Smoking, Chewing and Vaping Tobacco

There are two kinds of vaping devices:

• open, which means they can be refilled
• closed, which means either the whole product, or the part that holds the vaping substances, can’t be refilled

Open vaping devices are used to vape everything from e-juices to cannabis. E-juices can contain nicotine with different levels of nicotine strength in addition it also contains a number of chemicals with known toxicity (e.g. formaldehyde and acrolein).

Although the health effects of e-cigarettes are uncertain, long term exposure to e-cigarette vapour may be harmful to health.

• Chemicals found in many e-juices have been linked to severe respiratory disease (popcorn lung) including coughing, wheezing and worsening of asthma, heart disease and eye irritation.
• Many e-juices contain nicotine and students using them are at risk of becoming addicted.
• Nicotine can alter teen brain development and can affect memory and concentration.

In some cases, vaping liquid containers have enough nicotine to be poisonous and toxic.

Benefits of quitting smoking

Quitting smoking has short- and long-term benefits to your health:

• Within 20 minutes of quitting blood pressure decreases; your pulse returns to normal.
• After eight hours carbon monoxide levels decrease in your body.
• After 24 hours, your chances of having a heart attack decrease.
• After 48 hours, your sense of smell and taste will improve.
• After four days, your lung capacity will increase.
• Within two weeks to three months, your blood circulation will increase.
• In one to nine months your coughing, fatigue and shortness of breath will decrease.
• After one year, your risk of having a heart attack is cut in half.

In addition to your health, there are even more benefits to you when you quit smoking.

Making a quit plan

Making a quit smoking plan helps you increase your chances of staying quit. You can plan ahead to deal with cravings and avoid trigger situations.

Managing cravings

When cravings happen remember the four D's:

• Drink water.
• Delay smoking for 10 minutes.
• A craving only lasts as long as it takes to smoke one cigarette.
• Distract yourself from the craving with something else.
• Deep breathe.
• Breathe in through the abdomen. Pull up into the lungs. Repeat.

You may have a stronger addiction to nicotine if you "need" a cigarette within the first 30 minutes of waking up, and if it is very hard to go more than an hour without a cigarette.

Talk to your health care provider or pharmacist about nicotine replacement therapies such as nicotine patches, gum, lozenges or an inhaler.

Plan for triggers

Some common danger zones to plan for:

Alcohol

• Alcohol is big trigger for many people.
• Try to avoid alcohol. It lowers your chances of quitting.

Other smokers

• Being around other people who smoke can tempt you to smoke.
• Consider a temporary vacation from other smokers while you are quitting. Ask them not to smoke around you.

Environment

• Get rid of all cigarettes, ashtrays, matches or lighters and things that remind you of smoking.
• Clean your car and home.
• Consider keeping them both smoke-free.

Weight gain

• Some weight gain is normal when quitting smoking.
• Eat a healthy diet, stay active and do not let weight gain distract you from your main goal.
• Talk to your doctor if you have concerns about weight.

Stress and coping

Smoking does not reduce stress as many people think. It actually increases your stress response. It increases your pulse and blood pressure. When quitting it is important to reduce stress and choose healthy coping to help you quit:

• Make sure you are not under more stress than usual when you pick your quit date.
• Practice different coping mechanisms, like deep breathing, walking and yoga.
• Try using a healthy alternative to cigarettes, like eating carrot sticks, chewing sugar-free gum or exercising.

Positive thinking and celebrating

• Find alternative activities that give you pleasure, such as spending time with family or friends.
• Put encouraging and positive sticky notes in places where you used to smoke.
• Plan to reward yourself for each goal you reach (e.g. save the money you would have used for cigarettes and put it in a jar to save for something to reward yourself).

8 Tips to help you quit smoking

Community supports and resources

Resources and services available in the community to help you successfully quit smoking

Individual counselling

A trained therapist provides individual counselling. They often work in one or more face-to-face sessions to help smokers quit. Contact your health care provider or pharmacist and make an appointment to discuss your options.

Telephone counselling

Counselling is provided by telephone to help people stop smoking. Multiple sessions have been found to be most effective.

Smokers' Helpline is a free, confidential counselling service offering support and information about quitting smoking and tobacco use. It is available seven days a week by phone and online.
Monday - Thursday 8 a.m. - 9 p.m.
Friday 8 a.m. - 6 p.m.
Saturday - Sunday 9 a.m. - 5 p.m.
Call: 1-877-513-5333

Kids Help Phone is free, anonymous and confidential counselling services for youth aged 20 and under. It is available 24 hours a day, seven days a week by phone and online. Call 1-800-668-6868.

