn to knit or crochet! You don’t even need needles!
  • Games on phone such as Hearts, Sudoku, Euchre, or Words with Friends – especially if you want to keep your hands busy while watching TV/movies
  • Board games 
  • Schedule weekly calls or video chats with loved ones – or have a “virtual dinner”!
  • Journal
  • Plan “movie nights” with friends where you watch the same movie even if you can’t be together
  • Get moving! Whether you’re interested in dancing it out, yoga, walks, chair exercises, or more traditional forms of exercise this is a great way to boost your mood and keep you busy! You can find just about any type of workout on Youtube. You can also check out our HOPE program videos on our Facebook and Youtube pages.
  • Puzzles
  • Draw, color, or paint
  • Take up meditation
  • Listen to podcasts 
  • Organize your space
  • Give your home a deep clean
  • Reading – most libraries are offering virtual events and book downloads as well as other pickup services!
  • Virtual exhibits/events/etc.
  • Cooking/baking – you could even set up some sort of exchange with close friends to share the best recipes and results
  • Write letters to loved ones or your future self 
  • Make a bucket list or a list of all the things you want to do when it’s safe to
  • Try out a new hobby you’ve been interested in
  • Start an at home yoga practice

As with everything else, making massive changes all at once isn’t necessary to deal with your boredom. Planning out a couple activities/ideas (whether they’re on the above list or not!) to try the next time you find yourself experiencing boredom is a great way to start. Keep necessary supplies or even a list of your chosen ideas near your tobacco reduction supplies or somewhere easily accessible/viewable so they’re readily available the next time boredom sets in. 

Dealing with boredom while trying to quit or interested in finding out more about Unified’s Tobacco Reduction services? Contact our tobacco reduction team:

Detroit
Amber Jager – (313) 316-6226
ajager@miunified.org

Ypsilanti/Jackson
Caitlyn Clock – (313) 316-7561
cclock@miunified.org

Building Your Own Quit Kit

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If you’re currently a client in Unified’s tobacco program, or if you’ve ever discussed the tobacco program with another UHHB provider, you might know that one of the services we offer through our program are quit kits. Our quit kits include a variety of items and resources including fidget toys, journals/puzzles/coloring pages, gum/candies, tea bags, outside resources like information for the Michigan Quit Line, and cough drops. However, it should be noted that this is not all a quit kit can contain, and there are multiple ways to add to your quit kit (if you’ve received one from UHHB or another service) or to build your own quit kit.

What is a quit kit?

A quit kit is a compilation of items, strategies, and resources to support someone who is looking to quit or reduce their own tobacco use. A good way to think about quit kits is that they are essentially a toolkit for quitting smoking. Oftentimes, we might think of the quit kit as something that is specifically for an individual’s quit day or only the first week or so of being quit. However, the true purpose of a quit kit is to be there to support you on your quit journey, whether that be your first day tobacco-free or your thirtieth. While this might predominantly be in times of frustration or when an individual is trying to cope with a particularly challenging craving, quit kits can also be there for moments of celebration as people begin to meet their quit goals.

Why is quitting so challenging?

Celebrating quit milestones is more important than people realize, and that’s because quitting is difficult. In our most recent Tobacco Talk Tuesday livestream, we discussed the dual nature of tobacco addiction and how that dual nature is what makes quitting so challenging for most, if not all, of those who are trying to quit smoking. The first part of this is an individual’s physical dependence on/addiction to nicotine. When someone uses tobacco products, the nicotine moves into the brain and activates a receptor that leads to the release of dopamine (a chemical that boosts your mood, motivation, and attention). This process happens within seconds and leaves people feeling great, so when the effects wear off they’re often left feeling stressed, anxious, or tense, which is the result of the body craving the next dose of nicotine. Over time, an individual will build up a tolerance to nicotine, and will therefore need to consume a greater amount in order for them to get the pleasurable effects from smoking. 

The nicotine addiction cycle.
Image from ResearchGate

The second part of this dual nature has to do with how an individual’s tobacco use has infiltrated their daily life. Someone looking to quit smoking must also address the patterns and habits that have become closely associated with their smoking. These might include: their cup of coffee in the morning, meals or snacks, driving, working out, smoke breaks at work, stress, specific places and people, as well as other various situations in which they might reach for a cigarette either before, during, or after it occurring. In order to find success in quitting, people often need to work to change these routines, which on it’s own can be challenging. 

