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Medicine MD3001 cardiovascular system > cessation of smoking: issues and approaches > Flashcards

cessation of smoking: issues and approaches Flashcards

1
Q

What are the 3 principle fatal disease cause by smoking?

A
  • COPD
  • CVD
  • cancer
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2
Q

What are the health benefits to smoking cessation?

A
  • increased longevity
  • accelerated decline in lung function reduced
  • improved reproductive health
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3
Q

How does smoking cessation relate to risk lung cancer?

A

stabilisation of lung cancer risk but no absolute decline

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4
Q

How long does it take heart disease risk to reduce back to a non-smoker level after quitting?

A

10 years on average

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5
Q

How quickly are effects visible from quitting smoking?

A

20 minutes

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6
Q

What are the immediate effects on the body within 20 mins, 8 hours, 24 hours, 48 hours and 72 hours of quitting?

A

20 mins- normal pulse and blood pressure
8 hrs- blood nicotine and carbon monoxide levels halved
24 hours- CO eliminated, lungs begin clearing mucus
48 hours- nicotine eliminated, senses of smell+taste return
72 hours- breathing easier, bronchial tubes begin to relax

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7
Q

What are the long term effects of quitting smoking at 2-12 weeks, 3-9 months, 5 years and 10 years?

A

2-12- circulation improved
3-9- lung function increases >10%
5- risk of heart attack halved
10- lung cancer risk halved, risk of heart attack= non smoker level

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8
Q

At wat age if you stop by are almost all excessive risks of smoking ignored?

A

35 years

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9
Q

What proportion of all smokers will be killed by smoking?

A

half

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10
Q

How are post operative complications affected by smoking cessation?

A
  • fewer wound related complications, reduced cardiovascular problems
  • sorter hospital stay
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11
Q

What is a stage model? How does it relate to smoking?

A
  • the certain stages people have to successfully get through to complete the model
  • with smoking it is the stages smokers need to complete to become successful and quit
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12
Q

what stage model is used with smoking cessation?

A

Prochaska and DiClemente

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13
Q

What are the 6 components of the Prochaska and DiClemente stage model?

A
  • pre-contemplative
  • contemplative
  • preparation
  • action
  • maintenance
  • relapse
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14
Q

What is also coupled alongside the stage model?

A

nicotine replacement therapy such as: patches, gum etc.

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15
Q

What is the hardest barrier to cross when helping them quit?

A

getting them from the pre-contemplative stage to the contemplative stage

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16
Q

How long does it on average take for a smoker to quit?

A
  • they go through 3 complete cycles of the stage model

- takes roughly 5 years

17
Q

What are the key features of the pre contemplative stage? What is the strategy to overcoming it?

A
  • lack of awareness or intent to change

- short messages to attract attention, bring up facts or information not previously mentioned or known about

18
Q

What are the characteristics of the contemplative phase? what is the strategy to dealing with this phase?

A
  • increased awareness of negative aspects of smoking
  • dispel negative myths about quitting (on long term smoking increases anxiety and depression as the supposed calming effect)
19
Q

What are the characteristics of the preparatory phase? what is the strategy to overcoming it?

A
  • some small behavioural changes will have been made, set a quit date
  • longer messages, offers concrete tips and methods to help quit
20
Q

what are the characteristics of the action past? what is the strategy for dealing with the action phase?

A
  • individual has plan to stop, still adjusting

- offer nicotine replacement therapy to avoid relapse and congratulate patient on success

21
Q

What are the characteristics and strategies imposed in the maintenance phase?

A
  • long term adjustment as a non-smoker

- congratulate advise ongoing vigilance to keep off cigarettes, be ware of trigger points where patient could relapse

22
Q

What is the 4 A’s approach to smoking cessation? What is the potential 5th A?

A 
1-ask about tobacco use
2-advise to quit
(assess willingness to quit) 
3-assisst in quit attempt
4-arragne follow up
23
Q

Duration of the ask phase? What should you find out?

A
  • 1 minute

- if they have ever? if yes have the stopped? Why ?

24
Q

Duration of the advising phase? What 3 pieces of advice should you give?

A
  • 1 minute

- clear strong personalised advice

25
Q

What clear advice should you as a doctor give to a smoker?

A

best advice for you is to stop smoking now

26
Q

what strong advice should be given?

A

as your clinician I need you to know quitting is thee most important thing you can do to benefit your health right now

27
Q

what personalised advice can you give?

A

impact of smoking on the patients family and on their well-being

28
Q

Duration of assess stage? how do you assess? What do you do if they are willing? what do you do if they are not willing?

A
  • 1 minute
  • in next 30 days assess willingness to quit
  • if willing move on to assist step
  • if not perform 5 Rs approach
29
Q

duration of the assist stage? What do you do to help smoker quit?

A
  • 3+ minutes
  • suggest and encourage use of problem solving methods
  • provide social support
  • arrange social support in the smokers environment
  • provide specific self help smoking cessation materials
30
Q

duration of arrange phase? What should you do or plan in tis phase?

A
  • 1+ minute
  • follow up and monitor, provide support
  • encourage patient
  • invite to talk about success
  • ask about concerns and difficulties
31
Q

What are the 5Rs method to patients expressing an unwillingness to quit?

A
  • relevance
  • risks
  • rewards
  • roadblocks
  • repetition
32
Q

What is the purpose of the 5 Rs method?

A
  • here is the information
  • these are the dangers
  • these are the benefits
  • whats stopping you?
  • keep saying this over and over
33
Q

What reasons should you cover for smoking cessation to be relevant to a patient?

A
  • financial
  • children
  • history of smoking related illness
34
Q

What 2 methods should you use in the risks stage of 5Rs?

A
  • what ave you heard about smoking?

- reiterate benefits for them and for children or family

35
Q

What are the rewards of smoking cessation?

A
  • financial
  • O2 level improvement after a day
  • smell and hygiene will improve
  • more energy
36
Q

What are the 4 potential roadblocks to smoking cessation or reasons for relapse?

A
  • negative moods
  • being around other smokers
  • triggers and cravings
  • time pressure
37
Q

What advice can you give to overcome these roadblocks?

A
  • suck on candy instead of smoking
  • engage in physical activity
  • ask for support
  • engage and think of positive activities and things
  • get others to quit with you
  • leave room when others smoke
38
Q

What advice do you give smokers to overcoming the roadblock specifically of triggers and cravings?

A
  • get across that craving will reduce in a couple of weeks
  • anticipate triggers= coffee, gatherings, waking up, after a meal
  • change routine to accomodate
  • distract yourself throughout the day with pleasant activities such as gardening or listening to music

Medicine MD3001 cardiovascular system (44 decks)

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