General

Question 1

How many COPD deaths are attributed to smoking?

Answer 1

90%

Question 2

What percentage of moderate to severe COPDers still smoke?

Answer 2

20.4-43%

Question 3

Behaviour change model: Pre-contemplation

Answer 3

Tobacco user is not thinking of quitting within the next six months.

Question 4

Behaviour Change Model: Contemplation

Answer 4

Tobacco user is considering quitting within the next 6 months

Question 5

Behaviour Change Model: Preparation

Answer 5

Tobacco user is planning to quit within the next 6 months

Question 6

Behaviour Change Model: Action

Answer 6

Tobacco user has quit within the last 6 months

Question 7

Behaviour Change Model: Maintenance

Answer 7

Tobacco user has quit for 6 months or more

Question 8

What percentage of tobacco users are in the Contemplation stage?

Answer 8

35%

Question 9

What percentage of tobacco users are in the preparation stage?

Answer 9

11%

Question 10

What is the 5A Approach?

Answer 10

Ask, Assess, Advise, Assist & Arrange

Question 11

How long does it take for nicotine levels to peak in the brain?

Answer 11

7 seconds

Question 12

How do you choose a starting dose of NRT?

Answer 12

NRT dosages are based on number of daily cigarettes, and the time they have their first cigarette.
If person smokes 20+ cigarettes daily or within 30 minutes of waking…they should start at higher dose.

Question 13

Nicotine Patch Dosage

Answer 13

21, 14 & 7 mg

21 cig+ start with 21 otherwise start with 14

Question 14

How long does the patient wear each dosage of patch?

Answer 14

3-4 weeks, unless starting with 14mg then 6-8 weeks

Question 15

Nicotine Gum Dose

Answer 15

20+ cigs - 4 mg gum

Question 16

What is the bite, bite, park technique?

Answer 16

After chewing gum for initial 30 seconds; park the gum between gums & teeth then rechew with craving

Question 17

Nicotine Inhaler Dosage

Answer 17

4 mg of nicotine/ puff

3-12 weeks use at least 6 but no more that 12 cartridges per day. Each cartridge should last 20 minutes.

Question 18

Nicotine Lozenge

Answer 18

Suck until strong flavour appears and then parked in the side of the mouth

Question 19

Nicotine Mouth Spray Dosage

Answer 19

1-2 sprays every 30-60 minutes

Question 20

Max dose of Nicotine Mouth Spray

Answer 20

2 sprays/ episode, 4 sprays/ hour, 64 sprays/day

Question 21

What is Bupropion?

Answer 21

Helps reduce withdrawal symptoms by inhibiting dompamine & noradrenaline reuptake…mimics the effects of nicotine

Question 22

Bupropion dosage

Answer 22

150 mg once daily for 3 days, followed by 150 mg twice daily (at least 8 hrs apart) Do not exceed 300 mg

Question 23

Bupropion Treatment

Answer 23

Should start while still smoking, 1-2 weeks to achieve “steady state levels”
7-12 weeks up to a year if needed

Question 24

What is Varenicline?

Answer 24

Helps reduce withdrawal symptoms by blocking the alpha-4 beta-2 nicotinic acetylcholine receptor

Question 25

Varenicline Dosge

Answer 25

0.5 mg daily for days 1-3 then 0.5 mg twice daily for days 4-7 then 1.0 mg twice daily thereafter
Start medication while still smoking for 1-2 weeks

Question 26

Varenicline Treatment

Answer 26

12 weeks up to 24 if required

Should not be used with other NRT

Question 27

Reducing Risk for Relapse

Answer 27

prepare to deal with social situations (avoid, leave, distract, delay and use self-talk