It’s because of this dual nature that we suggest a two-sided strategy and response when it comes to quitting. This is done through a combination of pharmacotherapy (nicotine replacement therapies, Chantix, or Wellbutrin) with some form of behavioral intervention (individual counseling, support groups, or quitlines). 

Planning for your quit kit

Prior to starting your quit kit you might want to consider a few things:

  1. Have you already created a quit plan?
  2. Do you have a quit day (or a practice quit day!)?
  3. What does a typical day look like for you with smoking?
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If you’ve already created a quit plan you might have already considered and likely answered the second and third questions above. If you’ve created a quit plan, your quit kit should include items and resources that will support that plan. If you haven’t worked on creating a quit plan, tracking your smoking habits prior to creating a plan and building your kit may be beneficial. We often suggest individual’s track their habits over two days (a weekday and weekend) and write down what time they smoked, where they were/what they were doing, and how they were feeling at that time. Tracking your smoking habits will allow you to gain an understanding of what changes you might need to make in your daily life. Making sure your quit kit is ready (or at least partially ready) to go prior to your quit day is also important, and it might be useful to test out your quit kit on a practice quit day to see what was helpful and what was not. 

What goes in a quit kit?

When it comes to building your own quit kit, there are very few rules about what you can add to it. The most important thing to remember is that your quit kit should support you and your own quit efforts, and therefore items or resources that will help you cope with cravings or manage specific triggers should be included. The following list of items and resources isn’t a mandatory or even complete list by any means. Rather, it’s here to give ideas and be a starting point for anyone looking to put together their own quit kit.

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  • Fidget toys – bendy straws, stress balls, fidget cubes, putty, pipe cleaners, yarn loops, rubber bands
  • Colored pencils and coloring pages or books
  • Crosswords, Sudoku, or other puzzles
  • Journal and pens
  • Tea bags
  • Gum, mints, hard candies, lollipops
  • Plain or mint toothpicks
  • Cough drops
  • List of smoking triggers (and something you can do instead of smoking in that moment)
  • List of motivations to quit
  • Bubbles
  • List of snacks to replace smoking – carrots, celery, pickles, frozen grapes
  • A picture of something you’d like to buy with the money saved 
  • A planner or calendar 
  • A list of support or people you can call during a tough moment 
  • A book
  • Chosen quit medication(s)
  • Supplies for hobbies 
  • Quit smoking apps like quitStart (iOS, Android), Smoke Free (iOS, Android), and Kwit (iOS, Android)
  • Rewards for quit milestones
  • Recipes you want to try

Maybe some of these ideas have helped you on past quit attempts, or maybe a few will help you on a future quit attempt. Regardless of the items you choose to add to your quit kit, the most important thing is that the contents of your kit are there to support your quitting efforts.


Have additional questions about quit kits or just interested in finding out more about Unified’s Tobacco Reduction services? Contact your local Tobacco Treatment Specialist:

Detroit:
Amber Jager – (269) 350-3826
ajager@miunified.org

Ypsilanti/Jackson:
Caitlyn Clock – (734) 489-9916
cclock@miunified.org 

Understanding E-cigarettes and Vaping

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“Would switching to an e-cigarette be helpful?” is not an uncommon question to hear working in tobacco treatment, even with the nationwide panic over vaping occurring just under a year ago. Since their introduction into the U.S. market in 2007, e-cigarettes have been seen as a way to potentially aid in tobacco reduction/cessation by many, but most specifically the industry’s marketing teams. Additionally they’ve been marketed towards teenagers and young adults through social media and youth-oriented flavors, and as result we’ve seen major growth in use over the last five to ten years. Because of this, it continues to be important to consider the health risks and concerns that come along with e-cigarette use. 

Background

E-cigarettes are a type of electronic nicotine delivery systems (ENDS), and are also commonly referred to as vapes or vape pens, as well as various brand names (example: JUUL). The devices work by producing an aerosol from a liquid that’s heated within the device by a metal coil, which the user then inhales. “E-liquids” are made up of nicotine, glycerin or propylene glycol, flavorings, and various chemicals. The aerosols that are inhaled may also contain  ultrafine particles and heavy metals like nickel, tin, and lead. 

