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Healthy Heart, Healthy Family: A Community Health Worker's Manual for the Filipino Community

Manual Contents

Session 10
Take Control of Your Health: Enjoy Living Smoke Free

Page Contents


By the end of this session, group members will learn:

  • How cigarette smoking harms smokers
  • How secondhand smoke harms people who are near smokers
  • Tips that can help smokers who want to quit
  • Ways to ask people not to smoke around you

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Materials and Supplies

To conduct this session, you will need:

  • “Healthy Heart, Healthy Family” manual and picture cards
  • Blackboard and chalk or several large pieces of paper, markers, and tape

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Give each group member these handouts during this session:

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Introducing the Session

  1. Welcome
  2. Review of Last Week's Session
  3. About This Session
  1. Welcome
    • Welcome group members to the session.
  2. Review of Last Week’s Session
    • Say:
      At the last session, we talked about ways to save money on our food bills. Who can name some of them?
      Note: Write group members’ ideas on the blackboard or on a large piece of paper taped to the wall.
    • Add these ideas if they are not mentioned:
      • Plan weekly meals, and shop with a list.
      • Clip coupons for products you use.
      • Check the food sale ads.
      • Use fewer packaged foods.
      • Buy only the amount of food that your family needs.
      • Shop alone, when possible.
      • Try not to shop when you are hungry.
      • Check your receipt for errors at the register.
      • Shop at convenience stores less often.
      • Use store brands as often as possible.
    • Ask:
      How are you doing with your pledges to eat in a heart healthy way even when time or money is tight? What went well? Did you have problems? If so, what did you do to solve them?
      Note: Allow 5 to 8 minutes for group members to respond.
  3. About This Session
    • Say:
      This session is about the importance of not starting to smoke and quitting smoking. During this session, you will learn:
      • How cigarette smoking harms smokers
      • How secondhand smoke can harm you and those around you
      • Ways to ask people not to smoke around you
      • Tips to quit smoking (for you and others)
    • Say:
      This session is about the dangers of smoking to heart health. Lola Idad knows the dangers of smoking well. She saw her husband struggle with his smoking habit until his last days. Lola often reflects on the Visayan proverb, “Walang tagumpay, kung walang paghihirap.” “There is no success if there is no sacrifice.
    • Ask:
      • How many of you smoke?
      • How many of you live with a smoker?
      • How many of you would like to live smoke free?
    • Say:
      Tobacco is used in a variety of ways–in cigarettes, cigars, pipes, and chewing tobacco. This session focuses on cigarette smoking because it’s the most common use of tobacco.
      Note: Other names for cigarettes include “yosi,” “smokes,” “cigs,” and “butts.”

