sample essay on quitting smoking

Essay on Smoking

500 words essay on smoking.

One of the most common problems we are facing in today’s world which is killing people is smoking. A lot of people pick up this habit because of stress , personal issues and more. In fact, some even begin showing it off. When someone smokes a cigarette, they not only hurt themselves but everyone around them. It has many ill-effects on the human body which we will go through in the essay on smoking.

Ill-Effects of Smoking

Tobacco can have a disastrous impact on our health. Nonetheless, people consume it daily for a long period of time till it’s too late. Nearly one billion people in the whole world smoke. It is a shocking figure as that 1 billion puts millions of people at risk along with themselves.

Cigarettes have a major impact on the lungs. Around a third of all cancer cases happen due to smoking. For instance, it can affect breathing and causes shortness of breath and coughing. Further, it also increases the risk of respiratory tract infection which ultimately reduces the quality of life.

In addition to these serious health consequences, smoking impacts the well-being of a person as well. It alters the sense of smell and taste. Further, it also reduces the ability to perform physical exercises.

It also hampers your physical appearances like giving yellow teeth and aged skin. You also get a greater risk of depression or anxiety . Smoking also affects our relationship with our family, friends and colleagues.

Most importantly, it is also an expensive habit. In other words, it entails heavy financial costs. Even though some people don’t have money to get by, they waste it on cigarettes because of their addiction.

How to Quit Smoking?

There are many ways through which one can quit smoking. The first one is preparing for the day when you will quit. It is not easy to quit a habit abruptly, so set a date to give yourself time to prepare mentally.

Further, you can also use NRTs for your nicotine dependence. They can reduce your craving and withdrawal symptoms. NRTs like skin patches, chewing gums, lozenges, nasal spray and inhalers can help greatly.

Moreover, you can also consider non-nicotine medications. They require a prescription so it is essential to talk to your doctor to get access to it. Most importantly, seek behavioural support. To tackle your dependence on nicotine, it is essential to get counselling services, self-materials or more to get through this phase.

One can also try alternative therapies if they want to try them. There is no harm in trying as long as you are determined to quit smoking. For instance, filters, smoking deterrents, e-cigarettes, acupuncture, cold laser therapy, yoga and more can work for some people.

Always remember that you cannot quit smoking instantly as it will be bad for you as well. Try cutting down on it and then slowly and steadily give it up altogether.

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Conclusion of the Essay on Smoking

Thus, if anyone is a slave to cigarettes, it is essential for them to understand that it is never too late to stop smoking. With the help and a good action plan, anyone can quit it for good. Moreover, the benefits will be evident within a few days of quitting.

FAQ of Essay on Smoking

Question 1: What are the effects of smoking?

Answer 1: Smoking has major effects like cancer, heart disease, stroke, lung diseases, diabetes, and more. It also increases the risk for tuberculosis, certain eye diseases, and problems with the immune system .

Question 2: Why should we avoid smoking?

Answer 2: We must avoid smoking as it can lengthen your life expectancy. Moreover, by not smoking, you decrease your risk of disease which includes lung cancer, throat cancer, heart disease, high blood pressure, and more.

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Persuasive Essay Guide

Persuasive Essay About Smoking

Persuasive Essay About Smoking - Making a Powerful Argument with Examples

What You Need To Know About Persuasive Essay

A persuasive essay is a type of writing that aims to convince its readers to take a certain stance or action. It often uses logical arguments and evidence to back up its argument in order to persuade readers.

It also utilizes rhetorical techniques such as ethos, pathos, and logos to make the argument more convincing. In other words, persuasive essays use facts and evidence as well as emotion to make their points.

A persuasive essay about smoking would use these techniques to convince its readers about any point about smoking. Check out an example below:

Simple persuasive essay about smoking

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Persuasive Essay Examples About Smoking

Smoking is one of the leading causes of preventable death in the world. It leads to adverse health effects, including lung cancer, heart disease, and damage to the respiratory tract. However, the number of people who smoke cigarettes has been on the rise globally.

A lot has been written on topics related to the effects of smoking. Reading essays about it can help you get an idea of what makes a good persuasive essay.

Here are some sample persuasive essays about smoking that you can use as inspiration for your own writing:

Persuasive speech on smoking outline

Persuasive essay about smoking should be banned

Persuasive essay about smoking pdf

Persuasive essay about smoking cannot relieve stress

Persuasive essay about smoking in public places

Speech about smoking is dangerous

Persuasive Essay About Smoking Introduction

Persuasive Essay About Stop Smoking

Short Persuasive Essay About Smoking

Stop Smoking Persuasive Speech

Check out some more persuasive essay examples on various other topics.

Argumentative Essay About Smoking Examples

An argumentative essay is a type of essay that uses facts and logical arguments to back up a point. It is similar to a persuasive essay but differs in that it utilizes more evidence than emotion.

If you’re looking to write an argumentative essay about smoking, here are some examples to get you started on the arguments of why you should not smoke.

Argumentative essay about smoking pdf

Argumentative essay about smoking in public places

Argumentative essay about smoking introduction

Check out the video below to find useful arguments against smoking:

Tips for Writing a Persuasive Essay About Smoking

You have read some examples of persuasive and argumentative essays about smoking. Now here are some tips that will help you craft a powerful essay on this topic.

Choose a Specific Angle

Select a particular perspective on the issue that you can use to form your argument. When talking about smoking, you can focus on any aspect such as the health risks, economic costs, or environmental impact.

Think about how you want to approach the topic. For instance, you could write about why smoking should be banned.

Check out the list of persuasive essay topics to help you while you are thinking of an angle to choose!

Research the Facts

Before writing your essay, make sure to research the facts about smoking. This will give you reliable information to use in your arguments and evidence for why people should avoid smoking.

You can find and use credible data and information from reputable sources such as government websites, health organizations, and scientific studies.

For instance, you should gather facts about health issues and negative effects of tobacco if arguing against smoking. Moreover, you should use and cite sources carefully.

Paper Due? Why Suffer? That's our Job!

Make an Outline

The next step is to create an outline for your essay. This will help you organize your thoughts and make sure that all the points in your essay flow together logically.

Your outline should include the introduction, body paragraphs, and conclusion. This will help ensure that your essay has a clear structure and argument.

Use Persuasive Language

When writing your essay, make sure to use persuasive language such as “it is necessary” or “people must be aware”. This will help you convey your message more effectively and emphasize the importance of your point.

Also, don’t forget to use rhetorical devices such as ethos, pathos, and logos to make your arguments more convincing. That is, you should incorporate emotion, personal experience, and logic into your arguments.

Introduce Opposing Arguments

Another important tip when writing a persuasive essay on smoking is to introduce opposing arguments. It will show that you are aware of the counterarguments and can provide evidence to refute them. This will help you strengthen your argument.

By doing this, your essay will come off as more balanced and objective, making it more convincing.

Finish Strong

Finally, make sure to finish your essay with a powerful conclusion. This will help you leave a lasting impression on your readers and reinforce the main points of your argument. You can end by summarizing the key points or giving some advice to the reader.

A powerful conclusion could either include food for thought or a call to action. So be sure to use persuasive language and make your conclusion strong.

To conclude,

By following these tips, you can write an effective and persuasive essay on smoking. Remember to research the facts, make an outline, and use persuasive language.

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Essay on Stop Smoking

Students are often asked to write an essay on Stop Smoking in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Stop Smoking

Introduction.

Smoking is a dangerous habit that harms our health and environment. It’s crucial to stop smoking for a better life and future.

The Dangers of Smoking

Smoking causes diseases like cancer and heart problems. It also harms others through secondhand smoke.

Ways to Quit

You can stop smoking by seeking help from doctors, using nicotine patches, or joining support groups.

Benefits of Quitting

Quitting smoking improves health, saves money, and protects loved ones from secondhand smoke.

Stopping smoking is challenging but vital. Let’s strive for a smoke-free world for a healthier future.

250 Words Essay on Stop Smoking

The detrimental effects of smoking.

Smoking is a habit that has been ingrained in numerous societies for centuries. Despite its prevalence, the deleterious effects of smoking on health are undeniable. Every puff of smoke inhaled introduces a cocktail of chemicals into the body, many of which are carcinogens. The result is a heightened risk of diseases such as lung cancer, heart disease, and stroke.

Smoking and Its Socioeconomic Impact

Beyond the health implications, smoking also presents significant socioeconomic challenges. The cost of tobacco products and healthcare for smoking-related illnesses can be financially crippling for individuals and families. Moreover, the loss of productivity due to illness and premature death contributes to economic stagnation.

The Power of Prevention

Prevention is the most effective strategy in combating the smoking epidemic. Educational campaigns highlighting the dangers of smoking, combined with regulations limiting tobacco advertising and sales, can significantly reduce smoking rates. Furthermore, support for quitting smoking, like counseling services and nicotine replacement therapies, should be readily accessible.

Personal Responsibility and Collective Action

Ultimately, the decision to stop smoking lies with the individual. However, societal support is crucial in facilitating this decision. Collective action can create an environment that discourages smoking and encourages healthier alternatives.

In conclusion, the negative implications of smoking necessitate immediate action. By understanding the risks, acknowledging the socioeconomic impact, promoting prevention, and encouraging personal responsibility, we can work towards a smoke-free future.

500 Words Essay on Stop Smoking

The health hazards of smoking.

The primary reason to quit smoking revolves around health. Cigarette smoke is a toxic mix of over 7,000 chemicals, many of which are carcinogenic. Smoking is directly linked to lung cancer, heart disease, stroke, and chronic respiratory diseases. Moreover, it weakens the immune system, making smokers more susceptible to diseases. Secondhand smoke also poses severe risks, affecting non-smokers who are exposed to it.

The Economic Impact of Smoking

Smoking also has significant economic implications. The direct cost of smoking, such as the price of cigarettes, is just the tip of the iceberg. The indirect costs, including healthcare expenses and productivity loss due to smoking-related illnesses, are substantial. In the United States alone, the total economic cost of smoking is more than $300 billion a year.

Environmental Consequences

The social aspect of smoking.

Smoking can also strain relationships. The smell of smoke can be off-putting to non-smokers, and the health risks associated with secondhand smoke can cause tension. Additionally, the time spent on smoking breaks can lead to social exclusion or missed opportunities.

Benefits of Quitting Smoking

Quitting smoking brings immediate and long-term benefits. Within 20 minutes of quitting, heart rate and blood pressure drop. Within a year, the risk of heart disease is halved. Over time, the risk of stroke, lung cancer, and other diseases decrease significantly. Financially, quitting smoking can save individuals thousands of dollars annually. Environmentally, quitting reduces pollution and waste. Socially, it can improve relationships and increase social inclusion.

If you’re looking for more, here are essays on other interesting topics:

Apart from these, you can look at all the essays by clicking here .

The Perils of Smoking: Health Hazards and Societal Impact

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Introduction

Health hazards: unveiling the dangers within.

Financial Burdens: Counting the Cost of a Death Catalyst

Societal impact: beyond the individual smoker, conclusion: a call to action.