When they were initially introduced to the market, e-cigarettes looked very similar to combustible cigarettes and were a disposable product. Since then, we’ve seen major changes to both the appearance and functional capabilities of these devices – and not necessarily for the better. E-cigarettes and vapes no longer have one design, instead they now might look like pens, lighters, highlighters, USB devices, or even inhalers. In addition to modern generations being refillable and/or reusable, users can modify what is being put into their e-cigarette which leads to the ability to use marijuana and other substances with these devices

Growth, Marketing, and Current Use

The first time I saw an e-cigarette was at least 10 years ago in a kiosk in the local mall (those who frequented Briarwood mall in the 2007-2010 might have memories of this as well), and what I remember specifically is that they were primarily being marketed as a way help adults who smoked quit cigarettes. At some point the kiosk was changed, and I didn’t really think about e-cigarettes or other ENDS products for many years. During this time, e-cigarette and vaping companies began to make major strides within the market, with focus shifting from current tobacco users looking to quit smoking to youth and young adults .

E-cigarettes are currently the most commonly used tobacco product among youth in the United States, with over 5 million middle and high school students reporting use within the last 30 days in 2019. Specifically between 2011 and 2015 we saw a 900% increase in use within this demographic. Some (and likely most) of this growth can be attributed to the youth-oriented marketing that has been present in the last 5-10 years. Examples of this marketing include brightly colored ads (like the one below), social media use (including hashtags like JUUL’s #vaporized), promotion through celebrities and “influencers”, and youth-targeted flavors (fruit, candy, and mint). These efforts have succeeded in reaching U.S. youth, with more than 5 in 10 (over 14 million) middle school and high school students reporting seeing e-cigarette advertising in 2018. 

People use e-cigarettes and vapes for numerous reasons. For adults these include: to aid in quitting combustible cigarettes, to get around smoke-free laws/regulations in public spaces, and that they view them as a “safer” or “healthier” option. Youth also often believe e-cigarettes and vapes to be less harmful than combustible cigarettes (many are also unaware that these products contain nicotine) and have cited novelty and flavors as additional reasons for use.

Health Risks

Being a “safer” alternative to smoking is a commonly cited reason for using an e-cigarette, as well as being a belief many have seen used to promote these products by companies and other pro-vaping organizations and groups. Something that is seen far less in these promotions is that “safer” does not mean SAFE. There are still health risks and concerns when it comes to e-cigarette and vaping product use, with more research on long term health impacts still needed. These risks include:

  • Nicotine/nicotine addiction – particularly a concern for those under the age of 25 and pregnant individuals as nicotine is associated with issues with attention, learning, mood, and impulse control within the developing brain
  • Harmful chemicals – including cancer causing chemicals and chemicals like diacetyl (chemical flavoring) which is linked with serious lung disease
  • Inhalation of ultrafine particles and heavy metals such as nickel, tin, and lead
  • Increased likelihood for dual use and increased likelihood for using combustible tobacco products later in life 
  • Unintentional injuries – such as explosions and/or fires caused by defective batteries or poisoning caused by swallowing, breathing, or absorbing e-cigarette liquid through the skin or eyes
  • Secondhand exposure to chemicals via aerosol 
  • E-cigarette or Vaping product use Associated Lung Injury (EVALI) – has been linked with vitamin E acetate and THC containing products, and research continues to look into other causes and risks

You can find more information on health risks and resources for discussing e-cigarettes (particularly with youth) on the CDC, Michigan Department of Health and Human Services, and Surgeon General webpages for e-cigarettes and vaping. 

Regulations 

E-cigarettes are currently regulated at the federal level by the FDA, which implemented regulations for sales and manufacturers, and some regulations to ban flavored (non-menthol) cartridges. Additionally, the FDA began recognizing ENDS as a tobacco product in 2016. In Michigan, we have two laws that currently regulate e-cigarette use and sales which:

  • Define “liquid nicotine” and “liquid nicotine container”, as well as establish minimum safety standards for these containers
  • Define e-cigarettes and vaping products separately from tobacco products
  • Requires these products to be stored in a locked case or behind the counter in vape and smoke shops
  • Prohibits sale to minors 
  • Prohibits use/possession by minors

Like the FDA, Michigan and other states across the country have attempted flavor bans or other regulations of flavored e-liquids. Overall there have been issues with these attempts not being strong enough. Menthol and mint flavors are often not being targeted by these bans, and some brands are able to avoid them through device design, allowing for flavors popular with youth to remain on the market. 

