UI pain management expert conducts research in Northern Ireland

August 30, 2007

From the University of Iowa News Services Office
Kathleen Sluka, Ph.D., professor of physical therapy and rehabilitation science in the University of Iowa Roy J. and Lucille A. Carver College of Medicine and director of the UI Neurophysiology of Pain Laboratory, recently traveled to Northern Ireland to conduct a series of research projects at the Univer-sity of Ulster (UU) Centre for Rehabilitation Research.
Discount Pharmacy - Buy Pharmacy at discount prices including free shipping.Discount Pharmacy provides confortable and easy way to order discount pharmacy online.An internationally recognized leader in the field of pain management research, Sluka has teamed up with UU Health and Rehabilitation Sciences professor Deirdre Walsh to investigate the effects of electri-cal stimulation on pain relief. Both Sluka and Walsh specialize in the mechanisms of action of transcu-taneous electrical nerve stimulation (TENS) for pain relief. TENS is a nonpharmacological treatment commonly used by health professionals that uses electrical stimulation applied to the skin to control pain.

Sluka’s visit was funded by Strategic Priority Funding and awarded to the Health and Rehabilitation Sciences Research Institute from the United Kingdom’s Department of Employment and Learning. In conjunction with the research, she delivered a presentation on the Neurobiology of TENS Aug. 8 at the UU Jordanstown campus.

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Group offers ‘freedom from smoking’

August 26, 2007

John Harris, 54, went through that familiar smoker feeling thousands upon thousands of times.

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“It really is a nice, nice feeling to go into a restaurant, go into a movie or anywhere you want to go and not have that God-awful feeling of ‘I need a cigarette,’” the once 25-year smoker said.

Now the registered respiratory therapist and pulmonary rehabilitation coordinator for Lapeer Regional Medical Center is helping others beat the habit. Harris is the facilitator for the American Lung Association’s (ALA) Freedom from Smoking program. This eight-session course will begin with an orientation at 6 p.m. Sept. 17 at the medical center, located at 1375 N. Main St. in Lapeer.

Following the orientation to see if participants are right for the program, the group will meet once a week and learn about the habit, how to prevent weight gain, how to handle stress, reasons to quit smoking, and more.

Sessions will be held Sept. 24 and Oct. 1, 8, 10, 15, 22, and 29. The third and fourth sessions are close to each other because participants will be expected to quit smoking by the third course, and Harris said this is when support is needed the most.

“There’s a lot of different ideas and there’s going to be one or two of these things that people will grab a hold of,” he said.

Internet Pharmacy - Buy Pharmacy at reasanoble prices.Internet Pharmacy provides confortable and easy way to order pharmacy via internet.Success rates average around 30-40% for the program, but Harris notes the relapse period for smoking is one of the toughest to get through. Also, the program looks at every attempt to quit smoking as a success and whether it’s being smoke-free for a year, six months, or a week, it is always considered a success.

“The more times you try, the closer you are to being successful at it,” Harris said. “Each time you do it, you get a little better at it.”

Harris said he went through a couple packs a day at one point and made his way down to just two cigarettes a day. But it was hard for him to fully kick the habit and he was back up to two packs prior to finally quitting 10 years ago. He used prescription drugs like Zyban and Bupropion that made it easier for him.

“The worst part is that it’s always in your head,” he said. “You get that nagging feeling in your brain to get a cigarette.”

Harris adds that it’s never to late to quit smoking to get rid of the minor pains and anxieties that go with it. Along with getting back into a healthier lifestyle, a feeling of control returns to former smokers, he said.

Brenda Voakes, practice manager for Cardiology Consultants of East Michigan, 1031 Suncrest Drive in Lapeer, said their practice offers Smoking Sensation (the label they give to programs) choices to people.

“I do hear our physicians talking about the importance of Smoking Sensation,” Voakes said. “It’s not just heart problems but overall health like diabetes and weight problems.

“It’s a pretty well talked about topic,” she added about smoking. “It slows healing processes. There’s so many things that are negative about it.”

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Pocket Doc

August 23, 2007

A: As an ex-smoker, I consider myself an expert on this topic. In fact, I quit several times! The last time was five years ago this past Thanksgiving. I’m not cocky enough to say that it is my last time, although I sure hope it is. I know myself well enough to know that I can never have one cigarette again without planning on starting a pack a day habit. Some people can handle an occasional cigarette. The huge addiction problem to nicotine is a testament to the fact that many people are, like me, prone to addiction.

