messadi - 1/12 - methods of quitting tobacco use Flashcards
tobacco dependence is a two part problem:
physiological
behavioral
true or false
tobacco is a chronic brain disease
true
true or false
change is a process and not a single step
true
why do people choose NOT to quit? 7 reason
- nicotine is stimulant and gives you energy affects DO and NE gives high
- smoking is a social behavior
- smoking helps with stress managment, and relaxation
- smoking helps control body weight [esp women]
- smoking elevates mood [antidepressant]
- Automatic smoking
- multiple failed quit attempts
___ % try to quit and know to quit but only ___% succesfully quit
70 % know
3% succeed
_____ _____ helps pts learn to cope with these difficult situations without having a cig
behavioral counseling
nicotine pharmacodynamics: withdrawal effect
which 7 are MOST PROMINENT
anger/ irritable
anxiety
craving
difficulty concentrate
hugner/ weight gain
impatience
restlessness
tobacco cessation intervention
waht are the 5 As
Ask
advise
assess
assist
arrange
waht type of question is this:
do you ever smoke or live in a household with smoker?
ask question of the 5 A’s
advise with a ____ , ___ , ___ way
clear
strong
personalized
occasional or light smoking is still harmful
waht type of quesiton is this
adivse question
assess ____ or ____ to make a quit to attempt
willingness
readiness
assist when the pt is ____
ready to quit
pt who are i nthe process of quitting ins in the ___ stage
pt who have been off tobacco for MORE THAN 6 MONTHS are in ____ stage
pt is ready to quit [in the next 30 days — ____ stage)
not ready to quit is _____ stage
action
maintenance
preparation
contemplation or pre-contemplation
arrange for ___ ___. this can be the difference bt quitting and not for some pts
follow up couseling
___ % of all smokers are addictied by the time they reach ____>
90%
19
the additional “A” is what
anticipate
benefits of quitting
2 weeks to 3 months
circulation improves
walking easier
lung function increase to 30%
benefit of quit
1 - 9 months
benefit of quitting 1 year
benefit of quitting 5 years
benefit of quit after 10 years
benefit of quitting after 15 years
what are the 2 methods for quitting:
- non pharamlogical includes ___ and other ___
- pharamological: ____
non pharmalogical : couseling and nondrug approaches
pharmalogical - FDA approved meds
waht is the success rate of cold turkey and categorized as what type of method
5%
non-pharm
other non pharm methods or alternative methods 5 of them
- acunpuncuture and hypotherapy = NOT EFFECTIVE
- massage therapy
- aversion therapy [suggest smoke till they are sick]
- formal cessation programs:
- group programs
telephone counseling
what are the 1st line of therapy…
psychotropics = antipsychotic meds
NRT?
nicotine replacement therapy
patches, inhaler, nasal spray, gum, lozenge
true or false
pt can continue to use all forms of tobaccon upon intiation of the NRT regimen
false
STOP, as opposed to the pharmacological agents you can smoke up to 1 week before quitting
true or false
can the effectivnes of nicotine gum be reduced with food and drinks
true
they should stop eating and drnking around 15 - 30 min before using gum
lozenge delievers ___ % more nicotine than the gum
25%
dosing of lozenge is based on ____ as an indicator or nicotine addiction
TIME to FIRST cig [ttfc]
with the patch
- nicotine is well absorbed across the skin
- delivery to ____ avoids hepatic 1st pass metabolism
- plasma nicotine is ____ …
true
- systemic circulation
- lowers
true false
apply to the same area each day
do use the same area again for at least 1 week
false, do NOT APPLY same area
false, do NOT use the same area for at least 1 week
remove patch before an ___ procedure
remove the patch during ____ time of the day.
MRI procedure
night time
___ and ___ you can titrate the dose, but ___ you cant
lozenge and gum you can titrate dose
patch you can NOT titrate dose
the fastest nicotine replacement product taht goes to the brain is
nicotine spray
nicotine inhaler, delievers ___ mg of nicotine absorbed through the ___ ___
4 mg
buccal mucosa
____ is contraindicated in pt with seizures and is used as a reuptake inhibitor for ____ and ___
bupropion
NE
dopamine
true or false
pt with any other antidepressants, alcohol, or eating disorders [greater risk for seizures] are also contraindicated for use of bupropion
true
Bupropion sr:
pts should begin therapy _______ weeks _____ to their quit date to ensure that therapeutic plasma levles of the drgu are achieved.
1 to 2 weeks PRIOR
if by 12 weeks, no diff in pt so doesnt stop smoking or doesnt see the effect of the bupropion, you should ____
stop use and 12 weeks is the cut off time
true or false
- bupropion might benefical for pts wtih depression
- but if they are takig other anit depressants than shouldnt use bupropion
true
true
varenicline is a ___ neuronal nicotinic ____ receptor agonist
alpha4beta2
Ach R agonist [competively inhibits nicotine from binding]
_____ has neuropsychiatric symptoms and throughts of suicide
varenicline
___ also is a partial nicotinic agonist like varenicline
lobeline [indian leaf]
waht are the short acting formulation and what is the one long acting
short term:
gum
inhaler
nasal spray
long acting = patch
which two are the most expensive products as opposed to the cigs
inhaler and bupropion
to max success, interventions should include ___ and ___ meds
counseling
one or more meds
first line meds that increase long term smoking cessation reates include:
- bupropion SR
- nicotine replacement therapy [gum inhaler, lozenge, patch, nasal spray]
- varenicline
in smokers, clinicians may rely on the abscence of bleeding on probing as a MARKER of health in the same way as when assening non-smokers
true or false
false, smokers will not have bleeding less inflammation but doesnt not mean they have less periodontal disease
waht % of the periodontitis cases among adults int he US is associated with smoking
- 7
- 1
- 9
- 3
41.9
a patient has a fagerstrom scale of 8 this indicates a high plaque rate
high nicotine dependence
low nicotine dependence
stong correlation with oral cancer incidence
high nicotine dependence
the basis for dosing nicotine lozenges is
the number of cig smoked daily
the time of first cig smoked
the number of years the smokers have been smoking
the numbr of previeous quitting attempt
the time of first cig smoked
waht is the annual death rate attributed to smoking in the US
805, 000
443,000
11,000
1 mil
443,000
cigars has less nicotine content than cigarettes
true or false
false can have 20x more than cigs and 440mg nicotine than cigs
which statement is the least correct about Cannabis
- its use has decrease in the USA in the last 25 years
- increase in the last 10 years
- role in oral cancer development is still controversial
- used in the most age groups including teenagers
wrong: use has decreased in the uSA in the last 25 years
INCREASED IN THE LAST 25 YEARS