It should be noted that due to some of these efforts and restrictions at the federal and state level, there has been a shift in marketing tactics. Specifically JUUL, the largest e-cigarette and vaping company in the U.S., has removed their candy flavored “pods”, cleared out their social media, and given their website a sleeker and more mature look. With these changes, it appears they (along with other companies like IQOS) are now focusing their marketing on adults who currently smoke or adults who are looking to quit smoking. 

Use in Tobacco Cessation 

One of the most commonly asked questions when it comes to e-cigarettes and vaping products, and the question I decided to start this blog off with, is whether or not these devices are useful in quitting combustible cigarettes and other tobacco products. In a world that loves clear-cut answers, this one will certainly be unsatisfactory, and it is: we don’t know. Like long-term health impacts, there is still a need for more research on this topic moving forward. However, it should be noted by all who are considering using any form of these products that there currently is no evidence to support their usefulness in tobacco cessation. There is also concern that dual-use (i.e. use of an e-cigarette/vape and use of combustible cigarettes/tobacco products at the same time) may occur in those who try to use e-cigarettes to quit smoking. Additionally, e-cigarettes have not been approved by the FDA as an aid for quitting smoking, but there are currently seven approved quit medications that you can learn more about on our most recent tobacco blog.

The bottom line is that while these devices may be safer in some aspects, safer does not mean safe. Specifically, e-cigarettes and vapes are not safe for youth, people who are pregnant, and people who do not currently use tobacco products. There are numerous cessation aids and strategies that have been shown to be successful for people looking to quit their tobacco use, all of which should be considered first and foremost.

Have additional questions about a blog topic or just interested in finding out more about Unified’s Tobacco Reduction services? Contact your local Tobacco Treatment Specialist:

Detroit:
Amber Jager – (269) 350-3826
ajager@miunified.org

Ypsilanti/Jackson:
Caitlyn Clock – (734) 489-9916
cclock@miunified.org 

Pharmacotherapy for Quitting Smoking: NRT, Chantix, and Wellbutrin

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What's the Best Way to Quit Smoking? - GoodRx

Quitting doesn’t look the same for everyone, which is why there are so many different strategies and remedies to assist people with reducing, and eventually quitting smoking all together. I want to present the whole “menu of options” of pharmacotherapy to you, so that you are best equipped to make an informed decision that is right for you and your goals with your tobacco use.

First, let’s do a general walk through of pharmacotherapy and how it can be helpful

What is pharmacotherapy?

Pharmacotherapy is the use of FDA regulated medication to assist an individual with medical conditions, such as addiction. Regarding nicotine dependency specifically, there are two types of pharmacotherapy: nicotine replacement therapy (NRT) and medication in the form of a pill.

Evidence-based studies have proven that people who use tobacco products are two times more likely to be successful in their quit attempt if they combine nicotine dependency counseling with some form of pharmacotherapy, compared to using either pharmacotherapy or counseling alone.

There are many factors at play that make quitting so hard (societal, cognitive, the length of time someone has been smoking, etc.) but today we are going to focus on nicotine withdrawals and utilizing pharmacotherapy as a means to reduce the negative effects caused by withdrawals. Nicotine withdrawals can be a lot more difficult than most people think, and are a huge barrier to quitting tobacco use due to the extreme discomfort they can cause. For this reason, it is crucial that you know your options as someone who is trying to quit using tobacco products.

Chemical formula of Nicotine with spilled tobacco - Buy this stock ...

What are nicotine withdrawal symptoms and why do they occur?  

Nicotine withdrawals occur as symptoms of your brain adjusting to the new “normal” as nicotine levels fall within your brain, and eventually leave your system. Nicotine can leave your body entirely within a few days, thanks to the short half-life of the drug. It is important to note that just because the nicotine leaves your system so quickly does not mean that withdrawals will leave as quickly. Most people who quit smoking experience extreme symptoms to nicotine withdrawal for 1-2 weeks with withdrawal usually reaching its peak by day 3, and it can take a few months for them to be gone entirely. This is because it takes up to 3 three months for your brain chemistry, specifically dopamine receptors, to return to “normal” pre-smoking levels.

A more thorough explanation of how withdrawal happens, and why it takes so darn long for things to feel “normal” or for life to feel good again after quitting

Before you smoked, your brain created its own pleasure response (flood of dopamine) to daily activities such as spending time with people you enjoy, eating, having sex, and plenty of other activities. When you start smoking, your brain “doubles down” on the pleasure response thanks to nicotine increasing the volume of the pleasure response that becomes available to you as you smoke (or chew).

