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Introduction to Periodontics and Prevention > Lectures 7 & 8 > Flashcards

Lectures 7 & 8 Flashcards

1
Q

Fraction of tobacco users in the U.S.:

A

1/3

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2
Q

Around what time in a persons life do most people start smoking?

A

childhood or adolescence

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3
Q

Fraction of teenagers who try smoking that will die of tobacco-teated diseases:

A

1/3

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4
Q

More than ___ teenagers smoke their first cigarette each day.

A

3,000

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5
Q

% of men/ women smokers in 2006:

A

men: 23.4%, women: 18.4%

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6
Q

When was the 1st Surgeon General’s Report on the dangers of smoking?

A

1964

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7
Q

What change has caused a sharp decline in the prevalence of smoking?

A

the doubling of federal cigarette tax

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8
Q

Most prevalent source of tobacco for users, highest to lowest:

A

cigarette, cigar, snuff and chew (tie), then pipe

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9
Q

Current male/female % users of any tobacco:

A

men: 31.3, women: 21.3

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10
Q

Current male/female % users of cigarettes:

A

men: 25.7%, women: 21.0%

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11
Q

Does a higher % of people start using tobacco in middle school or high school?

A

high, 27.4% any use, 21.7% cigarette

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12
Q

of different gases, particles and compounds in tobacco:

A

4,000

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13
Q

of carcinogens in tobacco:

A

60+

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14
Q

Tobacco use causes __ time more deaths than firearms:

A

18

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15
Q

% of deaths caused by tobacco, diet/exercise, and alcohol, respectively:

A

18%, 15%, and about 4% respectively

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16
Q

of smoking related deaths per year:

A

400,000

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17
Q

What is the single largest preventable cause of premature death and disability in U.S.?

A

smoking

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18
Q

1 in __ death/ year are due to smoke-related illness:

A

5

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19
Q

__% of all cancer deaths, and more than __ % of all lung cancers are related to smoking:

A

30%, 80%

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20
Q

Smoking is linked to these health concerns:

A

colds, gastric and peptic ulcers, chronic bronchitis, emphysema (COPD), heart disease, atherosclerosis, cerebrovascular disease, low birth weight babies, perinatal mortality, cataract, macular degeneration, hip fracture, and cancers.

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21
Q

Cancers related to smoking:

A

lung, larynx, mouth, esophagus, bladder, pancreas, kidney and cervix

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22
Q

Effects of nicotine:

A

increases heart rate, vasoconstriction, blood pressure, and cholesterol deposition, decreases O2 carrying capacity and appetite

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23
Q

True or False? Nicotine is carcinogenic.

A

F, but may function as a “tumor promoter”

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24
Q

Fetal and adolescent nicotine exposure can lead to:

A

brain damage

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25
Q

On what 7 neurotransmitters does nicotine have effects?

A

dopamine, serotonin, epi, ne, AcH, vasopressin, and B-endorphins

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26
Q

How does nicotine effect dopamine?

A

pleasure and appetite suppression

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27
Q

How does nicotine effect serotonin:

A

mood modulation and apetite suppression

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28
Q

How does nicotine effect epinephrine and norepinephrine?

A

arousal and apetite suppression

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29
Q

How does nicotine effect acetylcholine?

A

arousal and cognitive enhancement

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30
Q

How does nicotine effect vasopressin?

A

memory improvement

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31
Q

How does nicotine effect B-endorphins?

A

mood modulation and analgesia

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32
Q

“Positive” effects of nicotine:

A

increases memory, alertness, reaction time, vigilance and work performance. Decreases stress, aggressiveness, and boredom

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33
Q

This is the vehicle for nicotine:

A

smoke

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34
Q

This is the dispenser of smoke:

A

cigarette

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35
Q

True or False? Tobacco addiction is different than heroin and cocaine addiction.

A

F, similar to

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36
Q

Oral effects of cigarette smoking:

A

oral and pharyngeal cancer, periodontitis, slowed wound healing, issues with implants and periodontal theapy, staining, bad breath, cleft lip and palate (maternal smoking), black hairy tongue

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37
Q

Oral manifestation of heavy smoking, know if someone is lying about how much they smoke:

A

smoker’s melanosis, gingiva or mucosa, reversible

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38
Q

What is smoker’s palate?

A

white opaque palate

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39
Q

True or False? Cigars have fewer of the harmful compounds than cigarettes.

A

F, about 25 times more CO, different mode of entry, lungs vs. oral mucosa

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40
Q

wet mixture of tobacco with sweeteners, and flavorings:

A

shisha

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41
Q

This is tobacco derived nicotine with non-tobacco cellulose fibers:

A

verve discs

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42
Q

Types of smokeless tobacco:

A

chewing tobacco or snuff

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43
Q

Types of chewing tobacco:

A

loose leaf, twist, or plug

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44
Q

Types of snuff:

A

moist, dry or sachet

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45
Q

How many users of smokeless tobacco are there?