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The Perils of Smoking: Health Hazards and Societal Impact essay

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Essay on Psychology

Free How to Quit Smoking Essay

Type of paper: Essay

Topic: Psychology , Smoking , Experience , Motivation , Friendship , Life , Management , Sociology

Published: 12/06/2019

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Introduction

Smoking is one of the habits that one can be badly addicted to. Smoking is a habit that is too difficult to quit. In a smoker’s life for instance, it can be a very big step for one to quit smoking, unfortunately this step is not easy to take. This does not recognize whether you are a teen smoker or whether you have smoked all your life. It is basically difficult to quit smoking ones you are an addict. So, improvements are needed to quit smoking which foundationally need some motivation. This motivation should come from the social aspect, and the persons well calculated moves. Through motivation therefore, it is possible to learn the new ways and finally quit and manage the vehement desires of smoking. (Greaves, 36) As a smoker, I have really found it hard to accept the fact that there are people who once smoked and are now free from this habit. I find it very wise to quit smoking but the initiative has been an uphill to me. This is what prompted me to carry out some research on this habit.

This research relies on people’s experience which I do put in prose form.

Why it is hard to quit smoking.

There are several reasons which I found that have kept me smoking. One, smoking comes out to be a physical addiction and psychological habit. Smoking is like a daily ritual which needs to be repeated on daily basis. In addition to this we find that the content of cigarette, nicotine, does provide temporary and addictive state. So if one is to refrain from smoking, then there must be some physical signs that automatically will call for only the determined to stand against and move on. Basically when one has to quit smoking he has to quit both the addiction and the habit. Only through this will one count himself to be out of the addiction of nicotine. (Hilton, 13) Secondly, it is not easy to quit smoking especially for people who were used to it in managing overwhelming and unpleasant feelings such as anxiety, stress, and loneliness. Basically, smoking act as the only companion when one is lonely or is stressed. You find that the comfort that people seem to find through smoking is not an easy thing to abandon and start doing something else. But because one will pretend that he is quitting smoking, he or she will continue smoking and may continue till the end of his or her life. This is because it is not easy due to its addictive nature. The comfort that cigarettes do provide is also addictive. In addition to the addiction, there are some side benefits that do come with smoking thus making it very difficult to quit. These side benefits can include the stimulation that smokers do get when the smoke, the pleasure, the relaxation that these smokers get is very overwhelming that stopping smoking is not easy. These are some of the reasons why I find it not easy to stop smoking. Though it is difficult to stop smoking, I have come to understand that people have been able to stop smoking. They have graduated from that class and have joined the class of non smokers. On inquiring, I came out with some possible solutions to why they managed to quit smoking. The foremost step is that one has to take the initiate to stop smoking. He or she should come out with an effective plan to help him or she quit the craving desire for cigarettes, to manage his or her unpleasant and overwhelming feelings. On top of these, one needs support from the social aspect of life. Those who are close to this smoker do play a very big role in ensuring that they either continue smoking or quit. Through the support of people like the family, the peers and friends from whichever dimension, quitting smoking will not be difficult to undertake.

Personally, I have found it very difficult to stop smoking but now I know that people can work their ways out of the habit. I just want to try my best to quit this habit just like my friends have done it. I want to acknowledge the role that psychology play in such calls for actions. The role that the mind plays stands out to be very significant and this proves that the major step in quitting smoking is having a determined mind to quit smoking. The experience I have had while smoking is pathetic and it is my wish you don’t fall into this trap that I fell in. kindly don not smoke.

Works cited:

Hilton, M. The Smoking Culture: Perfect Pleasures. Manchester University Press, 2000 Gilman, S. L. . Smoke: History of Smoking. Reaktion Books, 2003 Greaves, L. Reflections on Addiction and Modernity State University of New York Press, 2002 Robicsek, F. The Smoking Gods . Eve publishers. Michigan, 1978 West, R. and Shiffman, S. Fast Facts: Smoking Cessation. Health Press Ltd, 2007.

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Persuasive Essay

Persuasive Essay About Smoking

Last updated on: Jul 11, 2024

Writing Persuasive Essays About Smoking? Use These Samples

By: Donna C.

Reviewed By: Jacklyn H.

Published on: Jan 25, 2023

Smoking is a leading cause of preventable death in the United States, and it's not just smokers who are affected.

It's hard to find good essay examples about smoking that will help you write convincing arguments.

Occasionally when you're trying to find examples of persuasive essays, you end up reading articles that are poorly written.

We can arm you with persuasive essay examples about smoking that will help you write convincing arguments.

Let’s get started.

On this Page

What Is A Persuasive Essay?

A persuasive essay is a type of writing that seeks to convince the reader to accept a particular point of view.

It is written to persuade readers to take action or adopt a certain viewpoint.

Most people prefer writing on controversial persuasive essay topics , as they are perfect for arguing.

They may include a call to action or an appeal to emotion, but they should always be backed up with evidence.

The goal of a persuasive essay is to convince readers that your opinion is valid and worthy of consideration.

Here is a simple example to improve your understanding.

Simple Persuasive essay about smoking

Paper Due? Why Suffer? That's our Job!

Persuasive Essay Examples About Smoking

Writing a persuasive essay about smoking requires an understanding of why it is both beneficial and detrimental.

Here are some examples about smoking that can provide inspiration for your writing:

Persuasive speech on smoking outline

Persuasive essay about smoking should be banned

Persuasive essay about smoking pdf

Persuasive essay about smoking cannot relieve stress

Persuasive essay about smoking in public places

Speech about smoking is dangerous

Struggling to start your essay? Checkout how you can create a persuasive essay outline !

Argumentative Essay About Smoking Examples

To help you better understand how to write an argumentative essay about smoking, let's look at some examples.

Argumentative essay about smoking introduction

Argumentative essay about smoking pdf

Argumentative essay about smoking in public places

Looking for more samples? Check out these persuasive essay examples !

Tips For Writing a Persuasive Essay About Smoking

Writing a persuasive essay about cigarette smoking can be challenging. Here are some tips you can follow to make the writing process easier.

1. Show the facts

Include statistics, examples, and case studies to build a strong argument for why smoking should be banned or discouraged.

2. Be direct

Make sure your message is clear and convincing by getting straight to the point when making your argument.

3. Speak from experience

Share personal experiences with smoking or stories of others you have heard to make your argument more powerful.

4. Acknowledge the other side

Be sure to address any counterarguments and acknowledge why people may disagree with you. You should also try to explain why your position is stronger.

5. Emphasize the consequences

Showing how smoking can harm a person’s health, and the environment can make your argument even more compelling. For example, you can talk about how smoking leads to lung cancer.

This video talks about some consequences of smoking that you can use.

6. Call to action

End your essay with a call to action that encourages readers to take steps towards further educating themselves on the issue. For example, you can ask the reader to stop smoking for the good of their children.

7. Lead by example

Advocating for anti-smoking initiatives will help spread your message and convince more people to reconsider their lifestyle choices.

Remember, smoking is a serious issue with potentially life-threatening consequences. The only way to combat it effectively is by being persuasive and getting our message across.

Tough Essay Due? Hire Tough Writers!

writing a persuasive essay about smoking can be a powerful way to spread awareness about smoking. Using facts, examples, stories, and CTAs, you can create an essay that will convince stubborn smokers to reconsider their lifestyle choices.

Remember, your words have power – use them for good and help make a difference in the fight against smoking!

At SharkPapers.com, we provide a comprehensive essay writing service to help you create an effective argument.

Our expert persuasive essay writers have the necessary experience to craft a compelling argument that convinces your reader.

From crafting an outline and writing the content, our essay writer will ensure that your persuasive essay stands out. This is why we strive to provide you with the best persuasive essay writing service tailored specifically to your needs.

Frequently Asked Questions

What would be a good thesis statement for smoking.

A good thesis statement for a persuasive essay on smoking could be something like this:

“Smoking is not only dangerous to your health, but it also costs taxpayers billions of dollars each year in healthcare expenses. Additionally, cigarettes are a leading cause of fires and death in the United States. For all these reasons, it's clear that smoking should be banned.”

What are good topics for persuasive essays?

Here are some good topics for persuasive essays on smoking:

The dangers of smoking and the health risks associated with it.
How smoking affects non-smokers, including children, through secondhand smoke.
How quitting smoking can improve your overall health and extend your life expectancy.

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Donna writes on a broad range of topics, but she is mostly passionate about social issues, current events, and human-interest stories. She has received high praise for her writing from both colleagues and readers alike. Donna is known in her field for creating content that is not only professional but also captivating.

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Process Essay: How to Quit Smoking

All those anti-smoking campaigns seem to be working since the prevalence of smoking has been declining for a while now. But, the actual number of smokers is not declining whatsoever. On the opposite, people seem to be smoking less, but the number of smokers continues to increase.

According to the Institute for Health Metrics and Evaluation at the University of Washington, smoking prevalence decreased by 25% for men and 42% for women by 2012. However, the actual number of smokers increased by 41% in the period between 1980 and 2012.

Smoking is a terrible habit indeed, and everyone will tell you the same. Even those who once got rid of this scourge succumb to the temptation and return to smoking again. Because of this, many smokers wonder if it is possible to quick smoking forever and not return to it a short while afterward.

Those anti-smoking campaigns won’t really help you quit. All the scary pictures on the packs and lessons can do is inform people of the harm cigarettes can do to their bodies and health. If you want to quit smoking, you need to do it with your personal will and intent.

The first thing you need to do to stop smoking is to decide to stop smoking. People who keep persuading you to quit smoking cannot convince you unless you want it to, and attempting to do so for the exhortations of others will probably not be long-lasting or successful. I have found that the most important factor in quitting this habit is your will. If those ugly pictures on the billboards and the cigarette packs haven’t convinced you yet, get more informed about the harms of smoking.

Secondly, you need to start talking to people who managed to do this. Reading and listening to such stories will give you an idea as to what expects you and help you create a plan. When you calculate how much this terrible habit costs you in a year, you will surely be more inclined to stop smoking. Cigarettes get more and more expensive almost every year. When you find a reason why you need to quit smoking, you can start working on the strategy. Whether it is to preserve your health and avoid problems like heart attacks or to save some money, every reason is a reason good enough. Being certain that you want to quit will give you the motivation you need and you can start throwing away the cigarettes.

Of course, if you are smoking for a long time or smoke too many cigarettes a day, you shouldn’t quit right away. Quitting over a certain period of time is much easier for your body and your mind, especially if you are smoking when you are bored or stressed. A single cigarette with the morning cup of coffee does not mean that you are not quitting. Just calculate the steps and set a deadline. Reduce the number of cigarettes you are smoking throughout this period.

Assign the last day and the last cigarette. This is the day when you will stop being a smoker, but until that day, you will be working toward it. Some people say that quitting with someone else is much easier because you and the other person can motivate each other and not let ourselves slip. When that day comes, smoke the last cigarette. Make sure this cigarette is the very last you will ever smoke.

This all sounds so simple, but it is not. Smoking is much more of a psychological than a physical addiction, making it harder to get rid of. In order to quit smoking, you don’t only have to decide and buy nicotine patches. You need to find out what makes you smoke and do things to distract you from it. Even when you quit smoking, your job does not end here. For a very long time, you will have moments when you will feel the urge to smoke ‘just one cigarette’. If you allow yourself to do this, you will become a smoker again. Avoid things that make you want to smoke and if you cannot, find a hobby or make a habit that will distract you from these things when the time comes. When you feel like you really need a smoke, go running, go to a concert, ride your bike, take a walk with your dog, or do anything else that will keep you distracted. You may think that one more cigarette is all that you need, but this will rapidly turn into a renewed smoking habit.