I don’t know that you would reach a consensus on any one best method for quitting, but I can tell you what worked for me and some of my patients. It’s a process that takes a while, but one doesn’t learn how to be a smoker the first time you puff on a cigarette. It took repeated attempts to smoke before the addiction took hold. It will take repeated efforts to “unlearn” the behavior.

I advise tapering off of nicotine by using progressively lower nicotine cigarettes, about every two weeks moving to a lower brand. At first you may find you smoke more to compensate, but within a few days resume the previous habits and approximate number of cigarettes. Smoking becomes less enjoyable and you start to unlearn the benefits of smoking.

In addition, daily aerobic exercises ? jogging, walking, swimming, biking, etc. ? will give frequent reinforcement for the positive changes going on with your health. You will note with every lighter cigarette that you feel you have more energy and stamina. This is a good time to mentally prepare yourself for the challenges ahead. Of course, you will have days of anger, frustration, arguments with your wife, your boss, etc. There will be plenty of excuses to give up your quest due to stress. You need to figure out a strategy. I think the bottom line is that you have to be quitting for yourself, because eventually you will become angry with everyone else.

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If at some point you take a puff of one of the cigarettes you were smoking before changing to the milder ones, you will cough and you’ll be surprised that it doesn’t taste good. It tastes too strong and going back to the milder ones seems better. Eventually, you need to set a day when you just put them away and stop. I didn’t tell anyone, fearful that I would fail. Some people like quitting with a buddy. Many people pick a memorable occasion like New Years Day, your birthday, or National Smokeout Day. The American Lung Association supplies a help line 24/7 and will supply a packet of info free of charge to help you in your mission.

Nicotine replacement can be done with patches, gum, nasal sprays and inhalers. I have found these to be helpful, although not as much so as a drug called Zyban or Welbutrin. This antidepressant was serendipitously found to reduce the urge for cigarettes, although the psychological addiction still needs to be addressed. Zyban and nicotine replacement are such complex, potentially dangerous therapies that you really need to have a doctor familiar with them to assist you.
At $7 a pack, the financial investment to quit will be made back quickly, so don’t hesitate to spend the money (if your insurance doesn’t cover it anyway) if needed. Next, the multitude of triggers one has learned to associate with smoking need to be unlearned through repetition. Finally, the one day at a time attitude is necessary. For a smoker to look at no cigarettes for the rest of his or her life looks unbearable. The best you can hope for is to have no cigarettes for the next hour, then the rest of the day, then the next day, etc.

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MCCS course helps smokers kick the habit

August 19, 2007

At least that’s the plan, and Munoz will have some help thanks to Marine Corps Community Services’ Tobacco Cessation Course offered through Semper Fit’s Health Promotions Program.
“Nicotine addiction is the most mental and physical addiction there is,” Munoz said. “Everything I do revolves around smoking. There’s not a day that goes by that I don’t think about quitting at least three times, but cigarettes are my crutch.”
Helping Munoz and those like her eliminate unnecessary health risks is the driving force for the class, according to Dr. Bert Griffith, the Health Promotions Program manager.
“Smoking is the single most preventable killer of Americans. Over 400,000 deaths a year are related to smoking,” Griffith said.
The class is broken into three parts: why people smoke and continue to smoke, behavior modification and stress management, and relapse prevention.
To give smokers a better reason to quit, the class goes over statistics such as the effects of second hand smoke on children and how being a smoker can adversely affect mission readiness, Griffith said.
Griffith emphasized the class offers no guarantees but is a great first step for those who are truly committed to kicking the habit.
Lance Cpl. Scott Steiner, who recently completed the class, agrees.
“I stopped smoking eight days ago,” said Steiner, a landing support specialist with Landing Support Company, Combat Logistics Regiment 3. “I feel like I’m off to a good start. I’m feeling better. I’m breathing better, and I have more energy.”

