Healthy Living in the North

It’s all about the big picture

This article was co-written by Reg Wulff and Doreen Bond. Learn more about all of our contributors.


20160630-RWulff-470x394Did you read our last blog post about the rollout of Northern Health’s new and improved Smoke Free Grounds policy? Now that you’ve had a bit of time to think about it, it might seem like it’s all about telling people where they can’t smoke or use vapour products. However, the Smoke Free Grounds policy isn’t only about telling people that they can’t smoke on Northern Health property; it’s actually part of a bigger picture when it comes to Northern Health’s efforts to reduce tobacco use.

Northern Health is committed to addressing tobacco use as a standard of care. In addition to the Smoke Free Grounds policy, we’ve implemented three new clinical practice standards to give our nursing staff some tools to help tobacco users manage withdrawal symptoms and get support when it comes to quitting smoking. These standards are: Brief Intervention Training for nurses, the Nicotine Withdrawal Protocol, and the Registered Nurses Initiated Action.

What does this mean for you?

Using Brief Intervention, nurses can quickly identify patients who use tobacco. It helps nurses figure out who might need nicotine replacement therapy products such as the nicotine patch while in Northern Health facilities. Brief Intervention is very simple and it only takes a couple of minutes.

Then there’s the Nicotine Withdrawal Protocol and the Registered Nurses Initiated Action. I know they sound like fancy terms, but their purpose is quite simple: these two standards give nurses an opportunity to provide tobacco users with nicotine replacement therapy products for a short period until a doctor’s order can be obtained.

Going through nicotine withdrawal can be extremely uncomfortable for a tobacco user. Providing a nicotine patch can help ease withdrawal symptoms for patients who use tobacco. The three clinical practice standards are about enabling nursing staff to take action and help tobacco users manage their withdrawal symptoms.

The Nicotine Withdrawal Protocol and the Registered Nurses Initiated Action also contribute to patient safety. They provide another option for patients who might put themselves at risk by leaving Northern Health grounds to have a smoke. After all, though they seem like distant memories now, winter conditions in the north can be dangerous for anyone, let alone patients who use wheelchairs or have IV poles to deal with.

Creating a healthy environment is essential for the wellness of patients, residents, visitors, and staff who access or work in Northern Health facilities. Northern Health wants to lead by example and provide a healthy environment for everyone where they live, work, and play. The refreshed Smoke Free Grounds policy and the three clinical practice standards are important pieces of creating that healthy environment.

So remember, if you’re a tobacco user who is about to enter a Northern Health facility, the Smoke Free Grounds policy is about everyone’s health! If you need help managing nicotine withdrawal symptoms while in facility, talk to your nurse. There is help available.

Quitting smoking can greatly improve your health and help you live longer. For more information and support, contact HealthLink BC by dialing 8-1-1 or visit QuitNow.

If you’re interested in getting 12 weeks of free nicotine replacement therapy products, talk to your local pharmacist.

Reg Wulff

About Reg Wulff

Reg is a licensing officer with Northern Health and has his BA in Health Science. Previously, he worked as a Recreation Therapist with Mental Health and Addictions Services in Terrace as well as a Regional Tobacco Reduction Coordinator. Originally from Revelstoke, Reg enjoys the outdoor activities that Terrace offers, like mountain biking and fishing. Reg also likes playing hockey, working out, and creative writing. He is married and has two sons and believes strongly in a work/life balance as family time is important to him.

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Keep Your Breath

A man rides a bike

Smoking will be detrimental to your physical performance.

I have to admit, it’s been a great summer. The decent weather has let me ride my bike to work often and encouraged me to work towards my goal of running five kilometers. With all this exercise, I’m feeling great.

But it’s not going to last forever, the decent weather that is. When it’s cold and wet, the last thing I want to do is go for a run or hop on my bike. Fortunately for me, hockey is just around the corner. For others, sports such as basketball, racquetball, squash, volleyball, indoor badminton and floor hockey may be appealing ways to keep active over the winter.