A

10 million

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46
Q

% of smokeless tobacco users, men and women:

A

men: 5%, women: 1%

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47
Q

Median age for initial use of smokeless tobacco:

A

12 years old

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48
Q

% of kids in grade 9-12 that use smokeless tobacco at least once a month and % that use daily;

A

10-20%, 2-3%

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49
Q

Which has more nicotine, smokeless tobacco or cigarettes?

A

smokeless tobacco

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50
Q

How is the nicotine in smokeless tobacco absorbed?

A

oral mucosa

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51
Q

physiologic effects of absorption of nicotine across oral mucosa:

A

increases heart rate, tingling

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52
Q

The average dip is equivalent to smoking __ cigarettes.

A

4

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53
Q

Dipping 2 cans a week is equivalent to:

A

1-1.5 pack-a-day smoking habit

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54
Q

True or False? Sales of smokeless tobacco have been decreasing in the last 20 years.

A

F. increasing, moist snuff. Loose leaf, the same

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55
Q

True or False? Sales of loose leaf chewing tobacco have increased dramatically in the last 20 years.

A

F. moist snuff has

56
Q

How have the age groups of snuff users shifted in the last 30 years among men?

A

use increased with age in 70’s, now decreasing. Younger men are the target for the advertising campaigns of the last couple decades

57
Q

Men in rural areas are about __ times more likely to use smokeless tobacco.

A

3

58
Q

Effects of smokeless tobacco:

A

addiction, abrasion, recession, caries, staining, bad breath, black hairy tongue, smokers palate/ melanoma, oral cancer, leukoplakia, hyperkeratosis

59
Q

True or False? Smokers can get smoker’s melanosis while users of smokeless tobacco can not.

A

F. Both can get it

60
Q

If a patient comes to regular check up visits and has leukoplakia at each visit due to the use of smokeless tobacco, should you refer them for a biopsy at every appointment?

A

ask

61
Q

Most common form of oral cancer:

A

oral squamous cell carcinoma

62
Q

Tobacco is responsible for ___% of all oral cavity cancers.

A

80%

63
Q

Smokers have __ times greater risk for oral cancer:

A

6

64
Q

Tobacco users have __-__ times as much laryngeal cancer risk than a nonsmoker.

A

3-17 times the risk

65
Q

__-__% of daily smokeless tobacco users have non-cancerous and precancerous leukoplakia.

A

50-75%

66
Q

Is there a clinical distinction between keratosis and hyperkeratosis?

A

ask

67
Q

True or False? If a person quits tobacco use, the tobacco pouch may disappear.

A

T. it MAY, depending on severity

68
Q

Can oral leukoplakia be rubbed off?

A

no

69
Q

True or False? Oral leukoplakia is almost always malignant.

A

F

70
Q

% of oral leukoplakia that is malignant at 1st biopsy:

A

5%

71
Q

% of oral leukoplakia that becomes malignant even if first biopsy is not malignant.

A

5%

72
Q

oral squamous cell carcinoma:

A

non-healing, red or white, lateral border or floor of mouth

73
Q

Former smokers have __ times the prevalence of periodontitis than people who never smoked.

A

2 times

(5% vs 10%)

74
Q

Current smokers have __ times the prevalence of periodontitis than people who never smoked.

A

3 times (5% vs 16%)

75
Q

mean alveolar bone loss for a 5 pack-year smoker, 13y, 23y, 27y:

A

under 2mm, 2-2.9, 3-3.9, over 4mm

76
Q

Current smoker-attributable periodontitis in U.S.:

A

42% (6.4 million)

77
Q

Former smoker-attributable periodontitis in U.S.:

A

11% (1.7 million) (53% total, 8.1 million)

78
Q

What is the major risk factor for periodontal disease

A

smoking

79
Q

Smoking is responsible for this fraction of periodontitis in the last century:

A

1/2

80
Q

Smoker are __ times more likely to perio disease:

A

4 times

81
Q

Why do smokers show less inflammation at the gingival margin?

A

nicotine constricts vessels

82
Q

What is found in the “water vapor?”

A

propylene glycol, an aerosol

83
Q

What vaporizes nicotine in an E-cigarette?

A

microprocessor powered by a battery, heat

84
Q

True or False? E-cigarettes have none of the toxic by-products of burning tobacco.

A

F? (check)

85
Q

Sales of E-cigarettes are predicted to increase ___ times by 2030.

A

17 times

86
Q

Use of E-cigarettes doubled between these years:

A

2008-2012

87
Q

% of smokers and ex-smokers in U.S. that have tried E-cigarettes;

A

47%

88
Q

Main reason of E-cigarettes use:

A

reduce or quit, used in smoke-free places

89
Q

E-cigarette sales more than ___ between 2012 and 2013.

A

tripled

90
Q

Tobacco products that have seen an increase in use in teenagers:

A

E-cigarettes (dry?) and hookahs (wet?)

91
Q

Tobacco products that have decreases in use in teenagers:

A

cigarettes, cigars, smokeless, pipes

92
Q

What does ENDS stand for?