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Over repeated use, your brain drastically reduces the amount of pleasure response that is created on its own, without cue from nicotine, since the nicotine makes it so readily available anyways. Think of it this way- if you have a child who regularly cleans their room every day, but you start cleaning their room while they’re at school, they will stop doing it themselves. This is what your brain is doing (or not doing) as nicotine triggers the release of dopamine When you stop using tobacco products, your brain doesn’t catch on right away, so you are receiving much less pleasure response (dopamine) than you were when you were using tobacco, but now you’re also receiving less pleasure response than before you started smoking in the first place. This results in life feeling less satisfactory in a variety of ways.

After increased abstinence, your brain plays catch up, and the dopamine levels in your brain return to the pre-smoking levels. Life is bearable, and even enjoyable again. Understanding this aspect of nicotine withdrawal can help make the experience much less daunting, and give hope that better days really are to come and that all pleasure is not lost once you kick the cigarettes out of your life.

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Below is a list of common nicotine withdrawal symptoms:

  • Cravings (can be general, also the sense of needing something in your mouth constantly)
  • Irritability
  • Trouble concentrating
  • Anxiety
  • Depression/crying spells
  • Increased hunger/ weight gain
  • Fatigue
  • Headache

Now, time to see all of your options for keeping the above withdrawals at bay during your quit journey.

Your Guide to Pharmacotherapy for Reducing or Quitting Tobacco Use

***This information is purely educational, so that you understand what all of your options are and how each works. It is always wise to consult with a doctor or tobacco treatment specialist when utilizing any medication to help with reducing or quitting smoking in order to make sure that the dosing and recommendations are safe and make sense for your unique smoking pattern and nicotine dependency.***

Nicotine Replacement Therapy (NRT)

There are many options for someone who wishes to utilize nicotine replacement therapy, and nicotine replacement therapy seems to be the most popular form of assistance from my clientele base. There are five different types approved by the FDA, outlined below.

The Patch

How you use it: The nicotine patch is a transdermal patch that you put on each day (most people find it easiest to remember by replacing it each morning) and keep on throughout the day. It gives you a steady stream of nicotine throughout the day, in order to help stave off withdrawal symptoms while reducing or quitting.

How it works: The nicotine patch is the only NRT that is slow acting. What that means, is that the patch slowly releases an equal amount of nicotine into your bloodstream for the full day that you wear it. This is important, because the slow and steady release of nicotine into your system helps your body fight the nicotine addiction by making its presence less enforcing as you are no longer self-medicating as a direct response to triggers that may have effected your smoking patterns in the past. It is encouraged to pair a slow acting and quick acting NRT together to maximize success in quitting.

Dosing: Depends on recommendations made by your Tobacco Treatment Specialist (TTS) or Physician, but most people who smoke 1 pack per day or more utilize the 21mg patch to start. It also comes in 14mg and 7mg quantities.

Cautions: Using the patch can be very helpful as a means to help individuals reduce their tobacco use but please utilize caution and consult with your doctor or TTS if you are using the patch while still smoking. Nicotine poisoning can cause rapid heartbeat, nausea, and in  severe cases, result in a heart attack.

Nicotine Gum

How you use it: You chew the gum until it begins to taste “peppery” or not enjoyable. This change in taste as you chew it is the nicotine being activated to be released. Once the taste changes, you “park” the gum between your lip and your gums and keep it there for 15-30 minutes as the nicotine being released will then be absorbed by the mucous membranes that line your cheek.

NRT Gum AND Patch

How it works: The nicotine gum delivers nicotine to your system within a few minutes. It is a fast-acting NRT, meaning that it kicks in relatively quick. The dosing is quite small, making it a great companion to the patch when you quit. I usually recommend that clients utilize the gum in addition to the patch, as something to supplement getting through mornings or rough triggers, as they are waiting for the patch to kick in. Even with the gum delivering nicotine to your bloodstream within a few minutes, it is helping your body kick the withdrawals while also continuing to eliminate the positive reinforcement of smoking/utilizing nicotine as a stress response. This is because the delivery of nicotine to your bloodstream within a few minutes is still relatively slow when compared to the 7 seconds that it takes for nicotine to be delivered to your bloodstream when you are smoking a cigarette.