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Conducting the Session

  1. (Optional) “A Smoke-Free Life” Role Play
  2. Facts About Smoking
  3. Smoking Harms Infants and Children
  4. Youth and Smoking
  5. Smoking and Your Wallet
  6. Secondhand Smoke
    1. Secondhand Smoke Can Harm You and Those Around You
    2. Secondhand Smoke Role-Playing Activity
  7. Quitting Smoking
  1. (Optional) “A Smoke-Free Life” Role Play
    • Give each group member the “A Smoke-Free Life Role Play” handout. Ask for two volunteers to be actors for the role play. Select a third volunteer to be the narrator.
      Note: Allow 5 minutes for open discussion.
    • Ask:
      • What are some of the lessons we learned from this role play?
      • Is there any part of the play that you can use in your own life?
  2. Facts About Smoking
    • Say:
      About 15 percent of Filipino adults and 7 percent of Filipino adolescents (age 12 to 17 years) in the United States smoke cigarettes.
    • Say:
      There are many reasons why you should quit smoking or not start smoking. Let’s go over these reasons:
      • In the United States, about 440,000 people die each year from diseases related to smoking. This is more than 1,200 people each day. Smoking causes about one in every five deaths.
      • Health care costs due to smoking are about $75 billion each year in the United States.
      • Smokers use tobacco regularly because they become addicted to nicotine, which is a powerful drug. Nicotine is found in all tobacco products. Most cigarettes contain 10 milligrams (mg) or more of nicotine. By inhaling the smoke, the average smoker takes in 1 to 2 milligrams of nicotine per cigarette.
      • Smoking can harm those around you! Cigarette smoking puts the health of your family, children, and friends at risk.
      • Show picture card 10.1.
    • Show picture card 10.1.
    • Say:
      Today, we are going to talk about what can happen when you smoke. We also are going to talk about ways to stop smoking and ways to support a friend or family member who wants to quit.
    • Give group members the “Smoking Harms You” handout, and review the information.
      Note: Ask for volunteers to read each handout aloud. Keep the picture card on display while you review this handout.
  3. Smoking Harms Infants and Children
    • Show picture card 10.2.
    • Ask:
      Do you think it is alright for pregnant women to smoke?
      Note: Allow a moment for group members to respond.
    • Say:
      Pregnant women should not smoke because it will affect their babies’ health and well-being. They should also stay away from others who smoke, because of the harm that secondhand smoke causes.
    • Say:
      Let’s go over some problems that can arise when pregnant women smoke.
    • Give group members the “Smoking Harms Infants and Children” handout.
      Note: Ask for volunteers to read the handout aloud, or you can cut out the facts, following the dotted lines on the handout, and put them in a box. Let group members draw slips of paper and read the facts aloud. Keep picture card 10.2 on display while you review the handout.
  4. Youth and Smoking
    • Show picture card 10.3.
    • Ask:
      Why do you think many people begin smoking as teenagers?
      Note: Review the picture card to show the reasons that teens smoke.
    • Add the following reasons if they are not mentioned:
      • Teens want to be like their friends.
      • Young people smoke to try to look older.
      • Some teens want to be like celebrities who smoke in movies or on television.
      • Some teens are influenced by advertisements that make smoking look “cool” or glamorous.
      • Some teens may want to be like their parents or other family members who smoke.
      • Some teens will smoke just to do something their parents don’t want them to do.
