Healthy Living Messages

• Be Physically Active
• Eat Wisely
• Strive for a Healthy Weight
• Get Recommended Screening Tests & Immunizations
• Be Involved in Your Health Care
• Be Tobacco Free
• Limit Alcohol
• Manage Stress
• Be Safe
  

• Quitting smoking is the single most important thing you can do to improve your health and protect the health of your family members. Smoking harms nearly every organ of the body. Using tobacco causes many diseases and affects your overall health. Quitting smoking or other forms of tobacco has benefits in the short- and long-term for you and your loved ones.
• All forms of tobacco are harmful. This includes cigars, pipes, snuff, snus, chewing tobacco and electronic or smokeless cigarettes.
• Tobacco use and exposure to secondhand smoke kill approximately 443,000 people in the United States each year. It is the largest cause of preventable illness and death in the United States.
• Tobacco use is the cause of:
  • Cancers
  • Heart disease
  • Stroke
  • Complications of pregnancy
  • Chronic obstructive pulmonary disease (COPD)
• Second hand smoke is associated with: 
  • Sudden infant death syndrome (SIDS)
  • Acute lung infections, ear problems
  • More frequent and severe asthma attacks in children
• Even when people aren't smokers, exposure to secondhand smoke can cause them to develop heart disease and lung cancer.
• Nonsmokers who are exposed to secondhand smoke at home or work are 20%—30% more likely to develop heart disease or lung cancer.
• Breathing secondhand smoke has immediate harmful effects on your health and increases the risk of heart attack. People who already have heart disease are at especially high risk.
• There is no level of secondhand smoke that is risk-free. Even brief exposure can be dangerous.
• Talk to your VA health care provider about help with quitting smoking, including getting medication to improve your chances of quitting and a referral to a VA smoking cessation clinic.
• Good things happen as soon as you quit. You will:
  • Have more energy and breathe easier. 
  • Save money that you can spend on other things.
  • Find that your clothes, car, and home smell better.
  • Have fewer wrinkles, and no stains on your skin and nails.
  • Discover that food smells and tastes better.
  • Feel good about quitting.
  • Protect your family members and friends from secondhand smoke.
• If you are pregnant and quit smoking, your baby will:
  • Be healthier
  .
  • Get more oxygen.
  • Be less likely to be born too soon.
  • Be more likely to come home from the hospital on the same day that you come home.
  • Have fewer colds and ear infections.
  • Cough and cry less.
  • Have fewer asthma and wheezing problems. 

More Information

• VA Public Health Strategic Health Care group smoking cessation internet website (http://www.publichealth.va.gov/smoking/ ) (for patients)
• http://www.cdc.gov/tobacco/*
• You Can Quit Smoking. Support and Advice from Your Prenatal Care Provider. Consumer Tear Sheet, September 2008. U.S. Public Health Service. Agency for Healthcare Research and Quality. Rockville, MD. http://www.ahrq.gov/clinic/tobacco/prenatal.htm*
• Tobacco Cessation Quit line: 1-800-QUIT-NOW
• www.Smokefree.gov* - A government website with online resources to help you quit.
• www.Women.smokefree.gov*—A government website with online resources and information to help women quit smoking.
• Healthfinder: Quit Smoking
  http://www.healthfinder.gov/prevention/ViewTopic.asp?topicId=24*

* Indicates that the link leads to a non-VA website. VA is not responsible for the content that is on the site. 

Supporting Information

Definitions

• Snuff: Ground or pulverized tobacco, which is generally insufflated or "snuffed" through the nose. It is a type of smokeless tobacco. There are several types, but traditionally it means Dry/European nasal snuff. In the United States and Canada, "snuff" can also refer to dipping tobacco, which is applied to the gums rather than inhaled.
• Dipping tobacco: Also known as moist snuff, spit tobacco, a lip, or a lippy dippy, is a form of smokeless tobacco. It is commonly referred to as dip. A small clump of dip is 'pinched' out of the tin and placed between the lower lip and the gums. The dip rests on the inside lining of the mouth usually for 45 minutes to an hour, depending on the user's preference. Dip tobacco often causes the user to produce excess saliva while dipping. This is typically spat onto the ground or in a container, because swallowing can cause irritation to the esophagus, and induce nausea and vomiting.
• Snus: A moist powder tobacco product consumed by placing it under the lip for extended periods of time. Snus is a form of snuff that is used in a manner similar to American dipping tobacco, but typically does not result in the need for spitting.
• Electronic cigarette: An electronic cigarette, e-cigarette or personal vaporizer, is a battery-powered device that provides inhaled doses of nicotine by way of a vaporized solution. This vapor also provides a flavor and physical sensation similar to that of inhaled tobacco smoke, while no smoke or combustion is actually involved in its operation. An electronic cigarette takes the form of some manner of elongated tube, though many are designed to resemble the outward appearance of real smoking products, like cigarettes, cigars, and pipes. Another common design is the "pen-style", so named for its visual resemblance to a ballpoint pen. Most electronic cigarettes are reusable devices with replaceable and refillable parts. A number of disposable electronic cigarettes have also been developed. See FDA website for a warning about these products: http://www.fda.gov/downloads/ForConsumers/ConsumerUpdates/UCM173430.pdf. *

VA Policies

• VA Clinical Practice Guidelines: The VA/DoD EBPWG has adopted the Treating Tobacco Use and Dependence clinical practice guideline developed by the U.S. Public Health Service (PHS), 2008 Update. See this website for the guideline as well as related VA-specific materials.
  http://www.healthquality.va.gov/Management_of_Tobacco_Use_MTU.asp
• VHA Directives:
  • VHA Directive 2008-081 National Smoking and Tobacco Use Cessation Program
  • VHA Directive 2008-052 Smoke Free Policy for VA Health Care Facilities
  • VHA Directive 2010-048 Copayment for Outpatient Medical Care Provided to Veterans by the Department of Veterans Affairs

Source Documents

1. CDC tobacco website.
   http://www.cdc.gov/tobacco/basic_information/index.htm.
2. Community Guide - Tobacco Use.
   http://www.thecommunityguide.org/tobacco/index.html.
3. Counseling and interventions to prevent tobacco use and tobacco-caused disease in adults and pregnant women: U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med. Apr 21 2009;150(8):551-555.
   http://www.uspreventiveservicestaskforce.org/uspstf/uspstbac2.htm
4. Smokefree.gov website.
   http://www.smokefree.gov.
5. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Surgeon General 2006.
6. You Can Quit Smoking. Support and Advice from Your Prenatal Care Provider. In: Quality AfHRa, ed. Rockville, MD: U S Public Health Service; 2008.
7. VHA Office of Public Health and Environmental Hazards website.
   http://www.publichealth.va.gov/smoking/.
8. Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence. 2009;
   http://www.iom.edu/Reports/2009/Secondhand-Smoke-Exposure-and-Cardiovascular-Effects-Making-Sense-of-the-Evidence.asp.
9. FDA Guidance on Electronic Cigarettes.
   http://www.fda.gov/downloads/ForConsumers/ConsumerUpdates/UCM173430.pdf.