A physical, healthy routine can go a long way. If you start exercising regularly, you will literally turn the pages in your life. Not only will this distract you from smoking, but it will also come with a variety of health benefits and may just be what keeps you healthy after all those years of smoking. Don’t let your willpower be tested. It is easier to say ‘I will quit’ than actually quit, but once you do it, be strong enough not to get back to it. A bit of faith in yourself and some good distraction tricks is what keeps non-smokers from going back to this terrible habit.

Smoking is an unhealthy behavior that accounts for almost 40% of all deaths in the US. It is also very expensive and very dangerous to your health, so quitting smoking is simply the natural and logical thing to do. It isn’t easy, but many have done it. If they can, you can do it too.

References:

[1] http://www.healthdata.org/news-release/despite-declines-smoking-rates-number-smokers-and-cigarettes-rises

[2] A.H. Mokdad, J.S. Marks, J.S. Stroup, J.L. GeberdingActual causes of death on the United States, 2000 JAMA, 291 (2004), pp. 1238-1245

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Quitting Smoking Essay Example

Pages: 9 (2354 words)
Published: May 13, 2017
Type: Research Paper

Although smoking causes numerous health problems, such as lung cancer, it continues to be a widespread addiction. Nonetheless, there are attempts to stop smoking and discussions persist regarding the most successful techniques. This article investigates various strategies and resolutions for ceasing smoking. Although some individuals have quit successfully by meticulously planning, others encounter obstacles due to their nicotine dependence.

The main reason quitting smoking is difficult is the strong addiction to nicotine found in cigarettes and other tobacco products. Nicotine consumption leads to a psychological dependence, as it acts as a depressant that creates pleasurable effects. The nervous system becomes accustomed to nicotine, causing smokers to increase their intake to maintain effective bodily function.

Due to their addiction to nicotine, quitting smoking can be a difficult and seemingly impossible task for many smokers. Abruptly s

topping or reducing nicotine consumption can result in various symptoms such as increased appetite, headaches, disturbed sleep, depression, and lack of concentration. These symptoms are the body's natural response to the shortage or absence of nicotine. As a result, many smokers continue using despite experiencing withdrawal symptoms and may even relapse if they cannot tolerate these periods.

Smoking has various harmful consequences that can be significant enough to motivate individuals to stop. These consequences include serious health problems, financial strain, and social restrictions. The widespread support for creating non-smoking areas in public places demonstrates a desire for smoke-free surroundings among a large number of people. As a result of these limitations and worries over smoking-related diseases like lung, nutrition, and heart issues, smokers may contemplate quitting (Stratford D, 1998).

Smoke is the leading cause of cancer in living organisms. Smoking, specifically cigarettes, contributes t

more than 90% of lung cancer cases and raises the risk for throat, bladder, mouth, pancreas, and tongue cancers. The amount someone smokes directly correlates with their likelihood of developing lung cancer. While current smokers face a high risk of death from this habit, gradually quitting can decrease the probability of lung cancer.

Exposure to tobacco chemicals can damage lung cells and lead to cancer. However, quitting smoking can aid in the replacement of unhealthy cells with healthy ones, resulting in a 25% reduction in cancer risk within ten years. Additionally, cigarette usage is a major contributor to cardiovascular disease in America and is associated with other factors such as high blood pressure, obesity, diabetes, and lack of physical activity (Kevin C., 2002).

When fat and fatty substances accumulate in arteries, a condition called atherosclerosis occurs. This can lead to heart attacks. Smoking is already known to cause heart problems but becomes even more dangerous when combined with high blood pressure and increased blood clotting. People over 50 years old, especially women taking contraceptives, are at a higher risk of heart disease. The effects of smoking on these conditions are severe enough that young women may experience strokes if they are regularly exposed to smoke.

Consuming tobacco and smoking can have an unforeseen effect on nutritional health. They decrease the body's essential mineral and vitamin levels and hinder its ability to absorb these vital elements that are necessary for preventing diseases. The immune system's capability to maintain itself is negatively impacted by smoking, which specifically targets vitamin C, causing depletion of this nutrient in the bloodstream and harm. Consequently, the body needs more vitamins to repair this damage;

however, they may be trapped by smoke leading to long-term reduction of immunity over time.

Individuals who smoke require a higher intake of vitamins compared to those who do not smoke in order to combat immune deficiency and increase resistance against illnesses like colds and flu. Additionally, smoking places one at a greater risk for health issues and leads to societal limitations such as increased insurance expenses.

Warren K (2000) suggests that employers may favor non-smokers in order to avoid workplace complications and inconveniences. Smokers might face limitations at important locations like vehicles and restaurants. Moreover, smoking mothers have a greater chance of bearing babies with respiratory problems, low weight, nausea or sudden infant death syndrome. Though preventable, smoke-related ailments are widespread in society. Many individuals attempt to overcome their nicotine addiction and lower the likelihood of such illnesses. Nonetheless, people continue to smoke for various reasons despite being aware of associated risks.

Smoking is often taken up by young and inexperienced people who want to stay trendy and fashionable. Both boys and girls use smoking as a way to project a specific image and gain acceptance from their peers. Boys tend to use it to appear macho, while girls see it as a means of increasing their sex appeal and staying current with fashion trends.

(Kristi J, 1992) suggests that people may resort to smoking as a way of easing stress and enhancing their mood, even though it can lead to harmful outcomes. This tendency is especially evident when individuals are confronted with difficult situations or demanding activities.

Health experts strongly reject the idea that nicotine reduces stress in smokers. Instead, they argue that high dependency on

nicotine results in increased stress and depression. This is because a smoker's addiction to nicotine leads to a decrease in its normal levels in the body, causing an urge to inhale more nicotine and alleviate the resulting stress.

The fallacy of believing smoking reduces stress is a common misconception as it actually leads to increased stress levels due to addiction (Daniel F, 1999). Nicotine addicts often need to continuously replenish their nicotine levels to maintain their mood, resulting in a cycle of chain-smoking to counteract withdrawal symptoms. However, society's stereotype that being slim is cool has led to a widespread struggle for weight loss through various exercises and medications.

Some individuals think that smoking cigarettes, particularly among women, can assist in weight loss. However, this method is dangerous as people attempt to conform to societal expectations and beliefs. Smoking negatively impacts an individual's appetite and decreases their desire for food which leads to weight reduction. The compulsion for smoke suppresses the need for food. The feeling of relief prompting individuals to smoke is why they are frequently assumed to be beneficial for weight loss.

This situation of weight loss is aggravated by the unsupported belief that quitting smoking will promptly cause an increase in weight, which can ultimately lead to weight-related problems. This concept has some validity, as research has discovered instances of weight gain following smoking cessation. Nevertheless, to fight against this gain, one must focus on counteracting the resulting increase in weight and not use it as a justification for persisting in smoking. In this case, adopting a change in dietary and lifestyle habits is highly recommended (Franklin B et al, 2005).

The primary hindrance to quitting

smoking is said to be the withdrawal symptoms, which are comparable to those experienced when withdrawing from hard drugs such as marijuana or heroin. Overcoming an addiction is a challenging process that necessitates more than just physical strength. Therefore, the most effective approach for quitting any type of addiction should be capable of managing these withdrawal symptoms.

While there is strong resistance to the idea, stopping smoking is most effectively achieved through a method known as "cold turkey." Simply put, this involves quitting smoking abruptly and without any prior planning. This approach is based on the idea that no elaborate preparation is needed, as with cold turkeys. Although opponents of this method acknowledge its difficult and challenging nature, they recognize its cost-effectiveness and realistic approach with minimal side effects (Fred H, 2004).

To be successful with this method, the smoker's commitment and dedication are crucial. Coping with withdrawal symptoms is also necessary. Drinking plenty of fluids helps eliminate toxins accumulated from years of smoking. It's important to know the intensity of withdrawal symptoms, which typically subside within a few days. This approach requires keeping busy and ignoring smoking thoughts and withdrawal symptoms.

Individuals can manage strong cigarette cravings by using a cigarette alternative and inhaling fresh air deeply. Receiving assistance from a community of individuals who have also committed to quitting smoking can be beneficial. Although withdrawal symptoms may persist, they typically diminish as people maintain an environment free of nicotine.

This technique is a cost-effective and safe method for quitting smoking that circumvents the negative effects of switching from one addiction to the discomfort of stopping altogether. Nonetheless, some people find this approach overwhelming and prefer

to consider alternative options, such as hypnosis. Hypnotherapy entails several sessions with an expert practitioner whose objective is to target the subconscious mind by purifying it and creating a dislike for smoking and cigarettes while repressing any favorable associations someone may have had with them. (source: www)

Hypnosis.info explains that hypnosis uses both learned and innate techniques to induce mental relaxation and visualize quitting smoking as achievable. However, it is not suitable for everyone as it requires advanced concentration skills, the ability to relax the mind, a willingness to challenge preconceived beliefs about smoking, and a focus on its negative aspects.

Another way to quit smoking is by using patches. This method involves administering nicotine doses through the skin, starting with a high dosage that matches the smoker's usual daily intake and gradually reducing it over time. Although effective, it can be expensive and requires the guidance of a certified hypnotherapist.

The nicotine cravings of the user have been successfully eliminated. There are two patch variations available, tailored to address degrees of nicotine dependence. The 16-hour patch is intended for lighter users, whereas the 24-hour patch may cater to more experienced smokers by administering nicotine throughout the day. Visit www.quits-smoking-support for further information.

Health experts suggest taking patch medication for at least three months to fully transition off it. Nonetheless, this approach isn't ideal since the dosage extends beyond eight weeks and could potentially cause discomfort to the user due to its possible side effects.

Familydoctor.org explains that individuals may experience a range of symptoms including sleep disruption, dizziness, hallucinations, nausea, and muscle discomfort when attempting to quit smoking. However, the side effects associated with using patch therapy during withdrawal

may appear less severe. Alternatively, certain smokers choose to use nicotine gum as it promptly substitutes cigarettes by releasing nicotine into the body.

To avoid relapse into smoking, individuals with tobacco addiction are advised to limit their use of nicotine gum to six months. For ongoing nicotine replacement during cravings, it is recommended that the gum be chewed continuously. It should be noted that this approach may lead to dependence on the gum and mild side effects.

According to www.lungusa., the extended consumption of nicotine gum can cause several discomforts, including throat, mouth and jaw pain, nausea, and an elevated heart rate. Moreover, excessive usage may lead to dental and stomach problems as a result of nicotine ingestion.

Although attempts have been made to reduce cigarette smoking, it remains widespread among approximately 25% of people worldwide. This poses numerous challenges for both smokers and non-smokers, including health problems like heart disease, lung cancer, and nutrient deficiencies that impact not only smokers themselves but also individuals exposed to secondhand smoke.

Smoking restrictions enforced in public areas and establishments, like restaurants and government offices, have prompted many smokers to consider quitting. However, quitting smoking is a difficult undertaking that requires considerable commitment. The quest for the most successful ways to quit smoking has generated debate regarding the best approach. While some argue that going cold turkey is the most effective method because of its low cost and absence of side effects, others disagree.

Although some smokers turn to hypnosis, nicotine gum, and patches to manage withdrawal symptoms, I believe that quitting smoking abruptly is the most effective method. This approach can be supplemented with other strategies and does not require additional costs,

as opposed to the costly and time-consuming procedures associated with gum, hypnosis, and patches.