      • Young people downplay the harm smoking can do, or they think they will not be harmed.
      • Teens may like the jackets, hats, and other prizes tobacco companies offer.
    • Say:
      Let’s look at some of the facts about young people and smoking.
      • Each day about 2,000 young people under age 18 become regular smokers. That’s nearly 750,000 teens per year. If this continues, more than 6 million young people who are regular smokers could die from a tobacco-related disease.
      • Young people who use tobacco may find it hard to play sports. Smoking causes shortness of breath and dizziness. Chewing tobacco causes dehydration.
      • Use of spit tobacco can cause cracked lips, white spots, sores, and bleeding in the mouth.
      • People who start smoking at a young age are likely to smoke all their lives.
      • The longer a person smokes, the more likely he or she will develop the problems caused by smoking.
      • Young people who smoke cigarettes are also more likely to try other drugs, especially marijuana.
      • It is illegal in all states to sell cigarettes and other tobacco products to persons under age 18.
    • Say:
      Let your children know that most teens do not smoke. Tell your children that most teens who do smoke say they wish they had never started.
    • Say:
      If you smoke, set an example for your family by quitting. Be honest. Admit that you are having trouble kicking the habit. Let young people know that it is best not to start smoking, rather than trying to quit later. Try not to smoke in front of your children. Never ask your children to bring you cigarettes or to light a cigarette. Asking them to do those things can send the message that smoking is okay for them to do.
  5. Smoking and Your Wallet
    • Say:
      Smoking costs a lot in other ways. Let’s look at some things a smoker could buy with the money that he or she spends on cigarettes.
    • Give out and review the “Costs of Smoking” handout.
  6. Secondhand Smoke
    1. Secondhand Smoke Can Harm You and Those Around You
      • Ask:
        What have you heard about secondhand smoke?
        Note: Allow 3 to 5 minutes for group members to respond.
      • Say:
        Secondhand smoke is the smoke that you breathe in from someone else’s cigarette or cigar. Even nonsmokers can be harmed if they are near secondhand smoke.
      • Say:
        Let’s take a look at some facts about secondhand smoke.
        • Secondhand smoke contains poisons, such as arsenic, cyanide, ammonia, and formaldehyde.
        • Breathing secondhand smoke may cause eye irritation, nose and throat discomfort, headaches, and coughing.
        • Nonsmokers exposed to secondhand smoke increase the risk of developing heart disease by 25 to 30 percent.
        • Secondhand smoke causes nearly 1 in 10 smoking-related deaths.
        • Each year, about 3,000 nonsmokers die of lung cancer caused by secondhand smoke.
        • Infants and children who live with someone who smokes are twice as likely to have respiratory illness, bronchitis, and pneumonia as are children who do not live with someone who smokes.
        • Secondhand smoke can bring on an asthma attack.
    2. Secondhand Smoke Role-Playing Activity
      • Say:
        Let’s try role playing. Some people have a hard time telling smokers not to smoke around them or their children. This activity will let you practice what to say when someone smokes around you or your family.
      • Divide group members into groups of three. Give each group a scene from the Role Play” handouts to act out. Ask them to act out a solution to the problem, too.
        Note: Read the scenes one at a time, or hand out copies to each group. Allow about 5 minutes for each group to role-play a solution.

