Brief Tobacco Intervention

Question 1

How many people in Canada die from tobacco-related illnesses?

Answer 1

37,000 people per year in Canada

Question 2

Viewing tobacco addiction through the Chronic Disease Model supports recognition of:

Answer 2

• neurological change underlying and contributing to the chronic nature of tobacco addiction
• dependence on a psychoactive substance contributes to development of behaviours and preferences supporting its use
• the majority of people who use tobacco will experience cycles of relapse, remission, and continued use (those who quit permanently on their first attempt are a minority)

Question 3

How many people could be motivated to quit by a brief tobacco intervention performed by a HCP who sees 5-10 clients a day?

Answer 3

12-24 people quitting per year who would not have otherwise done so.

Question 4

What percentage of current tobacco users see a healthcare provider every year?

Answer 4

70%

Question 5

Brief advice from a HCP can increase chances of a successful quit attempt by how much?

Answer 5

Double it

Question 6

How can we assess mood within a brief intervention?

Answer 6

As part of Assess, we can use the PHQ-2 (Personal Health Questionnaire-2) as a brief depression screening measure.

Over the past 2 weeks, how often have you been bothered by any of the following problems? (0 = not at all, 1 = several days, 2 = more than half the days, 4 = nearly every day)

• Little interest or pleasure in doing things
• feeling down, depressed, or hopeless

Total score can range from 0 to 6; a score of 3 or higher would indicate need for referral to a mental health specialist.

Question 7

What is VBA?

Answer 7

Very Brief Advice may be a reasonable alternative to a brief tobacco intervention if less than a few minutes are available. It is the briefest possible intervention (as little as 30 seconds).

Ask
Advise
Act: offer support and treatment

Question 8

What are the 4 “D”s?

Answer 8

Practical strategy for coping with cravings:
Delay the urge
Distract yourself
Deep breathing
Drink water

Question 9

Which NRT product has the fastest release of nicotine?

Answer 9

Mouth spray (60 seconds)

Question 10

What is the NNT for successful cessation support preventing premature death?

Answer 10

9

Question 11

In Canada, the groups with the highest rates of tobacco use routinely have…

Answer 11

…the poorest health and the highest rates of premature illness and death.

Question 12

What are the three general considerations to start with for every client?

Answer 12

Accessibility to treatment
Accessibility to medications
Adaptation of medication doses

Question 13

Describe the mortality impact of tobacco on individuals with serious mental illness.

Answer 13

These people die on average 25 years prematurely, and the leading causes of death are chronic tobacco-related diseases

Question 14

How does the rate of smoking compare between people with psychiatric disorders and/or substance use disorders versus the general population?

Answer 14

2-4 times higher

Question 15

What is a physiological factor specific to mental health patients?

Answer 15

Many of the neurotransmitter systems impacted by nicotine administration through tobacco use are involved in the pathogen media of psychiatric and substance use disorders

Dopamine, norepinephrine, serotonin, acetylcholine, endogenous opioid peptides, glutamate, GABA, endocannabinoids