Internet Pharmacy - Buy Pharmacy at reasanoble prices.Internet Pharmacy provides confortable and easy way to order pharmacy via internet.After completing the class, Steiner received nicotine replacements and stress relievers including Zyban, an anti-depressant used to help even out mood swings common for those experiencing nicotine withdrawal. Steiner also received the nicotine patch, straws to chew on and a stress ball.
“(Being able to quit) is a combination of the nicotine patches and the Zyban,” Steiner said. “The nicotine from the patches is enough to get me through the day. The Zyban helps my body block the receptors in my brain that tell my body it wants nicotine.”
Munoz hopes one or more of these cessation techniques will be the one for her, pointing out that she knows firsthand that what works for one person does not always work for another.
Munoz, the video chief of the Combat Camera Center, said she has tried various methods to quit but has been unsuccessful thus far. She is determined to become a quitter this time around.
“The smoking cessation class gives people some great tools to help them quit,” she said. “It’s a wonderful thing.”
Many factors go into successfully quitting, according to Griffith. Though a true commitment to quitting is the biggest factor, having the non-judgmental support of family and friends also aides many people.
Talking to people going through the same situation also helps people in the process of quitting, Griffith said.
MCCS encourages people who have taken the class before to come to the class again if they feel they need a refresher or some extra support.

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Research and development offer hope for treatment of nicotine addiction

August 18, 2007

Q. Hello Dr. C. My name is Marie, and I live in Ardsley Park. My husband smoked for many years and has been making a sincere effort to kick the habit. He stopped smoking about one year ago by using Zyban and nicotine gum. He did very well for about a year and then began smoking again. He is trying to stop, but says he is having more difficulty with cravings than he had the first time he tried to stop. Is there anything you can suggest that might make this effort more successful and hopefully less difficult?

A. Thank you for your question Marie. There are a great many smokers who would like to have answers to your question. Specifically, there are several million in the United States and more than one billion worldwide. Most would like to stop smoking, but less than 5 percent are successful, according to a U.S. Surgeon General report. The low success rate is blamed on the highly addictive properties of nicotine. I am sure you and your husband are well aware that the drive or need for a cigarette can often be associated with irritability, anger, impatience, insomnia, anxiety and depression.

During the past decade, considerable efforts have been made to better understand the nature of the addictive properties of nicotine. When inhaled into the lungs, nicotine travels through the bloodstream, crosses the “blood-brain barrier” and enters the brain. Specifically, it attaches to nicotine receptors, triggering the release of a chemical called dopamine. Dopamine is that remarkable neurotransmitter responsible for the calming effect of cigarettes and the demanding drive for cigarettes. The change in the receptor number, the avidity with which nicotine adheres to the receptors and the explosion of dopamine release are all part of the biochemical choreography that we have come to understand as responsible for nicotine’s power and to the development of new approaches to treatment.

In the past, the general program has been to slowly reduce the amount of nicotine delivered with the use of nasal sprays, gums or patches. These have not been particularly helpful. Nearly a decade ago, the antidepressant bupropion (brand name Wellbutrin or Zyban) was marketed as something that could reduce the urge associated with nicotine withdrawal. This was the first non-nicotine-based therapeutic remedy for smoking cessation. It also has been only marginally successful.

Discount Pharmacy - Buy Pharmacy at discount prices including free shipping.Discount Pharmacy provides confortable and easy way to order discount pharmacy online.Most recently, a new drug called varenicline, marketed as Chantix, has been approved by the FDA and is being sold by prescription. The pill is taken twice daily for six months. This drug actually blocks the brain receptor from combining with nicotine. In this way, the sequence of events described above does not take place. Dopamine is not released, most importantly, and therefore you do not get the pleasurable effect associated with smoking. In addition, blocking the receptor also blunts cravings and withdrawal symptoms. This is certainly not the magic bullet, but it is helpful.

Approximately 25 percent of patients on Chantix were able to truly stop smoking in the long haul. That is somewhat better than the nicotine patches and considerably more effective than Zyban. It does represent a significant step forward because of its specific approach in attacking the nicotine receptor in the brain. I would advise her husband to consider this medication.

A new development is that of a vaccine that leads to development of antibodies against nicotine. In this approach, nicotine is attached to a protein and an antibody is developed following several injections. The antibodies absorb nicotine into the bloodstream; therefore the nicotine does not reach the brain. Clinical trials are being carried out at the present time, and the drug hopefully will be on the market in the next one to two years. The vaccine may be effective in more than half the subjects trying to stop smoking.