      Scenes for Role-Playing Activity: Someone Is Smoking. What Can You Do?

      • Scene 1
        Your brother-in-law’s friend comes to your home for a dinner party. Most of the family and guests are in the living room talking. Your brother-in-law’s friend comes to the kitchen to ask you for an ashtray, as he lights up his cigarette. You know smoking around the children is harmful. What can you do?
      • Solutions:
        • Tell him that cigarette smoke is harmful to you and your children.
        • Ask him if he would please go outside to smoke.
        • Tell him your home is smoke free.
        • Tell family members and friends ahead of time that you do not allow smoking inside your house.
        • Post a “Thank You for Not Smoking” sign for visitors.
      • Scene 2
        You go out to eat with a friend to celebrate a special occasion. You ask to sit in the nonsmoking section of the restaurant. The nonsmoking area is in a corner of the restaurant. There are no walls separating the smoking section from the nonsmoking section. As you order your meal, four people sit down about three tables away from you in the smoking section. They begin to smoke one cigarette after another. After a minute or two, you begin to smell their smoke at your table. You tell the waiter the smoke is bothering you. He says he cannot ask them to stop because they are in the smoking section. What do you do?
      • Solutions:
        • Ask to be moved to another table farther from the smokers.
        • Ask the waiter to wrap up your food and leave.
        • Tell the manager that you cannot be around smokers.
      • Scene 3
        Your teenager comes home after school smelling like smoke. What do you do?
      • Solutions:
        • Do not jump to conclusions. First, ask the teen if he or she was smoking cigarettes.
        • If so, ask the teen why and how long he or she has been smoking.
        • Encourage your teen to quit by explaining the dangers of smoking.
        • Give examples of family members and friends who have quit or have gotten sick from smoking.
        • If your teen was not smoking and says that it is the friends who smoke, compliment and encourage him or her to continue to say no to smoking.
        • Update your teen on the risks of secondhand smoke.
      • Ask group members if they have any comments or questions about the role play.
      • Say:
        One thing we all can do in our homes to prevent these situations is to post a sign that says “Thank You for Not Smoking” or “This Is a Smoke-Free Home.” This lets guests know your house is smoke free.
      • Give group members the “Smoke-Free Family Sign” handout.
      • Say:
        This sign can be used on a tabletop or taped to the wall or refrigerator.
  7. Quitting Smoking
    • Say:
      Quitting smoking is not easy, but it can be done. To quit smoking for good, some smokers need help to overcome their urges to smoke. They also need encouragement and support to help them break the habit.
    • Say:
      In the Philippines, it is often said that “Ang bawat sigarillo ay pako sa ataul mo.” “Every cigarette stick is a nail in your coffin.”
    • Say:
      Have any of you quit smoking? Or do you know anyone who has quit smoking? What are the benefits of quitting smoking?
      Note: Allow 3 to 5 minutes for group members to respond. Write their answers on the blackboard or on a large piece of paper taped to the wall.
    • Add the following answers if they are not mentioned:
      • You will live longer and have better health.
      • You will lower your chance of having a heart attack, stroke, cancer, and respiratory problems.
      • If you are pregnant, quitting smoking will improve your chances of having a healthy baby.
      • The people you live with, especially children and older adults, will be healthier.
      • You will have extra money to spend on things other than cigarettes.
      • You will be free of a morning cough.
      • Your clothes, hair, and breath will smell better, as will your home and car.
    • Say:
      To quit smoking, you need to know your personal feelings or the situations that trigger your urge to smoke. This will help you to overcome the urge to smoke.
    • Ask:
      What are some of these feelings or situations that bring on the urge to smoke?
      Note: Allow 3 to 5 minutes for group members to respond.
    • Write their answers on the blackboard or on a large piece of paper taped to the wall.
    • Add the following answers if they are not mentioned:
      • Drinking coffee
      • Drinking alcohol
      • Talking on the phone
      • Watching someone else smoke
      • Feeling stressed
      • Feeling bored
      • Feeling depressed
    • Say:
      Let’s review what smokers can do to overcome the urge to smoke.
    • Say:
      1. Find ways to relax. If stress causes you to want to smoke, try deep breathing to calm you. Let’s try it now. Take a slow, deep breath, count to five, and release it.
      2. Keep busy. Do activities that require the use of your hands, such as sewing, fishing, playing tennis, or doing arts and crafts, repair work, or a project around the house.
      3. Keep moving. Try going for a walk, working in the garden, doing stretching exercises, or practicing your favorite dance steps.
      4. Know what to expect. The nicotine in cigarettes and other tobacco products causes addiction. When smokers try to cut back or quit, the lack of nicotine in their bodies makes them have withdrawal symptoms. You may experience withdrawal symptoms. These symptoms are:
        • Headaches
        • Feeling irritable
        • Feeling tired
        • Having trouble concentrating
    • Say:
      Although withdrawal symptoms are not pleasant, it is important to know that they are signs that your body is recovering from smoking. Most symptoms will go away in 2 to 4 weeks.
    • Give group members the “Tips To Quit Smoking” handout. Ask for volunteers to read the tips aloud.
    • Say:
      These tips have helped other people. If you are a smoker, they can help you quit. If you’re not a smoker, share the tips with a family member or friend who would like to quit. Studies have shown that these steps will help you quit smoking for good.
    • Say:
      Nagging people about their smoking can make them become angry or defensive. Try these positive ways to help family members or friends who want to quit:
      • Say things such as “Quitting is hard, but I know you can do it.”
      • Help them stay away from smokers in the beginning, when it is the hardest to quit.
      • Suggest other activities that will help them beat the urge to smoke. For example, ask them to take a walk with you.
    • Ask:
      Do you have any questions about the information we covered today?
    • Give group members the “Help Your Heart – Don’t Smoke” and the “Break Free From the Smoking Habit” handouts.
    • Ask for volunteers to read the handouts out loud.

