Smoking Cessation and Relapse Assistance and Prevention Program: SCRAP Smoking for Good

SCRAP Smoking for Good

While the whole world is shouting “Stop smoking!” someone out there still finds himself reaching for a cigarette. While he is very much aware that smoking kills, the urge for another stick is still there.

This person could be someone you know or … this could be you. Nearly all smokers are aware that there are substantial health risks associated with smoking. And they all know that smoking can eventually kill them.

“However, most of them smoke because they are addicted to nicotine. Nicotine is addictive so the body craves it,” says Dr. Liza Garcia, chairperson of The Medical City Department of Medicine – Section of Pulmonary Medicine. Nicotine is a highly addictive substance that occurs naturally in tobacco. It is the active ingredient in tobacco smoke.

Dr. Garcia explained that even if smokers understand and accept the risks associated with smoking, they need additional motivation to stop smoking to counter the addiction and compulsion to smoke.  Rewards, such as improved physical fitness and increase in savings are two positive motivators. But still, smokers need a therapeutic approach to tobacco use and dependence which is based on their motivation and willingness to quit.

It is never easy to quit smoking and some smokers have a harder time kicking the habit. This is where medical assistance is needed. Dr. Garcia said The Medical City has a program called Smoking Cessation and Relapse Assistance and Prevention program or SCRAP which aids smokers in becoming and staying smoke-free, making them better prepared to deal with significant lifestyle changes. The program centers on education and motivation, providing individual counseling and psychosocial support groups to help smokers quit and maintain a non-smoking status for life.

The components of SCRAP include individualized patient assessment, motivational patient education and counseling, supplementary self-help materials, behavioral modification and cognitive therapy, assisted pharmacologic treatment, psycho-social support group, relaxation and stress-management techniques, periodic monitoring, relapse prevention techniques, and smoking reduction strategies.

SCRAP is composed of five weekly visits, all of which are equally important.  The first is the Assessment visit and the second is the Preparatory visit. The third visit is devoted to intervention and treatment. The fourth visit is for action planning and the fifth visit is for relapse prevention where the patient will be assessed for relapse risk. To do this, the patient will be screened for depression, anxiety or other mood disturbances caused or exacerbated by nicotine withdrawal and any high-risk behavior will be identified. The patient’s exposure to environmental tobacco smoke and nicotine withdrawal symptom severity will also be evaluated.

“Oftentimes, addiction persists despite a desire to quit or even repeated attempts to quit. This is mainly because of nicotine withdrawal syndrome bringing about the impairment in a person’s ability to function,” Dr. Garcia pointed out. The symptoms of nicotine withdrawal syndrome can develop rapidly after a smoker tries to quit, and characteristics include the psychological symptoms of dysphoric or depressed mood, anxiety, irritability, frustration, or anger and restlessness or impatience. Physical symptoms may include insomnia, increased appetite or weight gain and difficulty concentrating.

Nicotine withdrawal syndrome is carefully and thoroughly addressed under the program’s relapse prevention techniques. The techniques include educating the patient, discussing the possibility of withdrawal symptoms and preparing him for this.

After the five weekly visits, the patient is referred to his attending physician or pulmonologist for periodic follow-ups scheduled on the 3^rd month, 6^th, 9^th and 12^th month. Monthly telephone calls will be done by the respiratory therapist to ask about the patient’s cessation status.

Dr. Garcia said it is indeed possible for a smoker to quit smoking for good but the process should be gradual or step by step. One can contemplate on quitting, find out how, decide to quit, prepare to quit, quit for a day and then eventually quit for good.

For more details about SCRAP, you may call telephone numbers 988-1000 or 988-7000 ext. 6238 or visit the Pulmonary Diagnostics Center at the 2^nd Floor, Podium Bldg., The Medical City in Ortigas Ave. Pasig City.