Providing a cost-effective solution for smokers who have invested significantly in their addiction is crucial. Some alternative methods may yield undesired side effects that deter the smoker from quitting. The cold turkey approach solely necessitates the individual's determination and willingness to tolerate withdrawal symptoms for a short time, ultimately concluding in successful cessation within several days. References: Daniel F. Seidman, Lirio S. Covey. Helping the Hard-Core Smoker.

tags, there are three book titles listed, which are "A Clinicians Guide" by Lawrence Erlbaum Associates in 1999, "Quotations for all occasions" by Catherine Frank published by Columbia University Press in 2000, and "Reframing Health Behavior: Change with Behavioral Economics" by Warren K. Bickel and Rudy E. Vuchinich.The text in the mentions the publication "The Goetz Plan: A practical Smoking Cessation Program for college Student Journal" by Franklin B. Krohn and Kristin M. Goetz, which was published by Lawrence Erlbaum Associates in 2000. Additionally, it mentions an article written by Kristi J. in 2005, which was published in Vol. 39 of the same journal.The following three sources discuss smoking behavior: Ferguson examines how adolescents recruit new smokers, Douglas focuses on the length of time individuals smoke, and Chappell's work is not specified. All three sources were published in the 1990s. The information is presented within a paragraph tag.

Ebony Vol 57, July 2002 published an article about dealing with heart disease, which is the biggest killer. The Evening Chronicle in New Castle, England published an article on November 1, 2004 about the steps to quitting smoking. And quit smoking support website, quitsmokingsupport.com,

provides information on quitting smoking with the transdermal patch.

On 11/09/07, the article "Smoking: steps to help you break the habit" was found at http://familydoctor.org/online/famdocen/home/common/addictions/tobacco/1Fred H. The last update was made on 12/06/07.

Kecley (2004) recommended quitting smoking abruptly, known as "cold turkey," and the information can be found on quitsmoking.com under the articles section.

The American Lung Association reported that smoking cessation occurred in November 2003, with the source of information available at http://www.lungusa.org/site/pp. The date of retrieval was 11/09/07.

On http://www.hypnosis.info/cds/cd02.html, the Oxford Hypnotherapy website provides an article called "How to stop smoking using hypnosis" that examines hypnosis as a technique for smoking cessation. Retrieved on 11/09/07, this piece was originally posted on 07/09/2002.

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GCSE/IGCSE English Language "Smoking: A Trap You Can Escape" Persuasive Sample Answer

Subject: English

Age range: 14-16

Resource type: Other

Last updated

22 August 2024

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This file contains a top-tier GCSE/IGCSE English Language sample answer titled “Smoking: A Trap You Can Escape.” Crafted with excellence, this persuasive essay is designed to guide students through the structure and language techniques essential for high-scoring exam responses.

Introduction: “Smoking: A Trap You Can Escape”
Paragraph 1: The Hidden Dangers of Smoking
Paragraph 2: The Financial Burden of Smoking
Paragraph 3: The Social Impact of Smoking
Paragraph 4: Breaking Free from the Chains
Conclusion: The Choice is Yours—Choose Wisely

What This Sample Answer Is About: This sample answer addresses the serious issue of smoking, persuading a friend to quit by highlighting the severe health risks, financial costs and social drawbacks. It also provides a hopeful message about the power to change and the benefits of quitting smoking.

Language Techniques Included: The essay is packed with persuasive language techniques essential for exam success, including:

Emotive Language: Engages the reader’s feelings and conveys the urgency of the message.
Rhetorical Questions: Challenges the reader to think deeply about their choices.
Anecdotes: Adds a personal touch, making the argument relatable.
Alliteration: Adds emphasis and rhythm to key points.
Direct Address: Speaks directly to the reader, making the argument more compelling.

Why This Is Good for Exam Preparation: This sample answer is an excellent study tool for students aiming to excel in their GCSE/IGCSE English Language exams. It showcases how to structure an argument effectively, use persuasive language techniques, and maintain a formal yet engaging tone. By studying this sample, students will gain a clear understanding of what examiners look for in high-scoring essays.

Why Make the Purchase: Invest in this file to boost your exam preparation with a high-quality, well-crafted sample answer that demonstrates excellence in persuasive writing. Whether you’re struggling with structuring your essay or mastering language techniques, this awesome file provides a comprehensive guide to achieving top marks in your GCSE/IGCSE English Language exam. Don’t miss out on the opportunity to enhance your skills and gain the confidence to succeed.

CONTAINS: 9 PAGES

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Free Cause and Effect Essay on Smoking

Published by gudwriter on May 30, 2018 May 30, 2018

Causes and effects of smoking is a broad application that requires adequate research and knowledge to write and expound on the subject, thus students who doubt their research skills can opt to purchase a research proposal from a legit service like Gudwriter to help them with the homework.

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Smoking Cause and Effect Essay Outline

Introduction .

Thesis: To understand the social and health implications of smoking it is essential to look into some of its causes and effects.

Paragraph 1:

Peer pressure is the most prevalent cause of smoking.

Most people start smoking through the influence of their friends,
Smoking begins when most people are young; that is during adolescence and in their early twenties.
Quitting smoking due to addiction is difficult.

Paragraph 2:

Parenting style determines whether or not one will be a smoker.

A child whose parents were smokers is highly likely to become a smoker.
Children take after their parents’ behaviors.

Paragraph 3:

People are duped into believing that smoking relieves stress.

People engage in smoking as a way of managing stress.
Smoking does not relieve stress; instead, it increases it.
The level of stress in smokers is higher compared to non-smokers.

Paragraph 4:

Smoking is the leading cause of lung cancer in the world.

Smoking causes cancer both in active and passive smokers.
Smoking also causes anxiety on the victim.
Smoking damages the lining of one’s lungs thus causing lung cancer.
Continued smoking leads to permanent damage to lung tissues.

Paragraph 5:

Smoking causes loss of sight.

Cataracts are the number one cause of blindness in the world.
Smokers are twice at the risk of developing cataracts than non-smokers.
AMD is the leading cause of permanent blindness in people aged 65years and above.
Smokers are three times likely to develop AMD than non-smokers.

Paragraph 6:

Smoking is one of the major causes of type-2 diabetes.

40% of smokers are likely to develop type-2 diabetes.
Diabetic smokers make it hard to control the disease progress and insulin levels thus increasing their chances of dying from the disease.
Diabetic smokers are also likely to suffer from other health complications linked to diabetes such as heart failure, kidney problems, high blood pressure, retinopathy, and peripheral neuropathy.

Paragraph 7:

Smoking is the number one cause of death in the US among all the causes of preventable deaths.

480,000 deaths in the country are caused by cigarette smoking each year.
This translates to 20% of the total yearly deaths.

Conclusion:

Smoking is a general lifestyle behavior among young people. People engage in the practice as a way of having fun. Peer pressure is one of the leading factors that drive people to smoke. Parenting style also contributes to the chances of one becoming a smoker. Most people underestimate the health risks associated with smoking. Lung cancer, blindness, and type-2 diabetes are some of the few health effects attributed to smoking.

Learn how to write a cause and effect essay that will get you good grades.

Cause and Effect Essay on Smoking

Introduction.

Smoking is considered a lifestyle behavior. Many people engage in the practice without the awareness of the health risks it is associated with. Smoking is one of the most addictive lifestyle behaviors and has life-changing implications. It has been termed as one of the most significant health challenges that health organizations are facing today (Onor et al., 2017). According to reports by World Health Organization, there were more than 1 billion smokers all over the world in 2014. To understand the social and health implications of smoking, it is essential to look into some of its causes and effects.

Peer pressure is the most prevalent cause of smoking. According to research, most smokers start the smoking habit at a tender age. During adolescence and in the early twenties, most people are infatuated with friendships (Ukwayi, Eja & Unwanede, 2012). At this stage in life, friends hold great value and meaning in individuals. It is at this age that most people are either in their final years in high school or just starting off in college. Most young people particularly those at the college and high school levels engage in various dangerous and life-harming activities, one of which is smoking (Ukwayi, Eja & Unwanede, 2012). Often, their intent is not to become smokers but to enjoy the experience of being young and feel a celebrated status over their peers. If one belongs to a group whose members are smokers, then they too will likely start smoking (Ukwayi, Eja & Unwanede, 2012). Later in life, such people try to drop the smoking behavior, but it becomes challenging due to withdrawal effects.

Parenting style is another factor that may determine whether or not one will become a smoker. The manner in which a child is raised contributes significantly to their behavior as adults (Gilman et al., 2009). Most children look up to their parents and will adopt most of the lifestyle behaviors portrayed by the parents (Gilman et al., 2009). There are parents who have the habit of smoking in the presence of their children, a behavior which is utterly irresponsible (Gilman et al., 2009). Children get the idea that smoking is not unhealthy if their parents do it in their presence (Gilman et al., 2009). Once such children grow up, they develop a liking for tobacco smoking without knowing that it is an unhealthy lifestyle behavior.

There is also a misconception that smoking acts as strain reliever. This delusion blinds most people that smoking helps one relieve stress. Many people therefore find themselves engaging in the habit as a stress management strategy (Choi, Ota & Watanuki, 2015). Noteworthy, continued smoking leads to addiction, thereby making it very difficult for one to do away with the habit once they start it. Research has shown that smoking does not relieve stress, instead it increases it (Choi, Ota & Watanuki, 2015). The level of stress in smokers is twice as high as that in non-smokers.

Smoking is the leading cause of lung cancer in the world, according to research. The practice is likely to cause lung cancer both in active and passive smokers. Passive smokers are people who do not smoke but are exposed to cigarette smoke (Onor et al., 2017). According to medics, smoking damages the lining of one’s lungs thus causing lung cancer. When one inhales cigarette smoke, which consists of cancer-causing carcinogens, lung tissues start changing immediately (Onor et al., 2017). If one smokes for a small period then quits, the lung tissues will repair themselves thus reducing the chances of contracting lung cancer (Onor et al., 2017). However, continued smoking leads to permanent damage of the lung tissues to the extent that they become irreparable. These damages accelerate the development of lung cancer.

Smoking also causes loss of sight. According to medical research, cataracts are the number one cause of blindness in the world. Cataract is the blurring of the eyes standard lens. Studies reveal that smokers are twice at the risk of developing cataracts than non-smokers (Kennedy et al., 2017). Age-related Macular Degeneration (AMD) has an impact on the retina, which is the part of the eye that is responsible for the sharp vision that people use while driving and reading. AMD has been termed as the leading cause of permanent blindness in people aged 65years and above (Kennedy et al., 2017). Research shows that smokers are three times likely to develop AMD than non-smokers (Kennedy et al., 2017). However, if one quits smoking at an early stage, the damage caused to the eyes is repairable, but prolonged smoking leads to increased destruction of the eyes that in turn translates to permanent blindness.

Further, smoking is one of the major causes of type-2 diabetes. Research shows that 40% of smokers are likely to develop type-2 diabetes (Onor et al., 2017). Diabetic people who smoke are likely to experience difficulties in managing insulin levels in their bodies even with prescribed medications. Since increased smoking leads to increased chances of developing type-2 diabetes, diabetic smokers make it hard to control the disease’s progress and insulin levels thus increasing their chances of dying from it (Onor et al., 2017). Diabetic smokers are also likely to suffer from other health complications linked to diabetes such as heart failure, kidney problems, high blood pressure, retinopathy, and peripheral neuropathy (Onor et al., 2017). For a diabetic person, quitting smoking can help control insulin levels in the body.