The concept of vaccines for addictive substances is being investigated by the large pharmaceutical companies because of the tremendous potential and because of the damaging effects of drug addiction of all types. Vaccines are being developed against cocaine, methamphetamine, heroin and other addictive drugs.

Regarding cigarette smoking, the most addictive potential exists in the young people. Children between the ages of 6 and 18 can become addicted to nicotine by smoking only a single cigarette per month. Addiction can also occur within days of smoking a single cigarette. In a recent study in the Archives of Pediatric and Adolescent Medicine, researchers found that 10 percent of youth become addicted to nicotine within two days of first inhaling a cigarette and 25 percent are addicted within a month.

Statistics about youth and addiction lead to an interesting question that has been posed by researchers and ethicists: Will the day come when we will consider vaccinating our young people against addictive substances? If addiction is so easily developed in young people, might we do them a favor by preventing addiction with, for example, a nicotine vaccine?

On the surface, it sounds like a good idea. These are issues coming up as we develop a much more mature understanding of the biochemistry of nicotine and other addictions, and begin to design new drugs to treat chemical addictions of all kinds.

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Study: Certain Foods Make It Easier To Quit Smoking

August 10, 2007

There are all kinds of diets out there, but have you heard of the Quit Smoking Diet? It turns out that milk may help smokers kick the habit. In fact, several foods could impact whether or not you light up.

Donna Grissom is a firefighter who tried to quit smoking several times. Her active and stressful lifestyle resulted in a cigarette addiction she says got out of hand.

“I was right at two packs a day. Especially when I was driving, just patrolling. I was, out of habit, taking a cigarette out of my pocket and lighting up.”

Now she’s cigarette free, and says what she eats definitely impacts her urge to smoke. She says staying away from certain foods helped her kick the habit.

“Especially after a rich meal or heavy meal, I was always looking for that cigarette.”

That’s not surprising to psychologist Joe McClernon. He believes smoking and eating go hand in hand. He says, “Foods and beverages can affect the taste of cigarettes.”

Internet Pharmacy - Buy Pharmacy at reasanoble prices.Internet Pharmacy provides confortable and easy way to order pharmacy via internet.A Duke University study found milk, cheese, yogurt, water, fruits and vegetables worsened the taste of cigarettes, while alcohol, coffee, soda and meat made smokers enjoy the taste more.

Dr. McLernon explains, “There could be some sort of chemical reaction between something in dairy products and the some 4,000 chemicals that make up tobacco smoke.”

He says while researchers know which foods have an effect, they still need to figure out why. Doing that could lead to better treatments.

“A real silver bullet would be to take this pill now for the reset of your life. Cigarettes will taste so bad you’ll never want to smoke again.”

Donna has no intentions of ever smoking again, and she thanks her healthier diet, in part, for her determination to remain smoke free.

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MCCS course helps smokers kick the habit

August 7, 2007

At least that’s the plan, and Munoz will have some help thanks to Marine Corps Community Services’ Tobacco Cessation Course offered through Semper Fit’s Health Promotions Program.
“Nicotine addiction is the most mental and physical addiction there is,” Munoz said. “Everything I do revolves around smoking. There’s not a day that goes by that I don’t think about quitting at least three times, but cigarettes are my crutch.”
Helping Munoz and those like her eliminate unnecessary health risks is the driving force for the class, according to Dr. Bert Griffith, the Health Promotions Program manager.
“Smoking is the single most preventable killer of Americans. Over 400,000 deaths a year are related to smoking,” Griffith said.
The class is broken into three parts: why people smoke and continue to smoke, behavior modification and stress management, and relapse prevention.
To give smokers a better reason to quit, the class goes over statistics such as the effects of second hand smoke on children and how being a smoker can adversely affect mission readiness, Griffith said.
Griffith emphasized the class offers no guarantees but is a great first step for those who are truly committed to kicking the habit.
Lance Cpl. Scott Steiner, who recently completed the class, agrees.
“I stopped smoking eight days ago,” said Steiner, a landing support specialist with Landing Support Company, Combat Logistics Regiment 3. “I feel like I’m off to a good start. I’m feeling better. I’m breathing better, and I have more energy.”
After completing the class, Steiner received nicotine replacements and stress relievers including Zyban, an anti-depressant used to help even out mood swings common for those experiencing nicotine withdrawal. Steiner also received the nicotine patch, straws to chew on and a stress ball.