Dosing: The nicotine gum comes in 4mg and 2mg doses.

Cautions: Please make sure that you do not continue chewing the gum past the peppery taste and NEVER swallow the gum. Spit it out into the trash when you are done. With the dosing being so small with the gum, the chances of getting nicotine poisoning are extremely low, but you’re in for a nasty stomach ache and/or nausea if you swallow the nicotine gum directly.

Nicotine Lozenge

Nicotine lozenge

How you use it: Move the lozenge from one side to the other side of your mouth often, allowing it to slowly dissolve for about 20-30 minutes. Avoid chewing the lozenge.

How it works: The nicotine lozenge acts very similar to the Nicotine Gum and delivers nicotine to your system within a few minutes. It is a fast-acting NRT, meaning that it kicks in relatively quick. The dosing is quite small, making it a great companion to the patch when you quit. I usually recommend that clients utilize the lozenge in addition to the patch, as something to supplement getting through mornings or rough triggers, as they are waiting for the patch to kick in. Even with the lozenge delivering nicotine to your bloodstream within a few minutes, it is helping your body kick the withdrawals while also continuing to eliminate the positive reinforcement of smoking/utilizing nicotine as a stress response. This is because the delivery of nicotine to your bloodstream within a few minutes is still relatively slow when compared to the 7 seconds that it takes for nicotine to be delivered to your bloodstream when you are smoking a cigarette.

Dosing: The nicotine lozenge comes in 4mg and 2mg doses. It also comes in a variety of flavors (mint, cinnamon, fruit).

Cautions: Do not chew or swallow the lozenge, as this can cause a stomach ache and/or nausea. It is advised to not use more than 1 lozenge an hour- especially if you are already using it with the patch.

Nicotine Inhaler

*This product is only available by prescription from a doctor

How you use it: You should not begin to use an inhaler until after you have stopped smoking (on your quit date). It is also advised to not eat or drink 15-30 minutes before using the inhaler, to avoid irritation of the mouth. Once you put a nicotine cartridge into the inhaler, you inhale similarly to using an asthma inhaler, slowly letting the nicotine vapor absorb into your mouth and throat area.  nicotine inhaler

How it works: The inhaler mimics the look of a cigarette and contains a cartridge that fits in the inhaler, containing nicotine. Since you are absorbing the nicotine through your mucous membranes (inside of mouth, throat), you do not receive the same “hit” in your lungs like if you were to smoke a regular cigarette. The nicotine inhaler does not deliver nicotine to your brain as quickly as smoking a cigarette which helps prevent the positive reinforcement of nicotine consumption, allowing you to slowly taper down your use and prevent the onset of extreme nicotine withdrawal. The inhaler is great for heavier smokers (1-2 packs a day), as it helps you slowly ease out of your routine of grabbing a cigarette and putting it to your mouth.

Dosing: One nicotine cartridge contains enough nicotine for 20 minutes of “puffing.” It is recommended to use each cartridge in four separate five minute sessions, and to stick to less than 16 cartridges a day unless otherwise advised by a doctor. Most people end up using between six to ten cartridges a day.

Cautions: Make sure you dispose of the nicotine cartridges safely when finished, as there could be lingering nicotine inside that could harm pets or small children that come in contact with it. Discontinue use after six months. The mouthpiece should be regularly cleaned and disinfected to prevent bacteria build up.

Nasal Spray

*This product is only available by a prescription from your doctor

nicotine nasal spray

How you use it: When you have quit smoking completely, you may start using this product (quit date and beyond). You use this product just like you would use a nasal spray for colds/nasal congestion. After washing your hands, you should blow your nose in order to clear your nasal passageways.

How it works: This nicotine replacement therapy enters the blood stream quicker than the other forms of NRT due to it being absorbed through the nasal passage way. This increases the chance of the nasal spray being more habit forming than the other methods.

Dosing: Most people start with one or two doses an hour, but this can vary based on how many cigarettes you smoked a day before your quit date. Never use more than five doses an hour, or 40 doses within a 24 hour day.

Cautions: Wait at least five minutes after use before driving or  operating heavy machinery. Use the nasal spray regularly to help your body adjust to the following side effects that most people experience within the first week of us: hot, peppery feeling in the back of the throat or nose, sneezing, coughing, watery eyes or runny nose. If you are recovering from drugs that required a similar method of use, this product might not be right for you.