Typically, when you think of these activities, you don’t think of smoking, but how often do you see someone having a smoke outside the arena or recreation center? Some of the guys I’ve played hockey with have told me that a smoke before the game “picks them up” and “helps them focus.” However, smoking is not going to help your game in the end.

A 2013 study of female university athletes looked at the effect of smoking on athletic performance. In this study, 12 smokers and 21 non-smokers were asked to perform stress tests and six shuttle run tests to determine the impacts of smoking on aerobic capacity and anaerobic capacity.* What the researchers found was:

  • During shuttle runs four to six, the smokers’ average power decreased significantly.
  • Non-smokers were able to take in and use more oxygen during intense exercise.
  • The smoking group was less capable of dealing with fatigue.
  • Smoking impaired the athletes’ ability to recover after high intensity exercise.

Another study that examined the effect of smoking on the cardiovascular system noted a 10% decrease in the time smokers could exercise before becoming exhausted. This was attributed to a lack of available oxygen to the muscles.

Sports like hockey, basketball and racquetball all require short, intense bursts of speed and/or power that are anaerobic in nature. As the studies show, smoking has a negative impact on our body’s ability to absorb and use oxygen. This results in a loss of power, endurance, and a decreased ability to recover from intense activity.

If you have a quick smoke before the game, it’s going to catch up with you. In the second or third period, you’ll be gasping for air on the bench between shifts and lagging behind the play when you’re on the ice. That awe-inspiring, highlight reel move is going to be harder to pull off when the power in your legs is used up in the first half of the game.

Is that bit of a pick-up worth a weak finish? I don’t think so.

If you or some you know wants to quit using tobacco, they can receive free counselling and free nicotine replacement products through provincial programs.

*Anaerobic exercises are done with maximum intensity for short bursts (i.e. sprinting) where the energy requirement of the body exceeds that provided by breathing, and therefore, the body is forced to work without oxygen.  Aerobic exercises are the ones where oxygen is used to produce energy in order to fuel the body for a prolonged activity (i.e., marathon running)

Reg Wulff

About Reg Wulff

Reg is a licensing officer with Northern Health and has his BA in Health Science. Previously, he worked as a Recreation Therapist with Mental Health and Addictions Services in Terrace as well as a Regional Tobacco Reduction Coordinator. Originally from Revelstoke, Reg enjoys the outdoor activities that Terrace offers, like mountain biking and fishing. Reg also likes playing hockey, working out, and creative writing. He is married and has two sons and believes strongly in a work/life balance as family time is important to him.

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NH smoke-free grounds policy: Let’s do it right too!

At the end of 2012, Vancouver Coastal Health authority launched their fantastic new video to promote their tobacco reduction messages, using the music of Tom Lavin.

When I saw the video for the first time, I thought, we need a video like this for Northern Health! The music is great and everyone is involved.

Watch the Vancouver Coastal Health video:

Northern Health’s smoke-free grounds policy was developed to protect everyone from the harmful effects of second hand smoke. There is no safe level of exposure to second hand smoke and even the odour of smoke on clothing (third hand smoke) is harmful. It’s important for staff, physicians, patients and visitors to ensure that our facilities provide a safe environment for health and healing without tobacco smoke and the lingering toxic odour of smoke.

So what is it like for patients who normally smoke? The average smoker will start having cravings to smoke within 30-60 minutes of admission. They may develop a headache, restlessness, irritability, inability to concentrate and other discomforts of withdrawal.

When our patients who smoke are admitted to our facilities, it’s important to minimize the discomfort of their withdrawal symptoms. The Nicotine Withdrawal Protocol should be implemented on admission; patients are offered Nicotine Replacement Therapy products (NRT), such as patches, gum and/or inhalers to decrease their withdrawal symptoms. If cravings persist, the dose can be increased or the patch can be combined with the gum or inhaler. It’s like pain control and withdrawal should be treated like pain!

Patients who experience comfort without the constant need to smoke may even decide to quit, but for now they will feel better and heal faster. Being in an environment where no one is smoking also reduces the desire to smoke!