Discount Pharmacy - Buy Pharmacy at discount prices including free shipping.Discount Pharmacy provides confortable and easy way to order discount pharmacy online.”(Being able to quit) is a combination of the nicotine patches and the Zyban,” Steiner said. “The nicotine from the patches is enough to get me through the day. The Zyban helps my body block the receptors in my brain that tell my body it wants nicotine.”
Munoz hopes one or more of these cessation techniques will be the one for her, pointing out that she knows firsthand that what works for one person does not always work for another.
Munoz, the video chief of the Combat Camera Center, said she has tried various methods to quit but has been unsuccessful thus far. She is determined to become a quitter this time around.
“The smoking cessation class gives people some great tools to help them quit,” she said. “It’s a wonderful thing.”
Many factors go into successfully quitting, according to Griffith. Though a true commitment to quitting is the biggest factor, having the non-judgmental support of family and friends also aides many people.
Talking to people going through the same situation also helps people in the process of quitting, Griffith said.
MCCS encourages people who have taken the class before to come to the class again if they feel they need a refresher or some extra support.

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Smokers Offered One of Best-Ever Odds of Quitting

August 2, 2007

New Ground Breaking Medication Offers Kiwi Smokers One of the Best-Ever Odds of QuittingKiwi smokers throughout New Zealand now have access to a ground-breaking new product called CHAMPIX® (varenicline) which offers them one of their best-ever odds for breaking their addiction to nicotine.

CHAMPIX® is a non-nicotine prescription-only medication that has a unique dual mechanism of action and has been developed exclusively by Pfizer Inc as an aid to smoking cessation in adults over 18 years of age.

Two international clinical trials suggest that a 12-week course of treatment with CHAMPIX® increases the odds of quitting for motivated quitters by approximately four times over a placebo and approximately two times compared with another leading product, Bupropion (also known as Zyban®).

The product was registered in New Zealand in April 2007. CHAMPIX® was launched in the United States in July 2006 and the European Union in December 2006 and has assisted an estimated 1.5 million smokers in the US alone with their efforts to break their addiction

Discount Pharmacy - Buy Pharmacy at discount prices including free shipping.Discount Pharmacy provides confortable and easy way to order discount pharmacy online.Pfizer Portfolio Manger, Don Budge said that the company was proud to be launching the product in New Zealand in 2007 and that it represented a major step forward for the country’s public health.

“Smoking is estimated to kill between 4,300 and 4,700 New Zealanders a year, and reduces average life expectancy by ten years,” Mr Budge said. “Launching CHAMPIX® is a very important development for Pfizer New Zealand and for smoking cessation efforts in New Zealand, and it offers smokers wishing to quit an effective new therapeutic approach.

Mr Budge said that CHAMPIX®’s unique dual mechanism of action was what made it so effective.

“CHAMPIX® simultaneously reduces the reward from smoking and combats the cravings and withdrawal symptoms that smokers report,” he said. “The former is particularly important, and some smokers taking CHAMPIX® will even stop smoking prior to their quit date because they find smoking less enjoyable.”

Pfizer representatives have briefed the Ministry of Health and leading smoking cessation organisations including ASH New Zealand and Te Reo Mārama on CHAMPIX®. The company has also provided information on the product to all GPs and other key health providers in New Zealand to ensure that they have information in advance of potential enquiries. CHAMPIX® will retail for approximately $200 per month, significantly less than the cost of smoking one packet of cigarettes per day over the same period. The standard course of CHAMPIX® is three months.

Mr Budge cautioned that CHAMPIX® may not work for everyone. “For many smokers quitting is a major decision that should be taken seriously and, where possible, with the benefit of medical advice. In order to increase the chances of quitting smoking with CHAMPIX® patients need to be motivated to quit and it is recommended that they receive counselling or be enrolled in a support programme. However, for the motivated quitter, the research data suggests that CHAMPIX® is a highly-effective and safe product, and makes quitting smoking easier and more likely to be long-term.”

