LMBR9: TOBACCO & ALCOHOL MCQs 1 Flashcards
By Michelle Olson
The single largest preventable cause of morbidity and mortality in the US is (BR289)
a) Obesity
b) Tobacco
c) Alcohol
d) Diabetes
B Tobacco
However in 2017 Cleveland Clinic & NY School of Medicine said that obesity has become #1 COD & disease. BR 289
Tobacco use (BR289)
a. Cost is $300 billion annually
b. Direct medical cost is $130 billion
c. Lost productivity is $150 billion
d. Causes 10 years of life loss
e. All of the above
E All of the above
Todays smokers smoke fewer cigarettes, but have a greater risk of lung cancer because
a. Filters allow less vigorous inhalation
b. Changes in chemicals and composition increase adenocarcinoma
c. Environmental changes
d. The chemicals have decreased in the manufacturing process
e. None of the above
BR 289
Answer is B - changes in cigarette design and composition have led to an increased risk of adenocarcinoma.
- ventilated filters are now used which allow more vigorous inhalation => draw cancer-causing chemicals deeper into lung tissue.
Smoking related deaths (BR 304)
a. 480,000 deaths per year in the US (approx 1 of 5 deaths)
b. Tobacco kills 1 of every 3 people who use cigarettes
c. Smoking causes 80% COPD deaths
d. Smoking causes 100% lung cancer deaths
e. Answers A and C are correct
(BR 304)
Answer E
Tobacco products kill 1 in 2 people who use them.
Smoking causes
a) 480 K (1 in 5) deaths in the USA
b) 87% ol lung CA deaths
c) 32% of CAD deaths
Smoking related deaths
1) What proportion of smokers wil be killed by smoking ?
2) What proportion of the following causes of death is due to smoking:
a) Lung cancer
b) Coronary heart disease
c) COPD
3) Approx how many different cancers are related to tobacco use ?
BR289
1) Tobacco kills 1 in 2 people who smoke
2) Smoking causes 87% of lung CA deaths & 32% of CAD deaths & 80% of COPD deaths
3) 40+ cancers due to tobacco use - in all parts of the body
Smoking leads to or worsens
a. Diabetes
b. Rheumatoid arthritis
c. Poor/Delayed wound healing
d. Macular degeneration
e. Erectile dysfunction
f. All of the above
BR 290
Answer F
Also:
Cleft lip/palate
Risk of bone fractures
Increased failure rate for treatment of ALL cancers.
What are adverse health outcomes of smoking related to fertility & pregancy ?
BR 290
Smoking leads to or worsens:
1) Ectopic pregnancy
2) Preterm delivery
3) Still birth
4) Low birth weight
Mn: SPEL
Nicotine(BR290)
a. Second most common cause of dependence in the US
b. Is the key ingredient in tobacco products
c. Is usually able to be treated quickly, easily, and on the first attempt
d. Is not as addictive as heroin, cocaine, or alcohol
BR 290
Answer B
- nicotine is the #1 form of chemical dependence in the US
Health benefits of smoking cessation
a. Risk of heart disease is 50% less for one who quits then one who continues to smoke
b. Increases the risk of premature death and increases the rate of heart attack stroke and lethal cancers
c. After 1 year the risk of stroke is that of a non smoker
d. Quitting at 30 years old gains 5 year life expectancy
e. There are less benefits the younger you quit
(BR290)
Answer A
- takes 2-5 yrs for risk of stroke to = non-smoker
Health benefits of smoking cessation
1) After _ yrs the risk of lung cancer is reduced by _%
2) How many years of life are gained if one quits at:
a) Age 30
b) Age 60
(BR290)
1) After 10 yrs, risk of CA lung decreased by 50%
2) Yrs life gained if quit at _
30 => 10 YOL gained
60 => 3 YOL gained
Tobacco cessation
a. Smokers can and do quit
b. There are more former smokers in the world than current smokers
c. Most tobacco users want to quit
d. Only 5% of tobacco users who want to quit will be able to without assistance
e. All of the above
BR 290
Answer E
- 68% (2/3) of smokers want to quit.
Success in quitting smoking
1) If a person quits ‘cold turkey’, what is the risk of them resuming smoking ?
2) What is the net effect of MDs using evidence-based programs
3) In pts in MD directed Rx programs, at 3 mos, what proportion are tobacco free ?
BR 291
1) If quit ‘cold turkey’, resumption rates are:
- 50% @ 14 days
- 75% at 30 days
2) Net effect of MD program is a doubling of quitting success rates
3) In MD programs, at 3 mos, ~ 50% (40-50%) are tobacco free
Methods to quit smoking(BR291)
a. Counseling is effective evidence based treatment
b. Medication that has nicotine works best
c. Relapses are not normal in tobacco cessation
d. Counseling and medication is more potent than either alone
e. A and D are both true
Answer E
- non-nicotine meds also work
- other effective interventions:
1) Brief clinical interventions
2) Individual, group, or telephone counselling
3) Behavioral therapies
4) Program Rx using mobile phones
US Public Health Service Clinical Practice Guidelines(BR291)
a. Clinicians should assess the patients once a year and document
b. Tobacco use treatments are not effective across a broad range of populations
c. Brief tobacco dependence treatment is not effective and less than 3 minute interventions do not work
d. individual , group and telephone counseling is effective and the more intense the more effective
Answer D
Tobacco dependence treatments are clinically effective and very cost effective compared to interventions for other disorders - all of the following are true except
a. If a tobacco user is not ready to quit, it is not useful to use motivational interviewing until they are ready
b. Telephone quitline is effective
c. Combination of counseling and medication is more effective than either alone
d. Medication should be encouraged by clinicians unless the medication is contraindicated in that population(pregnant women, adolescents, light smokers, smokeless tobacco users)
e. There are 7 FDA approved medications, 5 nicotine replacement therapies and 2 non-nicotine replacement
(BR292)
Answer A
- if not ready to quit, use motivational interviewing to increase future quit attempts.
