Class #12 - Smoking cessation Flashcards
Historic events?
64: Surgeon general concluded smoking causes lung cancer and chronic bronchitis
89: NO advertising in CA
2006: Cannot smoke indoor in QC/ON
2016: NO smoking on terrace, in vehicle with child under 16, 9 meter radius
Benefits of smoking cessation?
20min: BP normal
24hours: Risk heart attack reduced
2weeks to 3 months: lung function increase by 5%
1 year: Risk of CHD reduced by half
10 years: Precancerous cells replaced
15 years: Risk of CHD and stroke is equivalent to people who never smoked
Withdrawal Sx?
Start after 24h, peak 48hours, last 1 month.
Irritability, hard to concentrate, anxiety, increased appetite, insomnia
Prochaska wheel of change?
Precontemplation -> Comtemplation (motiv. interviewing) -> Preparation -> Action -> Maintenance: can lead to permanent change -> Relapse
Counselling methods for smoking cessation?
5 A’s
Motivational Interviewing
Behavior change counselling
Efficacy of pharmacotherapy?
Varenicline (champix) = 33.2 %
Patch + ad lib gum = 36.5%
Abruptly stopping = to reducing before hand in success rates?
Yes
Counselling + phar. better then each alone?
Yes
E-cigarettes?
No firm conclusions
Smoking cessation intervention integrated starting with first intervention (IMPORTANT)?
Ambivalence -> Nicotine dependency -> SMART goal -> reasons for goal -> strategies to attain goal -> solution to overcome obstacles -> social support -> track progress -> reward efforts toward smart goal -> assess confidence
High dependency?
Smoke first 30min of the day
Strategies to attain goal?
3 A’s
Alternatives: gum
Alter triggers
Avoid triggers
Overcoming obstacles?
Craving 4D's: delay, deep breath, drink water, do something else Weight gain Stress Withdrawals = Rx Other smokers = ask for support
