Use over the counter products to really quit smoking in 2011

According to the World Health Organization, tobacco kills more than five million people a year. The CDC reports that smoking is the leading preventable cause of death in the United States today. Of the smokers in the United States, 70% desire to quit. Smoking cessation success rates double when tobacco use treatment is utilized.

Fortunately for smokers, there is a wide variety of OTC (over-the-counter) nicotine replacement products to assist them in their quest to quit. Nicotine replacement therapy dosage forms include patches, gum, and lozenges. As soon at these OTC nicotine replacement therapies are started, the smoker must completely quit using all tobacco products.

Nicotine Patches
Nicotine replacement patches are the only OTC product to provide a constant release of nicotine throughout the day. The downside of this constant release of nicotine is that the patches do not allow the smoker to respond to acute cravings throughout the day. Therapy with nicotine patches is available in three steps that included the dosages of 21 mg, 14 mg, and 7 mg patches. Smokers that use fewer than 10 cigarettes per day should start on the 14 mg patch for 5 weeks and then decrease to the 7mg patch for 2 weeks.

It is important to never cut nicotine patches or wear more than one patch at a time. Nicotine patches should be applied to clean; dry skin area and the application site should be rotated on a daily basis to help decrease skin irritation, which is the most commonly reported side effect. Some nicotine patch wearers have complained of insomnia and vivid or abnormal dreams . To prevent these side effects, the nicotine patch can be removed at bedtime and a new patch can then be applied every morning.

Nicotine Gum

Nicotine gum is available in 2 mg and 4 mg strengths. For smokers who smoke fewer than 25 cigarettes per day, the 2 mg strength should be used. Those smokers who smoke more than 25 cigarettes per day should use the 4 mg strength.
During weeks 1-6 of nicotine gum therapy, one piece of gum should be chewed every 1-2 hours with at least 9 pieces of gum used per day. During weeks 7-9, one piece of gum should be chewed every 2-4 hours. Finally in weeks 10-12, one piece of gum should be chewed every 4-8 hours. The most common side effects of nicotine gum include upset stomach, unpleasant taste, hiccups, and jaw soreness.

Nicotine Lozenges

Nicotine lozenges are available in 2 mg and 4 mg strengths. It is recommended that patients who smoke their first cigarette within 30 minutes of waking up should start with the 4 mg strength lozenge. For all other smokers, it is recommended to start with the 2 mg strength lozenge. It is important to dissolve the lozenge slowly in the mouth and never to chew or swallow the lozenge whole. Food or drink should be avoided for 15 minutes prior to, during, or after using the lozenge. Two lozenges should never be used at one time.

Never use two nicotine replacement therapies at the same time unless directed to do so by your primary care provider. It is generally not recommended to use the nicotine patches, gum, or lozenges longer than 2-3 months, but talk to your primary care provider to assess if a longer amount of therapy is needed.

Alisia Baker, PharmD

Texas Health Fort Worth

2011 Shouldn’t Hurt

Now is a time for resolutions and new beginnings and I want to challenge you all with a goal that you don’t have to take on alone.

The goal is to initiate a change in the rapidly increasing numbers of domestic violence crimes that are occurring in our community. Domestic violence, as defined by Webster's dictionary, is the inflicting of physical injury by one family or household member onto another. Violence takes many forms and usually leaves the victim traumatized for life if they survive.

At Texas Health Fort Worth we are dedicated to caring for patients mind, body and spirit, but the number one weapon against domestic violence is education. The Domestic Violence Task Force seeks to improve how we provide compassionate and caring service to the victims of domestic violence who come through our doors. Through the assistance of the continuous improvement department, the task force has developed a threefold strategy:

• Research the latest trends in domestic violence


• Educate Texas Health Fort Worth staff, physicians and volunteers on how to sensitively approach a potential victim


• Provide a resource manual for victims to find long-term support

If you suspect a loved one is a victim of domestic violence, please contact a health care professional.

Angelo Betancourt

Staff Chaplain

Well, it is nearly here. Everyone is gearing up, parties are being organized and I’m sure there are a few wagers out there regarding who the next Super Bowl champs will be. Cowboy Stadium is ready, all 73 acres. Did you know the entire Statue of Liberty and its base can fit into the stadium with the roof closed? And if that isn’t big enough, the stadium holds the world’s largest high-definition video display. The parking lots open at 10AM while the kick off is scheduled to begin at 5:30PM, so you know that local traffic will be hectic to say the least.

Much preparation has taken place to keep all 110,000 fans safe at the stadium. While we are all aware of the times we live in, not all the risks are at the game. Young males, ages 21-34 who are the core audience for major sporting events, are most likely to be involved in car crashes, to drive impaired and not wear seatbelts according to the National Highway Traffic Safety Administration. You have heard me say before that a seatbelt is your best defense against an impaired driver, so buckle up!

Personally, I am enjoying the game (and the innovative commercials) at home with friends. I can’t boast of having the largest high-definition TV, but I have a primo parking spot and reserved seating. If you are having friends and family over, remember to designate your driver early. Serve lots of food, including non-alcoholic beverages. In the third quarter, put the adult beverages up and bring out the coffee and desserts. It’s also a great idea to have the numbers for local cab companies handy. Enjoy this event without penalties, fouls or calls of unsportsmanlike conduct, because in real life there aren’t instant replays.

Mary Ann Contreras, RN

Injury Prevention Coordinator