A

Electronic Nicotine Delivery Systems

93
Q

True or False? Electronic Nicotine Delivery Systems pose no risk to developing fetuses.

A

F.

94
Q

Electronic Nicotine Delivery Systems can potentially irritate:

A

respiratory tract, eyes, nose and throat

95
Q

True or False? Electronic Nicotine Delivery Systems are likely to be less toxic than conventional cigarettes or other combusted tobacco products.

A

T

96
Q

Fraction of smokers that say they want to quit:

A

2/3

97
Q

__ in 10 smokers make at least one quit attempt each year:

A

4

98
Q

Most to least common methods used to TRY and quit in the past year:

A

cut back (52%), cold turkey (42%), medication (22%), with others (15%), switch to lights (12%), switch to chew (5%)

99
Q

most effective method to quit:

A

Meds and counseling

100
Q

Is advise to quit delivered by a health professional effective?

A

yes

101
Q

% of smokers that regret smoking:

A

90%

102
Q

% of smokers that have ever tried to quit:

A

70%

103
Q

% of smokers that tried to quit in last year:

A

50%

104
Q

% of smokers that would like to quit now:

A

40%

105
Q

Questions to ask regarding tobacco use:

A

do you?, how much?, want to quit?, ready now?, how much per day?, how long after you wake up do you have first?

106
Q

Heaviness of smoking index is on a scale from:

A

0-3

107
Q

Heaviness of smoking index for how soon in am do you have first?

A

3: within 5 minutes, 2: 6-30 minutes, 1: 31-60, 0: after 1 hr

108
Q

Heaviness of smoking index for # of cigarettes smoked per day:

A

3: over a pack and a half, 2: over a pack to a pack and a half, 1: over half a pack to a pack, 0: half pack or less

109
Q

4 steps to take to ACT:

A

set quit date, quite advice/ referral, pharmacotherapy as needed, arrange follow-up

110
Q

3 first-line pharmacotherapies:

A

NRT, Zyban (Bupropion), and Chantix (Varenicline)

111
Q

Long term abstinence rates, highest to lowest:

A

chantix (44%), Zyban (30%), NRT (24%), placebo (17%), counsel (16%), nothing (11%)

112
Q

Examples of NRT:

A

gum, patch, inhaler, nasal spray, lozenge

113
Q

Efficacy of NRT is strongest in these patients:

A

higher dependence levels

114
Q

What is the single best measure of nicotine dependence?

A

whether the person reports smoking within the first 30 minutes of waking

115
Q

Those who PROBABLY can benefit most form combination therapy:

A

minimal withdrawal relief, unable to quit completely, heavy smokers and those with failed quit attempts

116
Q

True or False? Bupropion is a NRT.

A

F. Non-nicotine medicaiton

117
Q

Year FDA approved Bupropion for smoking cessation treatment:

A

1997

118
Q

mechanism of action of Bupropion:

A

blocks reuptake of dopamine and/or norepinephrine. ( my way to remember: NSRI / DSRI

119
Q

Year FDA approved Varenicline as a non-nicotine tobacco cessation medication:

A

2006

120
Q

Brand name of Chantix outside of U.S.:

A

Champix

121
Q

True or False? Chantix is a NRT.

A

F

122
Q

Mechanism of action of Chantix:

A

alpha-4-Beta-2 receptor partial agonist, highly selective. Less dopamine release from the VTA at the nAcc and prevention of binding at the alpha-4-Beta-2 receptor

123
Q

Where does nicotine bind the alpha-4-Beta-2 receptor?

A

Ventral Tegmental Area , believed to cause relate of dopamine at the nucleus accumbens

124
Q

True or False? Chants has both agonist and antagonist activity.

A

T

125
Q

When should treatment with Varenicline begin?

A

1 week before quit date, continue for 12 weeks

126
Q

True or False? Titration of Zyban over the first week is important.

A

F. Chantix; day 1-3, single dose (0.5mg), day 4-7: both am and pm (0.5mg), after 1 week: am and pm (1 mg)

127
Q

True or False? Varenicline should be taken on an empty stomach.

A

F. after eating

128
Q

Side effects of varenicline:

A

nausea, sleep disturbances and headache, erratic changes in behavior, agitation, depressed mood, suicidal ideation, and actual suicidal behavior, possible connection to cardiac problems

129
Q

True or False? Light cigarettes have less tar.

A

F

130
Q

True or False? Lights have less nicotine.

A

F

131
Q

True or False? Switching to lights can help a person quit smoking.

A

F

132
Q

True or False? No SSRI or tricyclic antidepressants have been shown to help with smoking cessation.

A

F. nortriptyline (a tricyclic antidepressant)

133
Q

NRT and Zyban increase quit rates __ - __ fold.

A

1.5 to 2 fold

134
Q

Varenicline has quit rates that are __ fold over placebo.

A

3

135
Q

Brand of low nicotine cigarettes:

A

Quest 3

Introduction to Periodontics and Prevention (8 decks)

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