      More Information

      • In the Philippines, as of January 1, 2007, it became illegal to advertise tobacco products on television and radio. As of 2008, all forms of advertising tobacco products in the mass media are prohibited.
      • In the United States, tobacco companies spend billions of dollars advertising their products to get people to smoke. They do this through advertising in magazines, on billboards, and on posters in stores.
      • One study in San Diego, CA, found that Asian American communities had more tobacco billboards than any other community, and Caucasian communities had the least.
      • Tobacco ads usually show happy, attractive people enjoying life as they smoke their cigarettes. Many individuals want to be like those people, so they start smoking.
      • Tobacco companies also advertise their products by supporting special sporting events such as tennis tournaments and car racing events. They go to dances, festivals, and other community events to promote their products by giving away free merchandise and cigarettes.
      • Tobacco companies pay movie companies to have actors smoke on screen. This allows them to get around the law that bans cigarette advertising on television or in movie theaters.
      • Tobacco companies attract new smokers to make up for the thousands of people who die each day of diseases related to cigarette smoking. They target young people because young smokers are likely to be lifelong smokers. Teenage smokers are important for the tobacco companies because teens will continue to buy cigarettes for many years.
      • The advertising programs from tobacco companies influence young people. The number of youth who began smoking increased when tobacco companies introduced cartoon-like characters to sell cigarettes. Tobacco companies also give away gifts that appeal to youth to get them to smoke a certain brand.

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Review of Today's Key Points

  • Say:
    Let’s review what we learned today.
  • Ask these questions:
  • When people smoke, which diseases are they likely to develop?
    • Smoking contributes to heart disease, cancer, stroke, and respiratory diseases, such as chronic obstructive pulmonary disease and asthma.
  • Is it all right for pregnant women to smoke?
    • Pregnant women should not smoke. Smoking reduces the oxygen the baby receives, contributes to lower birth weight, and increases the chance of a baby being born dead.
  • What is secondhand smoke?
    • Secondhand smoke is smoke that you breathe in from someone else’s cigarette. It is filled with harmful chemicals.
  • What can you do if someone is smoking around you and you don’t like it?
    • Ask the person not to smoke inside, or leave the area yourself. Post a sign in your home that says “Thank You for Not Smoking” or “This Is a Smoke-Free Home.”

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Lola's Life Lessons: A Time To Reflect

  • Say:
    The de la Cruz family faces many challenges, from heart disease to smoking. This week, Lola Idad reminds us of the importance of hope on this journey. Lola and her family work hard to stay heart healthy and smoke free.
  • Give each group member the “Lola’s Life Lessons: Session 10” handout. Ask a volunteer to read the handout.
  • Say:
    Please take a few moments to reflect on Lola’s advice and how it applies to your life. At the bottom of the handout, there is a space called “A Time To Reflect.” Use this section to record your feelings about this week’s session. Please write down your thoughts. Remember, this is for you and no one else.
  • Give each group member 2 to 3 minutes to write down some thoughts.

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Pledge for Life!

  • Say:
    Pledge to do one thing to prevent or stop smoking or to reduce your exposure to secondhand smoke.
  • Give group members the “Pledge for Life! Session 10” handout.
  • Say:
    We will talk about how you do with your smoking pledge at the next session. Also, keep working on the pledges you made during earlier sessions!

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  • Say:
    Thank you for coming today. What did you think of today’s session?
    Note: Allow a moment for group members to respond.
  • Say:
    I am looking forward to seeing you next week. The next session will be a review and graduation celebration.
  • Ask group members if they want a potluck dinner at the final session. If so, ask for volunteers to bring heart healthy dishes. Do not forget nonfood items, such as paper plates, cups, and plastic forks and spoons.
  • Note for Educator: Think about today’s session. What worked and what didn’t work? Have you made any changes in your own life to quit smoking (if you smoke) and decrease exposure to secondhand smoke?

Go to Session 9

Go to Session 11

Information on this page is taken from the English print version of “Healthy Heart, Healthy Family: A Community Health Worker's Manual.” U.S. Department of Health and Human Services, National Institutes of Health, National Heart Lung and Blood Institute, NIH Publication No. 08-3674, Originally Printed 1999, Revised May 2008.

Last Updated March 2012

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