12.1 Treating tabacco Addiction Flashcards
What is the single biggest cause of preventable morbidity and mortality in the NHS?
Tobacco related disease
What are the health risks of smoking?
2 x risk of CVD
5 x more likely to have Micro biologically confirmed influenza
3 x relative risk of sudden infant death
11 x relative risk of lung cancer
What causes smoking addiction?
Nicotine
What are the markers of addiction?
- use despite knowledge of harmful consequences
- cravings during abstinence
- failure of attempts to stop
- withdrawal symptoms during abstinence
Describe the physiology of nicotine addiction
Nicotine acts on nicotinic acetylcholine
receptor stimulating dopamine release
This results in the satisfaction associated with smoking
Following chronic nicotine exposure, ACh receptors enter upregulated state - increases affinity and functional sensitivity to an agonist
A drop in nicotine levels leads to craving and withdrawal
1-2 puffs of a cigarette binds to 50% ACh receptors
ACh receptors take between 6-12 weeks to desensitise after the last cigarette
What are the 3As of treating smoking?
Ask - record smoking status
Advise - health benefits of cessation
Act - act on patients response.
What are the disadvantages of using e-cigarettes to aid smoking cessation?
- Continued nicotine use
- Long term effects unknown
- Dual use perpetuates smoking
- ‘Renormalise’ smoking
- Promotes nicotine in young
- Gateway to tobacco
- Products unsafe
- E-cigs made by tobacco companies
- Joint marketing of tobacco & e- cigs
What are the advantages of using e-cigs for an aid to smoking cessation
- Nicotine is a minor health risk
- Negligible compared to tobacco
- Quit rates continue to decrease
- Normalises E-cigs not tobacco
- Compared to tobacco favourable
- Experimenters are same group
- About to be regulated
- Bigger reach for harm reduction
- Regulations coming into place