Nicotine replacement therapy (NRT)

NRT helps reduce cravings and withdrawal symptoms. NRT is available as a patch, gum, inhaler, lozenges and spray, which are available over-the-counter. Speak to your pharmacist or health care provider for more information.

Medications for quitting smoking

Medications such as bupropion and varenicline can increase your chances of quitting. Talk to your healthcare provider to see if these options are right for you.

Quit smoking group program

Group programs help people in their attempt to stop smoking and increase chances of quitting by double.

More information and services

• Call the Durham Health Connection Line to talk to a public health nurse for support with quitting.

• Receive support at Carea Community Health Centre from health care professionals with quitting smoking through counselling and quit smoking support groups.

• Quit4Life is a program designed to help youth quit smoking cigarettes or using other tobacco products.

• Pinewood Addiction Support Services (PASS) and Withdrawal Management Program offers community support for addictions and accommodate housing for a couple of days. The services are for people who are 16 and older. Call 905-723-8195 or visit 300 Centre Street South, Oshawa.

The dangers of second-hand smoke

Second-hand smoke is dangerous. Each year in Canada 300 non-smokers will die from lung cancer because of second-hand smoke. There is no safe level of exposure:

• There are more than 7,000 chemicals in second-hand smoke.
• At least 69 of these can cause cancer.
• Going into another room or opening the window will not protect your family from its harmful effects.
• Outdoor levels of second-hand smoke within one to two metres of a lit cigarette can be as high as indoor levels.

Exposure to second-hand smoke can cause heart disease and lung cancer in adults.

It has also been linked to:

• Breast cancer
• Stroke
• Nasal sinus cancer
• Chronic obstructive pulmonary disease (COPD)
• Acute respiratory symptoms (cough, wheeze, chest tightness, difficulty breathing)
• Onset and worsening of asthma

In children, exposure to second-hand smoke can cause:

• Decreased lung function
• Low birth weight
• Bronchitis, pneumonia and other lower respiratory diseases
• Worsening of asthma
• Middle ear disease

It has also been linked to childhood cancer (leukemias, lymphomas, brain tumours), onset of asthma, and Sudden Infant Death Syndrome (SIDS).

Third-hand smoke

Third-hand smoke contains all the chemicals of second-hand smoke and it also clings to all surfaces like:

• Furniture
• Carpeting
• Walls
• Food
• Clothing
• Skin and hair

Third-hand smoke builds up on these surfaces over time and puts children, infants and pets at a greater risk for exposure than adults.

Youth

A majority of smokers begin smoking and vaping in their teen years. Youth are targeted by the media through movies and new products and packaging. The tobacco and vaping industry uses creative marketing strategies like adding flavours and introducing new products. These may appeal to youth and attract them to start using tobacco and vapour products. This is so they can continue to make money.

Youth opportunities

We are looking for youth who are interested in getting involved in tobacco prevention initiatives and/or advocating for tobacco control policies in Durham Region. We work with community youth agencies and youth volunteers (ages 13 to 24 and connected to a participating community youth agency) to engage youth in decreasing tobacco use in the community.

This programming is currently being funded by the Smoke-Free Ontario's Youth Engagement Strategy. Many smokers start in their teen years. Efforts to denormalize tobacco use and decrease negative role modelling are important to protect youth and young adults from future smoking and addiction.

Learn more about the campaigns you can help work on:

Smoke-free movies is the Ontario Coalition for Smoke-Free Movies who aim to get tobacco out of youth-rated movies in Ontario to protect children. They want to protect youth from exposure to on-screen tobacco. Smoking in movies gives youth the message that smoking is a normal and desirable activity.

Know what's in your mouth is a campaign designed by youth for youth to raise awareness about the dangers of chewing tobacco. Many young people have the misconception that smokeless tobacco (chewing tobacco, snuff) is less harmful compared to cigarettes or not harmful at all.

If you are interested in getting involved with these initiatives contact the Durham Health Connection Line.

Young adults

Young adulthood can be a stressful time which can increase your chances of starting to smoke or increase the amount you smoke. Getting support early on can help prevent or reduce the harmful effects of smoking on your body. We have information to help you quit smoking or reduce the number of cigarettes you smoke.

More information and support is available through:

Break it off

Pregnant women

Quitting smoking is one of the best things you can do for yourself and your baby. Smoking and second-hand smoke are harmful to you and your baby because when a women smokes or breathes in second-hand smoke, the baby does also.

This causes negative health effects on the baby and increased risks such as:

• Possibility of miscarriage.
• Complications during pregnancy.
• Premature labour and birth.
• Baby having a low birth weight.
• Possibility of your baby being born with cleft lip or cleft palate (it has been linked to mothers who smoke during pregnancy).
• Sudden Infant Death Syndrome (SIDS).