Even more disheartening is the fact that even though preventable, cigarette smoking is the number one cause of death in the US among all the causes of deaths that are preventable. The same applies to the United Kingdom. In the US alone, 480,000 deaths are caused by cigarette smoking each year, translating to 20% of the total yearly deaths ( Marshall , 2016). The total deaths resulting from a combination of the following causes every year is less than the number of deaths caused by cigarette smoking: firearm-related accidents, motor vehicle injuries, alcohol use, illegal drug use, and HIV. This further shows the seriousness of the effects of smoking on human health.

Smoking is a general lifestyle behavior among young and older people alike. People engage in the practice as a way of having fun. Peer pressure is one of the leading factors that drive people to smoke. Parenting style also contributes to the chances of one becoming a smoker. Many people underestimate the health risks associated with smoking. Lung cancer, blindness, and type-2 diabetes are some of the health effects associated with this habit.

Choi, D., Ota, S., & Watanuki, S. (2015). Does cigarette smoking relieve stress? Evidence from the event-related potential (ERP). International Journal of Psychophysiology , 98 (3), 470-476.

Gilman, S. E., Rende, R., Boergers, J., Abrams, D. B., Buka, S. L., Clark, M. A., … & Lloyd-Richardson, E. E. (2009). Parental smoking and adolescent smoking initiation: an intergenerational perspective on tobacco control. Pediatrics , 123 (2), e274-e281.

Kennedy, R. D., Hammond, D., Spafford, M. M., Douglas, O., Brûlé, J., Fong, G. T., & Schultz, A. S. (2016). Educating smokers about the risk of blindness–insights to improve tobacco product health warning labels. Tobacco Induced Diseases , 14 (1), 30.

Marshall, T. (2016). Public opinion, public policy, and smoking: the transformation of American attitudes and cigarette use, 1890–2016 (1st ed.) . Lanham, MD: Rowman & Littlefield.

Onor, I. O., Stirling, D. L., Williams, S. R., Bediako, D., Borghol, A., Harris, M. B., … & Sarpong, D. F. (2017). Clinical effects of cigarette smoking: epidemiologic impact and review of pharmacotherapy options. International Journal of Environmental Research and Public Health , 14 (10), 1147.

Ukwayi, J. K., Eja, O. F., & Unwanede, C. C. (2012). Peer pressure and tobacco smoking among undergraduate students of the University of Calabar, Cross River State. Higher Education Studies , 2 (3), 92.

Smoking Essay 2: The Effects of Smoking on Health and Social Care

A sample smoking essay outline.

Thesis: Smoking is harmful to nearly all body organs and thus quitting has health benefits.

Smoking damages the human heart and interferes with normal blood circulation.

This increases the risks of such conditions as cerebrovascular disease, peripheral vascular disease, stroke, heart attack, and coronary heart disease.
The heart is made to work faster and thereby strained.
The cigarette contents increase the risks of blood clots.
Smoking leads to furring of the coronary arteries.

Paragraph 2:

Smoking can cause lung disease.

Chronic obstructive pulmonary disease (COPD) is one of the lung diseases.
Most cases of lung cancer are caused by smoking.
An attack can be triggered or made worse by tobacco smoke in asthmatic people.

Smoking can cause serious damages to the mouth and throat.

It can cause strained teeth, bad breath and gum disease.
It causes an increased cancer risk in the gullet, voice box, throat, tongue, and lips.

Smoking can make a woman to experience difficulties in becoming pregnant.

There are higher risks for a pregnant smoker to miscarry.
They may have their baby born with a cleft palate and/or cleft lip,
They may give birth before time to a baby with an abnormally low birth weight,
They may have an ectopic pregnancy.

Quitting smoking reduces the risk of many diseases caused by the habit.

Reduced chances of dying from illnesses that are smoking-related
Quitters have substantial life expectancy gains in comparison to those who continue to smoke.

Paragraph 6:

It is only through quitting that one would be free from the problems caused by smoking.

Set the stage to quit by mentally preparing oneself.
Control cravings of smoking by using nicotine replacement products.
Apply SmokEnders’ behavioral changes in completely breaking emotional bonds developed between smokers and cigarettes.

Smoking Essay Sample

The harmful effects of smoking on health and social care essay.

There are many chemicals contained in tobacco smoke that pose health risks both to smokers and nonsmokers. It can be harmful to even breathe a little tobacco smoke. “Of the more than 7,000 chemicals in tobacco smoke, at least 250 are known to be harmful, including hydrogen cyanide, carbon monoxide, and ammonia” (National Cancer Institute, 2017). At least 69 of these 250 known harmful chemicals in tobacco smoke cause cancer. This explains why cigarette smoking is the leading cause of preventable premature deaths in the United States. Overall, smoking is harmful to nearly all body organs and thus quitting has health benefits.

Smoking damages the human heart and interferes with normal blood circulation. This increases the risks of such conditions as cerebrovascular disease (damage to arteries supplying blood to the brain), peripheral vascular disease (damaged blood vessels), stroke, heart attack, and coronary heart disease. The heart is made to work faster by nicotine and carbon monoxide from the smoke thereby straining it. The cigarette contents also increase the risks of one experiencing blood clots in their circulation system. In addition, smoking leads to furring of the coronary arteries as the lining of the arteries are damaged by other chemicals in the cigarette smoke. As a matter of fact, one faces a double risk of having a heart attack by smoking (NHS, 2018). Their risk of dying from coronary heart disease is also twice that of nonsmokers.

According to CDC (2018), “Smoking can cause lung disease by damaging your airways and the small air sacs (alveoli) found in your lungs.” Chronic obstructive pulmonary disease (COPD) is one of the lung diseases caused by smoking and it includes chronic bronchitis and emphysema. It is also noteworthy that most cases of lung cancer are caused by smoking. An attack can be triggered or made worse by tobacco smoke in people who have asthma. Compared to nonsmokers, the chances of smokers dying from COPD are 12 to 13 times higher. Additionally, smoking causes a cancer that forms in the intestines (rectum or colon) known as colorectal cancer and is the second leading contributor to cancer deaths in the U.S. (American Lung Association, 2018). A smoker has higher risks of developing this type of cancer.

Smoking can also cause serious damages to the mouth and throat. It can cause such unattractive problems as strained teeth, bad breath, and gum disease, as well as damage one’s sense of taste. The most serious damage caused by smoking in the throat and mouth is an increased cancer risk in the gullet (esophagus), voice box, throat, tongue, and lips. This risk increases with an increase in the intake of tobacco contents. “More than 93% of oropharyngeal cancers (cancer in part of the throat) are caused by smoking” (NHS, 2018). This implies that nonsmokers have a greatly reduced risk of developing mouth and throat cancers.

Further, smoking can make a woman to experience difficulties in becoming pregnant. Even if they succeed at conceiving, there are higher risks for a pregnant smoker to miscarry. In addition, they may have their baby born with a cleft palate and/or cleft lip, they may give birth before time to a baby with an abnormally low birth weight, and they may also have an ectopic pregnancy. Moreover, if a woman smokes during or after pregnancy, her infant would have higher risks of dying from Sudden Infant Death Syndrome (SIDS) (National Cancer Institute, 2017). This implies that even after birth, a mother’s consumption of tobacco contents is harmful to the baby because the baby feeds from her breasts. Furthermore, according to CDC (2018), a pregnant smoker may likely experience stillbirth whereby her baby may die before birth.

Quitting smoking reduces the risk of many diseases caused by the habit, including COPD, heart disease, and cancer. Data from the U.S. National Health Interview Survey indicate that if one quits smoking, they have reduced chances of dying from illnesses that are smoking-related as compared to those who continues to smoke. “Smokers who quit before age 40 reduce their chance of dying prematurely from smoking-related diseases by about 90%, and those who quit by age 45-54 reduce their chance of dying prematurely by about two-thirds” (National Cancer Institute, 2017). Generally, quitters have substantial life expectancy gains in comparison to those who continue to smoke. According to the U.S. National Health Interview Survey, quitters aged between 25 and 34 live longer for about ten years, 35 and 44 for about nine years, 45 and 54 for about six years, and 55 and 64 for about four years.

It is therefore only through quitting that one would be free from the problems caused by smoking. In this respect, there can never be specific solutions to specific health problems caused by smoking; rather, the problems may be best addressed through solutions whose target would be to make one quit. One of the solutions, as suggested by Usman and Davidson (2016), would be to set the stage to quit by mentally preparing oneself. One may also quit by controlling cravings of smoking by using nicotine replacement products which should be used based on consultations with a doctor. Another solution may be to apply SmokEnders’ behavioral changes in completely breaking emotional bonds developed between smokers and cigarettes.

Smoking affects almost every organ of the human body and is thus detrimental to health. It causes fatal diseases such as cancer, heart disease, COPD, and can also damage the mouth and throat. It results into premature deaths that could otherwise be prevented. It also affects pregnant women who may experience increased risks of orofacial clefts in infants, ectopic pregnancy, sudden infant death syndrome, low birth weight, stillbirth, and preterm delivery. As such, quitting smoking has several health benefits and generally increases one’s life expectancy. This is so irrespective of the age at which one quits the habit.

American Lung Association. (2018). “10 health effects caused by smoking you didn’t know about”. American Lung Association . Retrieved May 28, 2018 from http://www.lung.org/our-initiatives/tobacco/reports-resources/sotc/by-the-numbers/10-health-effects-caused-by-smoking.html

CDC. (2018). “Health effects of cigarette smoking”. Centers for Disease Control and Prevention . Retrieved May 28, 2018 from https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm

National Cancer Institute. (2017). “Harms of cigarette smoking and health benefits of quitting”. National Cancer Institute . Retrieved May 28, 2018 from https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/cessation-fact-sheet#q8

NHS. (2018). “How smoking affects your body”. NHS . Retrieved May 28, 2018 from https://www.nhs.uk/smokefree/why-quit/smoking-health-problems

Usman, M. & Davidson, J. (2016). Tips on how to stop smoking . Mendon, MA: Mendon Cottage Books.

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Home — Essay Samples — Nursing & Health — Smoking — The Importance of Quitting Smoking

The Importance of Quitting Smoking

Categories: Smoking

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Words: 611 |

Published: Dec 18, 2018

Words: 611 | Page: 1 | 4 min read

Let’s quit smoking, get your butts moving, the yummy yet healthy carrots, a helping hand.

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On Why One Should Stop Smoking Essay (Speech)

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Introduction

Credibility material: how do you really feel when some of the problems you or your relative or even friends face are due to smoking? And is it possible to stop smoking after you have been told that smoking will definitely give you serious health problems? Well, I had a friend who became a chain smoker. He used to wake and the first thing that went into his mouth was a cigarette stick, then any other thing will follow thereafter.

My friend had been experiencing persistent coughs that made him suspect he might have contracted HIV virus yet he had not yet spent with a woman. But he went for HIV test which proved negative. He continued smoking as he sought out the cough issue in his own way. One day he became very ill and the cough became even worse. As a friend, I accompanied him to a local hospital where he was diagnosed with cancer. The doctor’s advice was that he should stop smoking; however, he never adhered to the doctor’s advice and later died of serious cancer. That was a sad event caused by what could be avoided.