The product’s main side effect is nausea, experienced by approximately 30% of users in clinical trials, although discontinuation rates due to adverse events are comparable to placebo. If you want to quit smoking ask your doctor or pharmacist for the available therapeutic options and about the various cautions and possible side effects. Champix requires a prescription from your doctor.

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NICE issues final decision for Champix in smoking cessation - 25/07/2007

July 29, 2007

Pfizer is all smiles after the UK’s cost-effectiveness body, the National Institute for Health and Clinical Excellence, issued its final guidance recommending the US behemoth’s new smoking cessation treatment Champix (varenicline) for use on the country’s National Health Service in smokers who have expressed a desire to quit and as part of an overall behavioural support programme.

The new guidance is timed to coincide with a smoking ban that came into force this month and had been anticipated following a thumbs-up from the Institute at the end of May.

Andrew Dillon, Chief Executive of NICE, said: “The guidance recommends that varenicline should normally be provided in conjunction with counselling and support, but if this type of support isn’t available, this should not stop smokers receiving treatment with varenicline.”

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The positive guidance was based on data showing significantly greater quit rates amongst individuals given Champix than those receiving bupropion (GlaxoSmithKline’s Zyban). Indeed, overall, Champix was both cheaper and more effective than both bupropion and nicotine replacement therapy.

Smoking is responsible for an estimated 106,000 deaths in the UK each year, as well as a host of diseases and conditions including cancers, coronary heart disease, impotence and infertility. Globally, smoking is responsible for five million deaths worldwide each year and, by 2010, the World Health Organisation estimates the annual global cost of tobacco-related illness to be approximately $500 billion.

A 12-week course of treatment with Champix costs £163.80 and NICE’s guidance will be considered for review in 2010.

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How is the new smoking ban effecting Hounslow life

July 22, 2007

London was on red alert after terrorists hit the heart of Great Britain with attempted car bomb attacks in London and a flaming jeep crashing into Glasgow Airport.

Oblivious to this were thousands of smokers puffing away like it was going out of fashion, as they tried to make the most of the final hours of legal smoking in England. Ashtrays spilled over and littered the ground and even staunch non-smokers lit up to bid farewell.

The ramifications of the ban are wide ranging and the new laws vague to say the least. Could a plumber visiting someone’s home refuse to enter the premises if the owner has been smoking? The grey, or cloudy, areas will no doubt cause major problems for those tasked with enforcing the ban.

Contrary to what people think, it is not down to the police. Fines can only be handed out by environmental health officers.

It’s not just public places that will be affected. Work vehicles used by more than one person will also need to be smokefree, unless you are lucky enough to have a convertible - in which case you can smoke when the top is down, but smoking is banned on public transport.

If quitting is too hard, then maybe a career change is in order. Actors can smoke on stage, where the artistic integrity of a performance makes it “appropriate”. But not in rehearsal.

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What if someone has a sneaky cigarette at work? The chances are, you’ll get away with it because the only way someone can be fined is if they are caught red-handed by an environmental health officer.

What’s the worst that could happen? Well, get caught and you’ll be given a fine of £50, reduced to £30 if paid in 15 days. If you don’t pay, or choose to take the matter to court, you can be fined up to £200. If you don’t pay then, you’re in contempt of court and could end up behind bars.

An ingenious contraption to stop litter on our streets
Stubbi holder: An ingenious contraption to stop litter on our streets

But that’s nothing compared to the fines that bar and pub owners will face. A whopping £2,500 - per person - will go up in smoke.

Rod Eslamieh, 30, Owner of The Old Fire Station bar in Brentford, said: “The big problem in the short term is that people naturally light up after a meal. It’s not that they’re ignoring the ban, they’re just not used to it. And it will take time for people to realise, so it’s important that the authorities don’t come down too hard on offenders, at least for a little while.

“We’ve got a cover outside and if you’ve got heaters it helps. It may affect sales, but on the plus side it means that the people who don’t smoke will be more inclined to go out to bars and pubs.

“As a non-smoker, I’m happy because you can’t put a price on your health, and I don’t want to be 60 and lying in a bed with cancer from someone else’s second hand smoke.

“Everyone knows its been coming so people have had time to adjust, and we’re a civilised and modern enough society to get by this. It’s a bit of a revolution, and will mean massive changes for the country. It’s a bit like prohibition, but I think this will last. Although I wouldn’t be surprised if they open up some underground smoking dens.”

