Beat Cigarettes One At A Time..

You’re Twice As Likely To Succeed With

INTERVENSI
FARMAKOLOGI BERHENTI
MEROKOK SEBAGAI
PENDEKATAN PILIHAN
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

Merawat Ketagihan Nikotin

(Treating Tobacco Dependence)

&
Terapi Gantian Nikotin
(Nicotine Replacement Therapy)

…… Setiap Perokok berkelakuan berbeza.

(No two Smokers are alike)
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

Ketagihan Nikotin (Nicotine Dependence)

Nikotin digunakan untuk: Toleransi
(Nicotine used for:) (Tolerance)
• Keseronokan dan
(Pleasure)
• Meningkatkan pretasi Ketagihan fizikal
(Physical Dependence)
(Enhanced performance)
• Pengawalan emosi
(Mood regulation)

Nikotin digunakan untuk: Ketiadaan Nikotin:

(Nicotine used to) (Nicotine abstinence)
• Pengubatan sendiri Mengakibatkan Gian
(Self medicate) (produces craving)
• Gian dan
(Craving) Gejala ketagihan
• Gejala Ketagihan (withdrawal symptoms)
(Withdrawal symptoms)
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

Mengapakah Anda Sukar

Berhenti Merokok?
Dua Faktor
1. Ketagihan Nikotin secara fizikal.
(Physical Dependence On Nicotine)

2. Tabiat berhubung dengan menghisap

rokok.
(Behavioral or habit forming associated with smoking)
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

1. Ketagihan Nicotin secara fizikal.

(Physical Dependence On Nicotine)

• Nikotin adalah sejenis bahan yang sangat adektif

(Nicotine is a very addictive substance)

• Jika Anda berhenti merokok, anda akan

mengalami gejala ketagihan (Withdrawal Symptom).

Anda mungkin berasa:

• Cepat marah (Irritability),
• Cemas (Anxious),
• Kurang bersemangat (Depressed),
• Tidak dapat menumpukan perhatian (difficulty in concentration)
dan lain lain.
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

2. Tabiat berhubung dengan menghisap rokok.

(Behavioral or habit forming associated with smoking)
Dalam jangka masa yang panjang, merokok menjadi satu
tabiat yang sukar dihentikan.
• Pergerakkan antara tangan dengan mulut.
(Hand and mouth movement)

• Mengetuk rokok diatas kotak rokok.

(Tapping the cigarette onto the cigarette box)
• Menjentik abu (Flicking the ashes)
• Menghembuskan asap (Breathe out smoke).

Situasi juga mendorong seseorang untuk merokok

• Merokok selepas makan atau ketika minum petang.
(Smoking ‘triggers’ (drinking coffee, after meals, at the pub, etc)
Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

Ujian Ketagihan Nikotin

Fagerström’s test for nicotine dependence

(Ujian ketagihan Nikotin Fagerström)
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With
Soalan Jawapan Pilihan
Dalam masa 5min 3 ______
1. Berapa cepatkah anda menghisap rokok anda yang pertama
selepas bangun dari tidur? 6-30 min 2 ______
31-60 min 1 ______
Lepas 60 min 0 ______

Ya 1 ______
2. Adakah anda menghadapi kesukaran menahan diri dari merokok
Tidak 0 ______
ditempat-tempat yang dilarangkan, contohnya di rumah ibadat, di
perpustakaan, di panggung wayang dan sebagainya?
Yang pertama 1 ______
3. Menghisap rokok yang manakah yang paling sukar untuk disebelah pagi
anda tinggalkan? Yang lain 0 ______

10 atau kurang 0 ______

4. Berapa batang rokok yang anda hisap dalam sehari? 11-20 1 ______
21-30 2 ______
31 atau lebih 3 ______

Ya 1 ______
5. Adakah anda lebih banyak merokok dalam jam pertama selepas
bangun berbanding denganwaktu-waktu lain sepanjang hari? Tidak 0 ______

Ya 1 ______
6. Adakah anda merokok walaupun anda sakit walaupun dalam
keadaan di mana terpaksa berbaring diatas katil sepanjang hari? Tidak 0 ______

0-3 Ketagihan rendah 4-5 Ketagihan serdahana Jumlah

6-10 Ketagihan tinggi kepada Nikotin
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

Setiap Perokok berkelakuan berbeza

No Two Smokers Are Alike

• Kadar ketagihan nikotin berbeza

Different levels of nicotine addiction

• Sesetengah adalah lebih mendorong kepada tabiat

Some are more attached to the ritual of smoking than others

• Corak merokok berbeza

Different smoking patterns
Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

Terapi Gantian Nikotin

Nicotine Replacement Therapy (NRT)
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

Kejayaan berhenti merokok berganda

dengan NRT
Smokers are twice as likely to succeed with NRT

Kadar peratusan Cara-cara

Abstinence rate Intervention

• 10% Tiada kaunseling

(No counselling

• 14% Kaunseling berkumpulan

(Group counselling only)

• 18-30% NRT
Source: US Dept of Health & CPG,2000
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

Bagaimanakah NRT dapat membantu anda?

How NRT Can Help You?