Link to the audience: one of the people who have suffered health complications or death as a result of smoking maybe somebody close to you or someone you know.
Thesis and preview: today I am privileged to have your audience and I intend to talk to you about the effects of smoking, and also I propose to give a talk on how to solve the problem of smoking.

Shift into the main section of the speech: I will begin by telling you how smoking affects us.

So many people around the world have suffered the effects of smoking. I will talk about these effects in terms of health and financial effects.

Research has found out that non-smokers are also exposed to dangers related to smoking. It can lead to increased effects of asthma on those who already have asthma, especially children. Taking for instance, available statistics indicate that in the United States of America alone, 53,000 non-smokers are killed by issues related to smoking (San Francisco Tobacco Free Project para1).
To those who have coronary diseases, second-hand smoking increases the risk of the disease and can make it severe. Moreover, those who have high-risk factors of the disease can easily be attacked when exposed to smoking environment for a long.
Imagine that being exposed to second-hand smoke for only thirty minutes is enough to cause damage to your heart and the damages are just similar to those of an actual or habitual smoker.
Smoking also affects the unborn: the fetus is affected by secondary smoke inhaled by the mother.
In women who are young and have not reached menopause, secondary smoke increases the risk of breast cancer.
Other effects are impaired learning ability of children, increased risk of experiencing spinal pain, and reduced median cotinine levels (Bonnie pp.5-21).Transition: I believe that you can now realize that smoking does not only affect the smoker but even the non-smokers and the unborn. The problems related to smoking affect all of us, but the smokers are more exposed than non-smokers even though in some of the problems both groups suffer are just the same. Now I will tell you about the risks smokers directly face.

Habitual smokers are exposed to:

Habitual smokers are at a very high risk of cancer. It has been known that smoking is one of the leading causes of cancer. Taking the case of the United Kingdom alone, approximately 106, 000 individuals die annually due to smoke-related cancer.
Some of the diseases caused and or worsened by smoking include, lung cancer, diseases of the heart, chronic obstructive pulmonary diseases and also circulation problems.
To pregnant women, smoking is highly likely to cause miscarriages, complications, poor development of the child which may continue after birth and it may also result into still birth or death of the child in the first one week of birth (Litt 29).
Smoking also has economic and other effects on smokers. Smokers, especially heavy chain smokers, use a lot of money as cigarette expenditures. Some of other effects of smoking include, bad breath, clothes and home environment smell stale tobacco, reduces sense of taste, life insurance of smokers are damn expensive and potential employers may not like smokers due to the possibility of constantly seeking leave. Transition: you can see how much risk smokers are exposed to. It is important to note that these risks can potentially result into deaths. However, it is possible to avoid all these smoking-related problems. Now, my last discussion will be on how to solve the problem of smoking.

The only effective way in solving the problem is to stop smoking. But the question somebody may be asking is, “How do I stop smoking?” I will give some ways on how to do so:

Willpower is one of the ways to use in solving the problems but the most difficult of all other ways. One should have the courage and have undying persistence on quitting smoking.
Use nicotine-based chewing gum; even though they still contain nicotine, however, the victim under treatment is not getting the tar into the body system.
Use anti-depressants under a medical doctor’s guide.
It is important to stop smoking once diagnosed with problems related with smoking
Another way to stop smoking is to seek the intervention of a counsellor who will guide you on gradual process of stopping smoking.
Non-smokers, especially with risky diseases, should avoid smoking environments (Acts 50).

Brakelight/intention to stop: as you can realize, stopping smoking and campaigning against it will be beneficial to all of us.

Summary: I have talked to you about the effects of smoking on both habitual smokers and non-smokers and also on how the problems can be stopped or avoided. All of us must rise up and campaign against smokers or else we will gradually be affected and infected.

Link back to the audience: now that you know the effects of smoking and how to solve it will you help somebody stop smoking? How happy will you be or satisfied will you feel if someone is to come to thank you for helping him or her stop smoking? Let us take the challenge.

Concluding remark: I am going to stop here, but not before I give you a quote by somebody known as Dr. Gro Harlem Brundtland. “A cigarette is the only consumer product which when used as directed kills its consumer.”

Acts, Humbler. How to Stop Smoking in 50 Days . New York: Bookway International Services, 2001.

Bonnie, Richard. Ending the Tobacco Problem: A Blueprint for the Nation . New York: National Academies Press, 2007.

Litt, Iris. Taking our pulse: The health of America’s women . New York: Stanford University Press, 1997.

San Francisco Tobacco Free Project. “Untitled.” 2010.

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IvyPanda. (2022, June 2). On Why One Should Stop Smoking. https://ivypanda.com/essays/no-smoking-persuasive-speech/

"On Why One Should Stop Smoking." IvyPanda , 2 June 2022, ivypanda.com/essays/no-smoking-persuasive-speech/.

IvyPanda . (2022) 'On Why One Should Stop Smoking'. 2 June.

IvyPanda . 2022. "On Why One Should Stop Smoking." June 2, 2022. https://ivypanda.com/essays/no-smoking-persuasive-speech/.

1. IvyPanda . "On Why One Should Stop Smoking." June 2, 2022. https://ivypanda.com/essays/no-smoking-persuasive-speech/.

Bibliography

IvyPanda . "On Why One Should Stop Smoking." June 2, 2022. https://ivypanda.com/essays/no-smoking-persuasive-speech/.

Study Protocol
Open access
Published: 28 August 2024

A National Dental Practice-Based Research Network phase II, cluster-randomized clinical trial assessing nicotine replacement therapy sampling in dental settings: study protocol for the Free Samples for Health (FreSH) study

Pearl Fang 1 ,
Melissa Adkins-Hempel 1 ,
Tamara Lischka 2 ,
Sarah Basile 3 ,
D. Brad Rindal 3 ,
Matthew J. Carpenter 4 , 5 ,
Dorota T. Kopycka-Kedzierawski 6 ,
Jennifer Dahne 4 , 5 ,
Sarah A. Helseth 7 ,
Douglas E. Levy 8 , 9 ,
Arthur Truong 2 ,
Michael C. Leo 2 ,
Kimberly Funkhouser 2 ,
David R. Louis 10 ,
Sandra J. Japuntich 1 , 11 , 12 , 13 &

The National Dental PBRN Collaborative group

BMC Oral Health volume 24 , Article number: 1007 ( 2024 ) Cite this article

Metrics details

Cigarette smoking has major detrimental effects on oral health. Tobacco interventions in dental settings are effective, but rarely delivered. The American Dental Hygienists Association recommends that oral health providers: Ask patients about tobacco use, Advise quitting tobacco use, and Refer to state quitlines (Ask-Advise-Refer; AAR). While AAR connects patients to counseling, it does not directly connect patients to medication. Nicotine replacement therapy sampling (NRTS) is an empirically supported intervention to provide starter packs of nicotine replacement therapy (NRT) to people who smoke. NRTS combined with AAR could be an effective tobacco treatment intervention for dental settings.

This manuscript describes the study protocol for the Free Samples for Health (FreSH) study, a group randomized clinical trial testing the effectiveness of NRTS + AAR vs. AAR alone on long-term smoking abstinence. Fifty dental practices in the Midwest and Northeast nodes of the National Dental Practice-Based Research Network are randomly assigned to provide AAR and either a 2-week supply of 14-mg nicotine patches and 4-mg nicotine lozenges (NRTS condition) or an electric toothbrush (ET condition). Approximately 1,200 patients who currently smoke—regardless of interest in quitting— are recruited during dental visits. Participants complete a baseline survey in-person, then after visit, 1-, 3-, and 6-month follow-up surveys remotely. The primary outcome is carbon monoxide-confirmed 7-day point prevalence abstinence from combustible tobacco measured at 6 months post-enrollment. Secondary outcomes include: 24-h intentional quit attempts, change in cigarettes smoked per day, NRT utilization, attitudes toward NRT, intention to use NRT, and intention to quit smoking. A key informant process evaluation and cost effectiveness analysis will provide information for future implementation of NRTS.

This is the first clinical trial to assess the effectiveness of NRTS on promoting smoking cessation in dental settings. If effective, this treatment could be implemented to increase the provision of smoking cessation interventions in dental settings to provide an additional treatment access point for people who smoke.

Trial Registration.

Registered at ClincalTrials.gov (NCT05627596) on 11/25/2022.

Cigarette smoking is highly detrimental to health, including oral health, contributing to oral cancer, periodontal diseases, tooth loss, and bone loss; and decreasing the effectiveness of oral health treatments [ 1 , 2 , 3 , 4 ]. Dental practices are ideal settings for tobacco intervention. About half of adults who smoke visit a dentist annually [ 5 ] and the majority of patients who smoke would be motivated to make a quit attempt if encouraged by a dental practitioner [ 6 ]. Tobacco interventions delivered in dental settings including brief advice and nicotine replacement therapy increase abstinence by 2.7 times compared to usual care [ 7 ]. Despite the evidence of effectiveness, tobacco cessation treatments are rarely delivered in the oral health domain [ 8 ]. Novel approaches are needed in oral health settings to encourage use of evidence-based tobacco cessation treatment.

The American Dental Hygienists Association’s recommended intervention for tobacco use in oral healthcare settings is Ask-Advise-Refer (AAR): oral health professionals should Ask every patient about tobacco use at every visit, Advise patients using tobacco to quit, and Refer patients who use tobacco to state quitlines [ 9 ]. While AAR connects patients to counseling, it does not directly connect patients to pharmacotherapy. An estimate of only 11% to 31% of patients who smoke and visited the dentist in 2010 reported that they were advised to quit, and only 4% were advised to use tobacco cessation medication [ 5 ].

Tobacco cessation medication is underutilized. Fewer than one-third of people who smoke have used medication in support of a quit attempt and less than 10% have received counseling [ 10 ]. Among the 7 FDA-approved tobacco cessation medications, nicotine replacement therapies (NRT) are the most widely used [ 11 ]. Over-the-counter NRT is best suited for distribution within dental practices, where practitioners have limited time and may not have received training around prescription-only medications. NRT reduces withdrawal and cravings and meta-analytic evidence from 100 + trials shows a doubling of long-term abstinence [ 12 ].

Nicotine replacement therapy sampling (NRTS) is defined as providing short, starter packs of NRT [ 13 ]. NRTS is distinct from a full course of NRT: the intent is to engage smokers in the process of quitting, without an expectation to quit immediately [ 13 ]. It is designed to reduce barriers to obtaining and heighten the acceptance of NRT and enhance motivation and self-efficacy. It is rooted in marketing research, which shows that free samples increase positive opinions about and use of products [ 14 ]. NRTS can induce quit attempts even in those unmotivated to quit [ 15 ]. A clinical trial of NRTS in primary care clinics found that NRTS increased quit attempts, use of smoking cessation medications, and smoking abstinence at 6 months post-intervention compared to standard care [ 13 , 16 ]. NRTS is a good fit for dental settings because providing samples of products that improve oral health and addressing tobacco use are both routine parts of dental care.

In this manuscript, we describe the protocol for the Free Samples for Health (FreSH) study. The primary study hypothesis is that providing a 2-week supply of nicotine replacement therapy samples (nicotine patch and nicotine lozenge) will result in higher biochemically confirmed abstinence 6 months later than a cost-matched oral health related sample (electric toothbrushes).

Methods/design

Participants, interventions, outcomes, trial design.