Breastfeeding and smoking

The breast milk of smoking mothers and non-smoking mothers who are exposed to second-hand smoke has been found to have nicotine and other dangerous chemicals in cigarette smoke. If you continue to smoke, you should not smoke around your baby or have a cigarette before breastfeeding your baby. Breastfeeding is still best for your baby even if you continue to smoke.

For more information:

• Pregnets
• Centre for Addiction and Mental Health
• Stop Smoking Centre

Parents

Children and teens are influenced by their parents, peers and what they see in movies. According to the World Health Organization (WHO) the more youth see onscreen smoking, the more likely they are to start.

In Ontario the Film Review Board determines ratings on films (i.e. general admission, parental guidance, 18 Adult, etc.). In order to determine ratings the Ontario Film Review Board (OFRB) considers language, nudity, violence, sexual activity, horror and psychological impact. The OFRB does not consider smoking when assigning ratings to movies.

Most movies with smoking are rated for kids and teens in Ontario.

As a parent you can:

• Talk to your children and teens about what they are seeing in movies.
• Let them know about the health risks of smoking.
• Choose smoke-free movies for your children.
• Advocate for changes to how the Ontario Film Review Board rates movies with smoking scenes.
• Learn more facts about smoking in movies.

Schools

Smoking and vaping is not allowed on public areas within 20 metres from the perimeter of the grounds of elementary and secondary schools.

Teachers have one of the most influential roles in a student's life and are able to support students in quitting smoking.

We have information and supports to help you.

Workplaces

Tobacco-free workplaces save lives and money. In Durham Region 16 per cent of adults continue to smoke daily at work. Eight per cent of adult non-smokers report being exposed to second-hand smoke at their workplace.

Bystanders can also be exposed to vapour that is exhaled by users. The health effects to non-users from exposure to second-hand vapour are still unknown. Vaping products should be used with caution around non-users and youth. (Health Canada).

Your workplace can:

• Support employees who are trying to quit smoking.
• Motivate current smokers to think about quitting or smoking less.
• Prevent non-smokers from starting to smoke.
• Attract non-smokers to your workplace.
• Protect the health of all of your workers.
• Reduce your maintenance and insurance costs.

Order tobacco-free workplace resources

Learn where smoking tobacco or cannabis or vaping anything (e.g. with an e-cigarette) is banned in Ontario.

You cannot smoke or vape on and within 20 metres of school grounds of any school.

You cannot smoke or vape on children’s playgrounds or public areas within 20 metres of children’s playgrounds.

You cannot smoke or vape on a patio of any bar or restaurant, including the public areas within 9 metres of the patio.

You cannot smoke or vape on publicly owned sporting areas, their fan/viewing areas, and public areas within 20 metres of these places.

You cannot smoke or vape in any common indoor areas of condos, apartment buildings or college and university residences.

You cannot smoke or vape on the outdoor grounds of a community recreational facility and any public areas within 20 metres of its grounds.

Come to a Health Department tobacco and vapour retailer training workshop!

A specialty vape store is a business registered with the local Board of Health that primarily sells vapour products.

A retailer can register as a specialty vape store with the Durham Region Health Department if the following criteria are met:

• A specialty vape store must have vapour products account for at least 85 per cent of its total sales in the previous year.
• If the retailer has been in operation for less than one year, at least 85 per cent of the retailer's total inventory purchases or sales for that time period must be vapour products.
• The remaining up to 15 per cent of the store's revenues or inventory would have to be dedicated to other items associated with a vapour product or branded with the name of the specialty vape store or a brand of vapour products.

Guidelines for registration as a specialty vape store Application form

Tobacconist registration

A tobacconist is a business registered with the local board of health that primarily sells specialty tobacco products.

This includes tobacco products and accessories (e.g. cigars, pipes, humidors), but does not include cigarettes.

A retailer can register as a tobacconist with the Durham Region Health Department if the following criteria are met:

• Specialty tobacco products account for at least 85 per cent of its total sales in the previous year.
• If the retailer has been in operation for less than one year at least 85 per cent of the retailer's total inventory, purchases or sales during this time period must relate to speciality tobacco products.
• The remaining up to 15 per cent of the store's revenues or inventory would have to be from cigarettes or other items reasonably associated with a tobacco product and branded with the name of the tobacconist or a brand of tobacco.

Guidelines for registration as a tobacconist Application form

No smoking, no vaping signs for businesses and retailers

Durham Region businesses and retailers can request signs from the Health Department by contacting the Environmental Help Line.