Tobacco kills half of all its users and many of the patients in our facilities are there because of tobacco-related illnesses. Let’s all work together to escape the harmful effects of tobacco and tobacco smoke.

What can staff do?

  • Ask all patients about tobacco and treatment for withdrawal – make it a standard of care.
  • Use the 5A’s approach: Ask, Advise, Assess, Assist and Arrange.
  • If you smoke, do not smoke on the hospital grounds. Remind your co-workers to smoke off NH property.
  • Ask yourself: Do my clothes smell like smoke? If they do, consider changing after breaks.
  • Consider using NRT or cessation medications while at work.
  • Think about quitting – you can do it!

What can patients do?

  • Ask for the nicotine patch, gum and or inhaler to help you feel more comfortable.
  • Refrain from smoking on the hospital grounds.
  • Think about quitting.
  • Phone Healthlink BC at 8-1-1 for free patches or gum.
  • Visit www.quitnow.ca.

If you like videos, Dr. Mike Evans from Toronto has a good one that might help you quit: “What is the single most important thing you can do to quit smoking?”

Enjoy and live tobacco free!

Nancy Viney

About Nancy Viney

Nancy is a registered nurse working in Northern Health’s population health team. She often imagines a day when no one in northern British Columbia suffers from the harmful effects of tobacco. In her time off, she enjoys spending time with her family and friends, especially her two little grandchildren! Nancy also enjoys quilting, knitting, crocheting and many other home spun crafts.

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It’s a great time to quit! You can get free nicotine patches or nicotine gum!

Quitting smoking resources

There are lots of great resources out there to help you quit smoking, such as quitnow.ca, HealthLink BC and 8-1-1.

It’s November and it’s starting to get pretty cold. I see people huddled outside buildings and cars, trying to keep warm while they quickly smoke a cigarette or cigar. Tobacco is robbing them of their health, their appearance and their money. I’m thinking, wouldn’t it be wonderful if all tobacco users got the help they needed to quit? British Columbia has some of the best supports in Canada to help you become tobacco free!

If you’re a tobacco user, you’ve probably thought about quitting! Everyone knows that smoking cigarettes or chewing tobacco is bad for our health. Are you wishing that you never started? Do you hope that your kids never start?

You’re probably planning to quit some day. Why not make it today?

Some people find lists help them with decisions. Make a top 10 list for yourself of reasons to quit, or you can use some of these.

  1. I can get free nicotine replacement therapy through the Provincial Smoking Cessation Program. Everyone living in British Columbia can get 12 weeks of nicotine patches or nicotine gum every calendar year.  This means if I quit now, I can get nicotine replacement therapy for the rest of the year and another 12 weeks starting in the New Year!
  2. My health will improve within eight hours of my last cigarette.
  3. I can stop worrying about how smoking is hurting my health. I will lower my chances of getting cancer, heart disease, lung disease and other disabling diseases. I will also look younger.
  4. Winter is coming. I won’t have to go outside in nasty weather to smoke or buy cigarettes etc.
  5. I will save money! I will have more money for Christmas and other fun stuff.
  6. My clothes, house or car won’t smell like smoke.
  7. I won’t have to live with the constant cravings to smoke or chew once I have quit.
  8. I will feel more in control of your life. Smoking isn’t cool anymore.
  9. I will no longer expose my friends and family to the harmful effects of second hand smoke.
  10. I will help prevent my kids from getting addicted to tobacco.

To access your free Nicotine Replacement Therapy call HealthLink BC at 8-1-1. You can also get more information on the Provincial Smoking Cessation Program website.

You can access counselling by phone, email or text. Visit www.quitnow.ca or call 8-1-1 for support from QuitNow services.

Visit our website for the Northern Health position on tobacco reduction.

Nancy Viney

About Nancy Viney

Nancy is a registered nurse working in Northern Health’s population health team. She often imagines a day when no one in northern British Columbia suffers from the harmful effects of tobacco. In her time off, she enjoys spending time with her family and friends, especially her two little grandchildren! Nancy also enjoys quilting, knitting, crocheting and many other home spun crafts.

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