Say: At the last session, we talked about ways to save money on our food bills. Who can name some of them?
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 said:
Plan weekly meals, and shop with a list.
Clip coupons for products you use.
Check the food sale ads.
Use fewer prepackaged foods.
Buy only the amount of food that your family needs.
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 pledge 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.
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)
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 – 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 “smokers,” “cigs,” and “butts.”
(Optional) “The Big Game: Quit Smoking” Telenovela or Fotonovela Show the Telenovela “The Big Game: Quit Smoking,” or ask volunteers to read the Fotonovela. Note: The Telenovela is available in Spanish only.
Facts About Smoking
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.
Nearly one in every four Latino men smokes (about 23 percent). Fewer Latina women smoke (one in eight, or about 12 percent), but this number is increasing.
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. From inhaling 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 and friends at risk.
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 tip aloud. Keep the picture card on display while you review this handout.
Smoking Harms Infants and Children
Show picture card 10.2.
Say: Do you think that pregnant women should 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 also should stay away from others who smoke, because of the harm that secondhand smoke causes.
Say: Let's go over some problems that can happen if pregnant women smoke.
Give group members the “Smoking Harms Infants and Children” handout. Note: Ask 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 the picture card on display while you review the handout.
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 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.
It can be hard for young people who use tobacco 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 it is that 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, smokeless tobacco, and other tobacco products to people under age 18.
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. 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.
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.
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.
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.
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.
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.
Say: This sign can be used on a tabletop or taped to the wall or refrigerator.
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.
Ask: 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 reduce your chances 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 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:
Talking on the phone
Watching someone else smoking
Say: Let's review what a smoker can do to overcome the urge to smoke.
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.
Keep busy. Do activities that require the use of your hands, such as sewing, arts and crafts, or a project around the house.
Keep moving. Try going for a walk, working in the garden, doing stretching exercises, or practicing your favorite dance steps.
Know what to expect. The nicotine that is 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:
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.
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?
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.
Tobacco ads usually show happy, attractive people enjoying life while they smoke cigarettes. Many individuals want to be like these attractive people, so they start smoking.
Tobacco companies also advertise their products by supporting special sporting events such as soccer games 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 the movies.
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.
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).
Should a pregnant woman 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.”
Say: You have learned a lot today about living smoke free. Now, let's think about how you can apply what you have learned. Please think of one change you can make in your everyday life to quit smoking or avoid secondhand smoke. This will be your pledge for the week.
Say: Be specific about what you plan to do, how you plan to do it, and when you will start. Let's take a look at some examples:
If I smoke, I will choose a quit date within the next 2 weeks and quit smoking on that day.
I will ask my children to make a sign to let people know that our home is smoke free. Note: Allow 5 minutes for group members to think of a pledge. Tell group members to write their pledges on the “Break Free From the Smoking Habit” handout.
Ask: Would anyone like to share his or her pledge with the group? Note: Write down pledge ideas on the blackboard or on a large piece of paper taped to the wall.
(Optional)Say: Keeping a personal value in mind can help you quit smoking for good. Remember that a personal value is a quality that you consider important. Today's value is peace. When you feel at peace with your life, you can overcome the fears that may prevent you from breaking the smoking habit. Peace helps you to trust in yourself and remain optimistic in spite of the problems you may face.
Ask: How could you use peace, or another value, to help you keep your pledge? Note: Allow 3 minutes for group members to share their thoughts.
Say: We will discuss the results of your pledges next week. Don't forget to work on your pledges to be more physically active; to cut back on salt, sodium, saturated fat, trans fat, and cholesterol; to reach and keep a healthy weight; to prevent or control diabetes; to make heart healthy eating a part of your family life; and to eat in a heart healthy way, even when you are on a tight budget or have little time.
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. Don't forget nonfood items such as paper plates, plastic forks, and spoons. Note: Think about today's session. What worked and what didn't work? Have you made any changes in your own life that were covered in today's session?
Information on this page is taken from the English print version of “Your Heart, Your Life, 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.