• NRT telah terbukti paling berkesan membantu anda

untuk berhenti merokok.
(NRT has been proven to be most effective smoking cessation aids)

• NRT mengeluarkan sejumlah kecil nikotin yang

terkawal kedalam badan untuk membantu
melegakan gejala ketagihan, tanpa tar, perengsa dan
karbon monoksida berbahaya didalam asap rokok.
(NRT replaces a small amount of nicotine that the body misses when smoker quits, and cuts
out the harmful tobacco smoke).
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

Jika digunakan dengan betul, keazaman

yang kuat (willpower) dan NRT, dapat
menggandakan peluang kejayaan anda

Nicotine tidak mengakibatkan penyakit barah, hanya

mengakibatkan ketagihan

Punca barah adalah Tar dan lain-lain bahan kimia

didalam rokok.
Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

Nicorette Gum
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

Faedah Nicorette Gum

• Dos yang fleksibel untuk memenuhi keperluan individu & keadaan
• Gantian tingkah laku (kepuasan pada mulut)
(Some behavioral replacement: oral gratification)

• Baik untuk mencegah ulangan (Relapse prevention)

Terdapat dua kekuatan;

2mg untuk ketagihan Nicotin rendah &
sederhana
4mg untuk ketagihan Nicotin tinggi
(Two strengths: 2mg for low- and medium and
4mg for high-dependent smokers)
Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

Nicorette® Chewing Gums

Panduan Pengurangan
8 - 12 gum 4 - 6 gum 3-0 gum
sehari sehari sehari

12 Minggu 2 Minggu 2 Minggu

Program 16 minggu
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

Kesimpulan

When you got the urge Take a Nicorette Gum Chew Nicorette Gum slowly Rests Nicorette Gum
to light up Gunakan Nicorette until taste becomes strong. between the gum and
Bila ingin menghisap Kunyah perlahan-lahan cheek.
rokok sehingga rasa Nicorette Rehatkan Nicorette Gum
Gum menjadi kuat diantara gusi dan pipi

After about 30 minutes Chew Nicorette Gum again Wait a minute….

- safely discard it once the taste has faded. Nicotine is being released
Selepas 30min, buang Nicorette Bila rasa Nicorette Gum Tunggu selama seminit…..
Gum ke dalam tong sampah. berkurangan, kunyah sekali lagi. Nicotin sedang dikeluarkan.
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

KONTRA INDIKASI

• Semua bentuk nikotin adalah tidak

dibenarkan semasa hamil
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

KESAN SAMPINGAN
• Irritasi kerongkong
• Salivasi
• Sendawa
• Lambat penghazaman
• Mual dan pening

ALWAYS ENCOURAGE FIRST TIME USER TO CHEW ONE PIECE

IN FRONT OF YOU TO ENSURE THE RIGHT CHEWING
TECHNIQUE
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

Kos Perubatan (Nicorette Gums)

Minggu Dosage (Gums/hari) Preskripsi Kos Perubatan
2mg Gums
1-12 8-12 7 kotak RM759.70
Or
RM9.05/hari
13-14 4-6 4 Strip RM63.35
Or
RM4.55/hari
15-16 2-3 2 Strip RM31.65
Or
RM2.30/hari
Jumlah 7-8 kotak RM854.70
Or
RM7.65/hari
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

Faedah-faedah
• Terdapat dalam 3 kekuatan – 15mg, 10mg & 5mg
• Mudah digunakan
• Sekeping sehari
• Memberi gantian nikotin selama 16 jam
• Sesuai untuk ketagihan nikotin sederhana.
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

Panduan pengurangan Nicorette Patch

15 mg
10 mg
5 mg

8 minggu 2 minggu 2 minggu

Program untuk 12 minggu

 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

Nicorette Patch
Possible side-effects

• local skin reactions - < 20%,

transient, rarely severe

• low incidence of systemic - nausea,

headache
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

Kos Perubatan Nicorette 16-hour Patch

Minggu Dosage (Patch/ hari) Preskipsi Kos Perubatan

1-8 1 x 15mg 1 kotak 15mg Nicorette RM576

Patch Or
seminggu RM10.30/hari
9-10 1 x 10mg 1 kotak 10mg Nicorette RM130.70
Patch Or
seminggu RM9.35/hari
11-12 1 x 5mg 1 kotak 15mg Nicorette RM120
Patch Or
seminggu RM8.60/hari
Jumlah 8 kotak 15mg RM826.70
2 kotak 10mg Or
2 kotak of 5mg RM9.85/hari
Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

Nicorette® Inhaler
Panduan pengurangan

6 - 12 3-6 3-0
cartridge cartridges catridges
sehari sehari sehari

8 Minggu 2 Minggu 2 Minggu

Program untuk 12 minggu

Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

 Champix provides a unique

combination of agonist and
antagonist effects to reduce
craving, many withdrawal
symptoms, and the
reinforcing effects of
smoking
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With
Champix – A 12 week treatment

• The duration of treatment for

Champix is 12 weeks
• Set a quit date with the patient 1
week after starting Champix
• Champix can be taken with or
without food
• If patient has not stopped
smoking by their target quit date,
they could still quite if the 12
week course is continued
Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With
Demonstrated safety and tolerability

The most frequently reported adverse events

(>10%), included:
• Nausea
• Headache
• Insomnia
• Abnormal dreams
 Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With

$$$$$$$$Wang yang anda boleh jimat selepas berhenti merokok

Batang Rokok Sehari 20 40

Kos Memberi Rokok Sehari (RM) $ 5.00 $ 10.00

Hari Pertama Berhenti Merokok $ 5.00 $ 10.00

Satu Minggu $ 35.00 $ 70.00

Satu Bulan $ 150.00 $ 300.00

Satu Tahun $ 1,825.00 $ 3,650.00

Lima Tahun $ 11,141.81 $ 22,283.62

Sepuluh Tahun* $ 29,085.80 $ 58,171.60

*Andaikan Harga Rokok Naik Sebanyak 10% Setahun
Beat Cigarettes One At A Time.. You’re Twice As Likely To Succeed With