Quit Smoking Medications

There are currently two types of medications that have been approved by the FDA to assist individuals with quitting smoking. They are proven to be as effective as NRT.

*Both of these medications require a prescription by a doctor

Chantix (Varenicline)

chantix

How you use it: You can start taking Chantix before you quit smoking, as it takes some time for the medication to build up in your system. Some people take Chantix a week before their quit date, and others try an even more gradual quit approach and take Chantix for 12 weeks as they are working towards quitting and then remain on Chantix for an additional 12 weeks after quitting. When you do start taking Chantix, there is a specific protocol that you will take so that you can slowly increase the dose over the first week. It is advised to take the pill after eating a meal with a full glass of water.

How it works: When you start taking Chantix, as it builds up in your system, it attaches to the nicotine receptors in your brain. This makes smoking less enjoyable as the nicotine receptors are blocked in your brain and the nicotine is unable to release the flood of dopamine that usually occurs when you smoke. In turn, this helps break the reward cycle of smoking, which ends up lessening your urges to smoke. And if you do smoke while taking Chantix, the effect is significantly less pleasurable. Additionally, since Chantix is now binding to the nicotine receptors in your brain, it does produce a small amount of dopamine to mimic the effect of smoking… only on such a small level that it is not addictive, and just to serve the purpose of easing nicotine withdrawal symptoms.

Dosing: The dosing schedule can vary based on specific needs, but generally follows the following protocol: Days 1-3 you take 1 white pill (.5mg) daily, on Days 4-7 you take 1 white pill (.5mg) in the morning and 1 in the evening. Finally, on day 8 until the end of your treatment regimen you take 1 blue pill (1mg) in the morning and 1 in the evening. This allows the medication to slowly build up in your system in a safe way.

Cautions: If you have a history depression or other mental health conditions, or a history of seizures, this may not be the best option for you. A variety of side effects can occur with this medication and it is important to discuss these with your doctor if you are thinking about using this method to quit smoking.

Zyban / Wellbutrin (Bupropion)

bupropion

How you use it: Most people will start taking Bupropion 1-2 weeks before their quit date, or as they are reducing, to allow the medication to build up in your system before you officially quit.

How it works: It is still unclear precisely how Bupropion works, though it has been proven to be effective in easing irritability, concentration problems, and the urge to overeat while quitting smoking. Researchers do know that Bupropion blocks some of the chemicals in your brain that interact with nicotine, making smoking and other tobacco use less re-enforcing, leading to reduced cravings. Bupropion is also commonly prescribed as an anti-depressant.

Dosing: Days 1-3 you take one 150mg tablet each morning, day 4 to the end of your treatment regimen you take one 150mg tablet twice a day- once in the morning and once in the evening (about 8 hours between doses).

Cautions: If you have a history of anxiety, anorexia, binge drinking, or seizures, this medication might not be for you. It is important to discuss your medical history with your doctor if you are interested in taking this medication for smoking cessation.

Additional Notes

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If you are pregnant, breastfeeding, or are under the age of 18 you should consult with a doctor before using any of the above medications or NRT.

Get a prescription anyways and save your money to use on other things that will assist your reduction or quit, such as gum, sugar-free candy, toothpicks, etc.

Although you can get the patch, gum and lozenge over the counter at most stores, they can get quite expensive. Especially if you plan to use them for 6 months (the maximum amount of time suggested to help prevent relapse after quitting). With a prescription from your doctor, you can receive these products for free or a substantially reduced price, as many insurance companies will cover the cost to help individuals quit smoking with evidence based interventions. Why pay for it if you don’t have to? In the light of COVID-19, it might not be possible to go into your doctor’s office physically. Instead, you can schedule a virtual “telehealth” visit or try calling the office to explain your situation.

QUITLINE

 

If you are uninsured or underinsured, call the Michigan Quitline at 1-800-QUIT-NOW (1-800-784-8669) to see how you can get NRT mailed directly to your door.

 


Feel like you need to adjust your tobacco treatment plan due to COVID-19 or just interested in finding out more about Unified’s Tobacco Reduction services? Contact your local Tobacco Treatment Specialist:

Detroit:
Amber Jager – (269) 350-3826
ajager@miunified.org

Ypsilanti/Jackson:
Caitlyn Clock – (734) 489-9916
cclock@miunified.org