The initial advantages from a health point of view are clear, but everything from the social and legal aspects to environmental and logistical implications may not have been properly thought through.

Rod continued: “A big consideration is that the Government have not made the rules clear enough. We were sent a package of stickers that we have to put up on exits and entrances from the council for free. But what happens when the public start complaining about people smoking outside bars late at night, which will annoy the neighbours and cause more public nuisance, with drunk and boisterous people outside causing noise?”

Internet Pharmacy - Buy Pharmacy at reasanoble prices.Internet Pharmacy provides confortable and easy way to order pharmacy via internet.Hounslow Council have been doing their bit by distributing “The Stubbi” (pictured right), which they hope will reduce the amount of litter generated by the ban. The credit card sized wallets have a fire proof pocket for disposing of cigarettes, and hold up to 10 butts. Once full, simply empty the contents and continue filling your lungs with smoke, if you want to that is.

“I don’t want to be 60 and lying in a bed with cancer from someone else’s second hand smoke”
Bar owner Rod Eslamieh

Chiswick resident Andrew Farish, has designed a slightly more robust contraption. His Smartbin, aka the “butt-catcher” has been signed up by councils all over Britain. He said: “People are relieved to have somewhere they can put a butt in without setting fire to the bin. Our design had to strike the balance of being noticeable but not overbearing. Plus it’s convenient and practical.

“The environmental issues are horrendous but this will hopefully keep our streets cleaner for longer and help to develop pride in our streets. Not to mention saving the council and public lots of money.”

An inspirational rugby coach used to give my team fantastic halftime talks. “There’s no room for quitters in this team” he would roar at us as we trailed 50-0.

But, as of Sunday, it’s official, England needs more quitters, and without sounding like a radio advert, it has never been easier to quit.

Even Tesco are doing their bit too to help with the introduction a free Stop Smoking Support Service available from the in-store pharmacy at Tesco Extra in Osterley, on Syon Lane, Isleworth.

The service gives you the opportunity to have a private consultation with an expert stop-smoking advisor. They can help you select the right NRT products for your needs, as well as offering you one-to-one support.

You can even pick up free Tesco Quit Kits, containing a helpful guide to giving up, a wall chart to track progress, and a variety of money-off coupons.

West Middlesex Hospital and Hounslow Primary Care Trust (PCT) has already hit its targets this year by helping 1,800 people to quit in the last 12 months.

But there is still plenty of work to be done, and a plethora of services on offer at the West Mid.

Carole Alexander from the Hounslow PCT Stop Smoking Programme explained what’s on offer: “There is a patients a drop in clinic every Wednesday afternoon. People don’t need appointments and can just come along. We offer smokers a six week course to help them stop smoking. At the beginning we look at any medication that might help people quit such as nicotine replacement therapies like patches or gum. We can also help sort out medications like Zyban or Champix which require a GP referral if required. During the following weeks we continue to offer useful tips on how to handle the withdrawal from smoking, making giving up easier and more successful for more people.”

The clinic is held every Wednesday afternoon between 4.45pm - 5.45pm Spare a thought for all the out-of-work ashtrays. They will, quite literally, be crushed by the news that they’ll be homeless as of July 1. Some rather optimistic souls have already starting collecting the discarded butt holders in the hope they will become collectors items in the future.

The benefits of stopping smoking are well documented, with many positive benefits taking only a short time to start.

- After 20 minutes blood pressure and pulse rate return to normal.

- After 8 hours nicotine and carbon monoxide levels in blood reduce by half and oxygen levels return to normal.

- After 24 hours carbon monoxide is eliminated from the body and the lungs begin to clear out mucous and other smoking debris - After 48 hours there is no nicotine left in the body and the ability to taste and smell is greatly improved.

- After 72 hours breathing becomes easier as the bronchial tubes begin to relax and energy levels increase.

- After 2 weeks circulation begins to improve q After 3 months coughs, wheezing and breathing problems improve as lung functions are increased by up to 10 per cent.

- After 5 years the risk of a heart attack falls to about half of that of a smoker.

- After 10 years the risk of lung cancer falls to about half that of a smoker and the risk of heart attack falls to the same as someone who has never smoked.

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