The FreSH study is a phase 2 cluster randomized effectiveness trial. AAR + NRTS is compared to enhanced usual care (AAR + electric toothbrush; ET) in a target sample size of 1,200 patients who smoke combustible cigarettes recruited from approximately 50 dental practices in the National Dental Practice-Based Research Network (National Dental PBRN; See Fig. 1 ) [ 17 , 18 ]. The FreSH study is registered with ClinicalTrials.gov (NCT05627596) and has been approved by the University of Alabama at Birmingham IRB (#300010014), which serves as the central IRB for the National Dental PBRN. The Standard Protocol Items for Clinical Trials (SPIRIT) criteria guided the present protocol; see Appendix 1 for checklist [ 19 , 20 ].

High level study flow

Study setting

The FreSH study is being conducted at 50 dental practices across the Midwest and Northeast Regions of the National Dental PBRN [ 18 ]. The National Dental PBRN is a community of participating dental practices and organizations, including private and group practices, public health clinics, community health centers, and federally qualified health centers [ 21 ]. The network was established in 2005 and includes over 7,500 participating dentists, hygienists, and other oral health professionals [ 17 , 22 ]. The National Dental PBRN is funded by the National Institute of Dental and Craniofacial Research (NIDCR) and operates across six regional nodes and a specialty node; its National Coordinating Center (NCC) is based at Kaiser Permanente in Oregon and the Administrative Resource Center (ARC) is based at the University of Alabama at Birmingham (UAB). Practitioner-investigators provide input on the design, conduct, and/or analysis of studies to increase relevance to real-world care.

Eligibility criteria

Practitioner eligibility criteria include being a dentist of any specialty, dental therapist, or dental hygienist who is a member or who is willing to become a member of the National Dental PBRN; willing to consent patients to the study and provide enrollment and intervention procedures; and expects to remain in their current practice for the next year.

Patient eligibility criteria. Inclusion criteria are: 18 years old or older (except in Nebraska, where the age of consent is ≥ 19 years), and smoking at least 1 combustible cigarette per day, 25 days per month. Exclusion criteria are: does not own a smart phone with internet access; unwilling to receive study emails and text messages; past week use of tobacco cessation medication; or report of contraindications for NRT, including myocardial infarction or stroke in the past 3 months or current pregnancy/breastfeeding.

Interventions

Ask-advise-refer (aar).

Practitioners in both study arms administer AAR to patients [ 9 ]. This involves asking patients about tobacco use, advising those using tobacco to quit, and referring the participant to the state quitline, electronically or via fax.

Enhanced usual care (Electric Toothbrush; ET)

Practices assigned to the enhanced usual care condition (AAR + ET) provide participants with a Philips Sonicare Electric Toothbrushes ($43 value). ETs were selected to incentivize participation in enhanced usual care practices. Prior to providing the ET to enrolled patients, practitioners spend 1–3 min instructing patients how to use the ET via a written script. Written instructions are also provided.

Nicotine Replacement Therapy Sampling (NRTS)

Practices assigned to the NRTS condition (AAR + NRTS) provide participants with a “starter pack” (2-week supply) of over-the-counter NRT, consisting of a box of 14 mg nicotine patches (14 count) and a box of 4 mg lozenges (81 count; $46 value). Prior to dispensing samples, practitioners spend 1–3 min reviewing instructions with the patient, via a script (Appendix 2). Written instructions are also provided.

Participant withdrawal or discontinuation of study interventions

Reasons for participant withdrawal are documented. Patient participants are instructed by study staff to discontinue use of the patch and/or lozenge entirely if a severe reaction (e.g., a reaction requiring medical attention) develops. A study physician is on call to make determinations regarding discontinuations of study interventions.

Patient participant study assessments

Patient participant assessments occur at 5 timepoints: baseline (during routine dental visit), immediately following the intervention visit (within 72 h) and 1, 3, and 6 months following the baseline visit (see Table 1 ). Participants are compensated $20 for each survey they complete, except the baseline survey ($80 for all surveys). The baseline survey is self-administered immediately following enrollment, using the study-provided tablet. Participants are emailed and/or texted (participant preference) a direct link to all other follow-up surveys on the first date of their follow-up window. If an assessment is not completed, study staff send the survey link every day, switching between their preferred and non-preferred contact method, for up to 5 days. Participants who do not respond via email or text will be called and offered the opportunity to complete the survey by phone.

Primary outcome and measure

The primary outcome is carbon monoxide (CO) confirmed 7-day point prevalence abstinence (PPA) from combustible tobacco at 6 months post-baseline, measured through a self-report item using a modified timeline follow-back procedure [ 16 , 23 , 24 ]. Biochemical verification is established using the iCO quit personal CO monitor [ 25 ]. Those who report abstinence on all 7 days prior to the 6 month follow-up and have a CO test result of < 6 ppm are classified as abstinent. Those who report any combustible tobacco use in the past 7 days or have a CO result > 6 ppm are classified as non-abstinent.

Secondary outcomes and measures

Self-reported 7-day PPA from combustible tobacco is also assessed at 1 and 3 months post-baseline, using the same modified timeline follow back procedure [ 16 , 23 , 24 ].

Twenty-four-hour intentional quit attempts reflect intentional periods of abstinence due to a quit attempt (not abstinence due to other reasons such as hospitalization, etc.). This is assessed via self-report single survey item from the Phenx toolkit [ 26 , 27 ] on the 1, 3 and 6 month follow-up surveys.

Smoking heaviness (cigarettes per day) is measured at baseline and at 1, 3 and 6 month follow-up surveys [ 28 , 29 ].

Treatment targets

Cessation medication utilization is measured via self-report survey items assessing use of all 7 FDA approved smoking cessation medications at 1, 3, and 6 months post-intervention (yes, no, prefer not to answer) [ 16 ].

Attitudes towards NRT (safety and efficacy) are measured via self-report survey items at baseline, 1, 3, and 6 months post-baseline. We assess participants’ perceptions of NRT efficacy and safety [ 16 ] on 5-point Likert-scales, [ 30 ] where higher scores indicate greater efficacy/safety [ 13 , 31 , 32 , 33 ].

Intention to use NRT is measured at baseline and at 1-, 3-, and 6-month follow-up. Intention to use the nicotine patch and nicotine lozenge is assessed using 2 items regarding intentions to use nicotine patch and nicotine lozenge in one of 5 categories (currently using, plan to use in the next 30 days, plan to use in the next 6 months, may use some day, will never use).

Intention to quit smoking is assessed at baseline, 1, 3 and 6 months using a self-report survey item from the PHENX toolkit where participants report if they are considering quitting in the next 30 days, the next 6 months, or not in the next 6 months [ 26 , 27 ].

Sample characteristic variables

Demographic variables are collected at baseline, including biological sex, gender, ethnicity, race, age, income, health and dental insurance status, and geographic region [ 34 , 35 , 36 , 37 , 38 ].

Smoking history is assessed at baseline. We assess smoking heaviness (i.e., total cigarettes per day) [ 28 , 29 ], average time (minutes) to first cigarette in the morning, [ 39 , 40 , 41 ] count of previous lifetime quit attempts, [ 27 , 42 ] past cessation treatment utilization, [ 16 ] interest in quitting and confidence to quit, [ 43 , 44 ] interest in quitting and confidence to quit. [ 43 , 44 ].

Oral health is assessed at baseline and all follow-ups and includes assessing toothbrushing habits (frequency of brushing, [ 45 , 46 ] type of toothbrush), and perceived oral health status [ 47 , 48 ].

Process evaluation measures

Feasibility and acceptability of NRTS are measured 3 ways:

Surveys: to assess acceptability, patients complete the client satisfaction questionnaire [ 49 ] regarding the FreSH study interventions during the after-visit survey.

Readiness to implement NRTS is measured for NRTS practitioners using the Organizational Readiness to Implement Change measure [ 50 ] and the Acceptability of Intervention Measure, the Appropriateness of Intervention measure, and Feasibility of Intervention measure [ 51 ] prior to and following site data collection. To allow examination of implementation variables by practitioner characteristics, we assess provider sex, gender identity, age, race, ethnicity, [ 34 , 35 , 36 , 37 , 38 ] job role, years in practice, and years at current practice.

Interviews: 10–12 patients, 10–12 dentists and 10–12 other staff (e.g., hygienists, dental therapists) in study sites assigned to the NRTS condition participate interviews at the end of site data collection regarding the feasibility and acceptability of the NRTS intervention.

Administrative data: We assess acceptability by the number of patient participants offered the intervention who accept it. We also collect the costs of the intervention including staff time, costs of printed materials, and costs of NRT to assess cost effectiveness.

Practitioner fidelity to the AAR intervention is assessed during the patient after-visit survey with 7 items that map on to AAR including asking if the participant smokes, asking about readiness to quit smoking, discussing cessation medications, recommending cessation medications, providing medication samples, and referring to the state quitline [ 13 , 16 ]. Practitioners also attest to having provided the interventions (AAR plus sample distribution) on the tablet as part of the intervention data collection.

Sample size

The sample size and power calculations pertain to the primary outcome biochemically verified abstinence from combustible tobacco at 6 months post quit. With a sample size of 1200 and a cluster size of 24, the study was designed to have acceptable (> 80%) power to detect a difference in CO-verified quit rates of 5.5 percentage points, and good power (> 90%) for effect sizes of 6.5 percentage points or higher. Sample size estimates account for 11% lost to follow-up/withdrawal among patients. The calculations were informed by a study of nicotine replacement therapy sampling in primary care and assume an intraclass correlation coefficient of 0.013 and a CO-confirmed quit rate of 4.7% in the ET arm [ 13 , 16 ]. This is somewhat lower than in the usual care condition from the primary care trial because it is more common for primary care physicians than for oral health professionals to prescribe NRT [ 5 ].

Recruitment

Practitioner recruitment.

Network practitioners in the Midwest and Northeast regional nodes are approached for interest in study participation by node via webinars, newsletters, announcements at network meetings, email blasts, direct mail campaigns, and directly targeting practitioners with existing relationships with node coordinators.

Practitioner training

Interested and eligible practitioners complete human subjects training and good clinical practice training, as well as a live or pre-recorded training about AAR adapted from Rx for Change [ 52 ]. They then complete a live training regarding condition-specific study procedures and are given quick guides (which include an outline of study procedures) as well as a manual of operating procedures. Practitioners deliver the study interventions via a script provided on study tablets.

Patient recruitment

Practitioners or practice staff approach consecutive adult patients with a chart-documented smoking history regardless of interest in cessation and invite them to participate. Patients interested in the study undergo a self-screening process, which takes place on a tablet computer. Patients read a study description and indicate interest. Then they complete an eligibility screen. Interested and eligible participants complete an electronic written informed consent via REDCap [ 53 , 54 ] electronic data capture tools hosted at the NCC. A Health Information Portability and Accountability Act (HIPAA) authorization form is completed on paper or electronically (depending on the regional IRB requirements). Then participants complete the baseline assessment. Upon completion, instructions on the screen direct patients to return the tablet to clinic staff who then provide the study intervention.

Assignment of interventions

The NCC Data Manager, who has no contact with participants or practices, conducts randomization. Practices are randomized to NRTS or ET with a 1:1 allocation (approximately 25 practices per condition). Condition assignment is stratified by practice-level patient demographic data (highest percentage minority race/ethnicity vs. lowest) and practice payer mix (highest vs. lowest public insurance/free care) reported when the practitioner enrolls in the National Dental PBRN. We use block randomization with permutated block sizes of 2 and 4. Randomization occurs once the practice has completed all activities required for onboarding.

Blinding of practitioners, participants, and study staff engaged in data collection is not possible, due to evident differences between the conditions. However, surveys are conducted primarily electronically. In a minority of cases, study staff may administer the survey by phone. An external researcher with no relationship with the study practices or participants will perform the statistical analysis.

Data collection, management, and analysis

Data collection methods.

Participant data collection is centralized. Survey data are collected using the REDCap [ 53 , 54 ] platform administered by the NCC. CO data are collected via the iCOquit personal CO monitor. Upon completion of the 6-month survey, participants who report abstinence are overnight mailed the iCOquit device. Along with the device, participants receive instructions on how to download the Bedfont Scientific iCOquit app [ 25 ] onto their smartphone, a deidentified username and password, instructions on how to self-administer the CO breath test, and an information sheet explaining the meaning of their result. Participants are encouraged to complete the test within 24 h of receiving the CO monitor. Participants who do not complete the test receive daily reminders via text, email, or phone. Participants are paid $50 for the completion of the CO test. Study staff log into the iCOquit app to receive the result and enter it into the study database. Interviews are completed by phone and audio recorded for later transcription. Practitioner time use for cost analysis is automatically logged as they work through the study procedures on the study tablet.

Data management

All data are managed centrally at the NCC. Survey data are managed in REDCap. The NCC generates reports on data completeness and accuracy as well as protocol compliance on an ongoing basis. Data quality is assessed using measures such as time from study visit to data entry, time to resolution of data queries, number of missing forms, and proportion of all study variables queried. Interview data is transcribed and uploaded on an electronic file share system.

Statistical methods

To test the primary hypothesis, that NRTS will produce more 6-month abstinence than ET, we compare treatment groups with respect to the primary outcome (i.e., biologically verified 7-day PPA from use of combusted tobacco at 6 months) using generalized hierarchical linear modeling [ 55 , 56 , 57 ] with a binomial distribution and logit link (aka mixed effects logistic regression) that account for the clustering of individual observations within dental practices, while adjusting for various patient and practice related factors [ 58 , 59 ].This same model framework is used to examine the secondary outcomes of abstinence at 1 month and abstinence at 3 months and whether there was a quit attempt at 1, 3, or 6 months. To determine whether the intervention had an effect on secondary outcomes, (e.g., smoking heaviness) over time, we use hierarchical linear modeling.

We test whether NRT utilization, perceptions of NRT effectiveness and safety, intent to use NRT, and intent to quit mediate the relationship between study group (ET vs NRTS) and smoking abstinence using a cross-lagged panel model (CLPM) in a structural equation modeling (SEM) framework [ 60 , 61 ].

With regard to survey data relating to implementation, we will report on descriptive statistics of the full sample and as they relate to demographic variables.

With regard to missing data, for the primary outcome, participants who do not complete a follow-up assessment or CO test will be coded as non-abstinent. However, we will also consider sensitivity analyses using multiple imputation and complete case analysis. For longitudinal outcomes, we rely on the direct maximum likelihood approach used in the hierarchical linear model to handle missing data.

To evaluate readiness for future implementation, we conduct a qualitative analysis of stakeholder interviews. Deductive codes are drawn from the interview questions; inductive codes capture concepts that emerge from the interviews. Two coders will independently code the transcripts and meet to resolve discrepancies. A qualitative expert will conduct a framework matrix analysis [ 62 ] to identify the most effective ways to organize the content and logistics of conducting the trial to help guide our trial protocol [ 62 , 63 ].

Finally, we conduct a cost effectiveness analysis (CEA) to calculate the incremental cost-per-quit and cost-per-quit [ 64 ]. The incremental cost-per-quit of NRTS vs. ET is estimated as: (Total costs at follow-up for NRTS participants—Total costs at follow-up for ET participants)/(Total successful quits at follow-up for NRTS participants—Total successful quits at follow-up for ET participants).

NIDCR determined this study did not require a Data Safety and Monitoring Board or a medical monitor due to the minimal risk of the intervention and the streamlined electronic data collection.

Safety monitoring for this study will focus on Unanticipated Problems (UPs) involving risks to participants, including unanticipated problems that meet the definition of a Serious Adverse Event (SAE). Practitioners are trained to direct any participants reporting AEs to Hennepin Healthcare Research Institute study staff and will alert study staff of any reports of AEs. Adverse events (AEs) to study medication are queried in the 1-, 3-, and 6-month follow-up assessments. AEs, including SAEs, are recorded, and the principal investigator (PI) will review these events to grade severity, relationship to the study intervention, and assess whether the nature, severity, or frequency is unexpected. Safety events are recorded and reported into the National Dental PBRN safety event reporting system maintained by the NCC and to the IRB if the events are determined to be both unexpected and related to the study intervention.

The potential risks of the study are: (1) risk of negative reaction to study procedures, (2) risk of breach of confidentiality or loss of privacy, (3) risk of nicotine replacement therapy side effects, (4) risk of negative reactions to the electric toothbrush.

The NCC developed a data management system for study collection and safety event reporting. Study progress and safety is reviewed monthly by the PI via reports provided by the NCC.

Questionnaire data is obtained electronically through the NCC-managed study-specific electronic data system (REDCap). The RedCAP provides: 1) an intuitive interface for validated data entry; 2) audit trails for tracking data manipulation; 3) access to study datasets that can be imported into common statistical packages; and 4) procedures for importing data from external sources.

Ethics and dissemination

Research ethics approval.

The protocol, informed consent form, recruitment materials, and all participant materials have been approved by the sIRB (University of Alabama at Birmingham; sIRB #300,010,014). Any modification to the protocol will be approved by the sIRB before implementation (See Table 2 for major protocol amendments; current protocol version 3.0; 8/18/23).

For participating patients, an electronic written, informed consent form is completed via REDCap (Appendix 3). HIPAA information as required by state law is shared with the patient. The practitioner or appropriate trained office staff explain the research study to the patient and answer any questions that may arise. The rights and welfare of the patients is protected by emphasizing to them that the quality of their clinical care will not be adversely affected if they decline to participate in this study.

Providers who agree to be part of the key informant process evaluation receive a study fact sheet and completion of study surveys and/or interviews. A waiver of documentation of informed consent has been obtained.

Confidentiality

No information is given to anyone without permission from the subject. Confidentiality is assured by use of identification codes linked to the subject. HIPAA guidelines of all Network clinical sites are followed. A certificate of confidentiality has been issued for this study.

Availability of data

The NCC is responsible for creating publicly available data and resources following the completion of the study. The protocol, data dictionaries, a de-identified dataset(s), and key study publications will be posted on the National Dental PBRN public website.

Approximately 47.1 million U.S. adults currently use a tobacco product [ 65 ]. Cigarette smoking has detrimental oral health effects [ 1 , 2 , 3 ]. While previous studies of tobacco treatment interventions in oral healthcare settings were effective at increasing abstinence, [ 7 ] few oral healthcare providers address their patients’ smoking and even fewer recommend cessation medication [ 5 ]. This is the first study to assess the effectiveness of nicotine replacement therapy sampling as a tobacco treatment intervention on smoking abstinence and other oral health factors in a dental setting.

We considered other possible designs when developing this protocol. We considered randomizing by the patient vs. the practice to increase power and decrease sample size. We selected randomization at the practice level to reduce contamination (e.g., a practitioner being excited about NRT and recommending it to patients in the enhanced usual care condition) and potential errors delivering the wrong samples. Another design decision was regarding intervention duration. We decided against providing a full course of NRT for several reasons. (1) quitline research suggests that 2-week provision of NRT is as effective for cessation as a full course, (2) Not all patients who are given NRT will use it. Providing a 2-week supply will increase reach due to reduced per patient cost. Furthermore, in previous studies many patients who received a sample of NRT obtained additional NRT on their own (19–26%) [ 66 ]. In the United States, the Affordable Care Act requires smoking cessation medication to be covered by insurance without co-pay if prescribed. The median duration of NRT use is ≤ 2 weeks despite package instructions [ 67 ].

The study design has limitations. First, we only include patients who have smart phones because the CO assessment device requires use with a smart phone. There is a concern that this could limit participation amongst low-income patients. In 2021, 85% of the US population owned smartphones including 76% of people with an income less than $30,000 per year. [ 68 ] There are some generalizability concerns in that National Dental PBRN practitioners are a self-selected group who may be more interested in NRTS than the general population of dentists. In addition, we are only recruiting from the Northeast and Midwest regions. However, previous research has shown that PBRN practices are similar to US dental practices [ 69 ].

The results of this study may reduce barriers to obtaining and heightening the acceptance of NRT by enhancing motivation and self-efficacy. NRTS, when added to the American Dental Hygienist's Association AAR model during routine dental care could leverage a novel point of intervention with smokers. If effective and acceptable to practitioners and patients, this study could support a new model for distributing medication treatments for smoking cessation to patients.

Availability of data and materials

No datasets were generated or analysed during the current study.

Abbreviations

Ask-Advise-Refer

Adverse event

Administrative Resource Center

Cost effectiveness analysis

Comparative Fit Index

Cross-lagged panel model

Electronic data system

Free Samples for Health

Health Information Portability and Accountability Act

Intraclass correlation coefficient

National Coordinating Center

National Institute of Dental and Craniofacial Research

Nicotine replacement therapy
Nicotine replacement therapy sampling

PPA in the ET group

PPA in the NRT group

Principal Investigator

Point Prevalence Abstinence

Quality adjusted life year

Root mean square error of approximation

Serious adverse event

Structural equation modeling

University of Alabama

Unanticipated problem

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Acknowledgements

We would like to acknowledge Michael Dunbar, Zachary Predmore, and Erika Bloom for their help designing the study protocol and for preparatory work for the current trial. We’d like to acknowledge the National Dental PBRN investigators and staff for their guidance in developing the study protocol.

This study is supported by grants from the National Institute of Dental & Craniofacial Research (UH3-DE-029973, U19-DE-028717 and U01-DE-028727). Address: 9000 Rockville Pike, Bethesda, Maryland 20892. Email: [email protected]. Phone: 1–866-232–4528. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Contributions

SJJ, MJC, JD, DKK, DL & DBR contributed to the conception of this trial. SJJ, MJC, JD, DKK, DL, DBR, PF, MAH, TL, SB, AT, MCL, KF, and DRL contributed to the design of the trial. SB, AT, TL, DRL, and MCL contributed to the data acquisition and analysis plan. All authors have approved the submitted version and have agreed both to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.

Corresponding author

Correspondence to Sandra J. Japuntich .

Ethics declarations

Ethics approval and consent to participate.

sIRB #300010014, protocol described here approved on January 25th, 2023, consent included here approved January 25th, 2023.

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The authors declare no competing interests.

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Fang, P., Adkins-Hempel, M., Lischka, T. et al. A National Dental Practice-Based Research Network phase II, cluster-randomized clinical trial assessing nicotine replacement therapy sampling in dental settings: study protocol for the Free Samples for Health (FreSH) study. BMC Oral Health 24 , 1007 (2024). https://doi.org/10.1186/s12903-024-04758-w

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Received : 23 July 2024

Accepted : 15 August 2024

Published : 28 August 2024

DOI : https://doi.org/10.1186/s12903-024-04758-w

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