Module 9: Smoking Cessation Flashcards
What is the leading cause of death in North America
Smoking
What is the single most significant cause of preventable death and illness in Canada
Smoking
____% of all smokers die from a smoking-related illness
50%
the average smoker loses ___years of life
22 years
_____ is a central nervous system stimulant and is classified as a drug
Nicotine
What is a “reinforcing” drug
users desire the drug regardless of their knowledge of its damaging effects
How long does addiction to nicotine take?
may take weeks or months to develop
While nicotine is the addictive ingredient in cigarettes, it is the thousands of _____ present in tobacco and its combustion products that are responsible for CVD.
toxins
There are more than 4000 compounds in tobacco and tobacco smoke, and over 40 of these substances, including ________ are known to cause cancer
- benzopyrene
- nitrosamines
- vinyl chloride
- arsenic
- chromium
- nickel
What are the benefits to quitting smoking?
The benefits of quitting smoking are direct. Some adverse effects of smoking are reversible:
- risk of heart attack and stroke drop within 24 hours
- breathing is easier within 3 days
- coughing is improved within 2 weeks
- risk of coronary artery disease is reduced by 20% - 50% in one year
- risk of stroke normalizes within 1 year
- risk of dying is equal to a non-smoker after 15 years.
_____ is the single most important thing a person can do for his/her health.
Quitting smoking
What 3 interrelated factors does tobacco dependance result from?
neurochemical, environmental and individual
What 3 interrelated factors make be taken into account for successful treatment of tobacco dependence.
neurochemical, environmental and individual
From the list of additional readings, please read: Treatment of tobacco dependence: integrating recent progress into practice.
Recognize the signs and symptoms of nicotine withdrawal.
In addition to the above article, read Smoking cessation: lessons learned from clinical trial evidence (omit section about Rimonabant).
a
As a starting point with smoking counselling, the essential features of smoking cessation treatment have been described as the 5 As:
- ASK every client at every visit about smoking in the last 6 months
- ADVISE all smokers that not smoking is the single most important thing they can do for themselves
- ASSESS their willingness to stop at this time (are they in the precontemplation or contemplation phase?)
- ASSIST the smoker to stop by helping them to develop a quit plan, helping them obtain social support, and providing supplementary materials / resources, and
- ARRANGE follow-up
Prochaska’s Transtheoretical Stages of Change Model describes _____ as a process of change that takes place over time
smoking cessation
The stages of change model help to guide intervention by defining five stages of change:
precontemplation (unaware of the problem, no thoughts about change)
contemplation (thinking about change in the near future)
decision (making a plan to change)
action (implementation of specific action plan)
maintenance (continuation of specific actions, or repeating periodic recommended steps)
People are motivated to change their behaviour when
a) they perceive the change to be important to them
b) when they are confident in their ability to change
c) when they are ready to change.
all the above
a) they perceive the change to be important to them
b) when they are confident in their ability to change
c) when they are ready to change.
During what stage should you investigate the client’s decisional balance for smoking: what are the pro’s and cons to both smoking and not smoking for that person?
contemplative phase
What is the conviction – confidence model?
Conviction is related to their perceived benefits of stopping smoking and their confidence to overcome barriers to stop smoking. If both or one or the other is low it usually means the smoker will not be successful in quitting (Counselling aims to strengthen both)
What is an example of an intervention to increase conviction by provoking expression of benefits?
“If you decided to … how would that benefit you?” Then give precise information on the benefits of changing the behaviour (background with empathy)
What is an example of an intervention with a series of questions to increase confidence
- “If you decided to … do you think you could do it?”
- “What would prevent you from …?” (barriers).
- “How do you think you can …?” (strategies).
Build on prior success
As part of your assessment, complete the Fagerström questionnaire to assess the level of nicotine addiction. Scores of ____ or greater indicate a high level of addiction. Scores of ____ indicate a moderate level of addiction.
As part of your assessment, complete the Fagerström questionnaire to assess the level of nicotine addiction. Scores of 7 or greater indicate a high level of addiction. Scores of 4-6 indicate a moderate level of addiction.
What should be done during preparation phase?
In the preparation phase, for those willing to quit, help them develop a quit plan by setting a quit date, review past quit attempts, anticipate fears, barriers (withdrawal symptoms, fear of failure, weight gain, depression, enjoyment of tobacco), and challenges or lifestyle “triggers” which the client associates with smoking. Triggers include alcohol, being around other smokers, feeling under pressure or feeling stress, negative feelings, morning coffee, etc. It is important to develop coping skills in recognition of these trigger situations: anticipate and avoid temptation, find strategies that will reduce negative moods, reduce stress and improve quality of life by participating in things you enjoy, involve yourself in activities such as physical exercise that help to reduce stress
Emphasize that low-tar, smokeless, cigars and pipes do not eliminate risks.
People often prefer to try cutting down the numbers of cigarettes they smoke before using a pharmaceutical agent. Cutting down or tapering strategies for smoking cessation include:
Smoke only ½ of the cigarette
Make your car and home smoke free
Enlist the support of your family, friends, and colleagues – tell them that you are quitting so they won’t offer you cigarettes or smoke in front of you
Buy a brand of cigarettes that you dislike
Delay the time between each cigarette
When you are craving a cigarette, try to wait 15 minutes
Chew gum or crunchy foods (i.e.: carrot sticks)
Keep yourself busy and your hands occupied
Track your cigarettes so you are aware of exactly how much you are smoking and under what circumstances
Avoid coffee, alcohol and any other triggers that you link to smoking
Change your routine (i.e.: go for a walk immediately after meals, eat breakfast in another room) (Centre for Addiction and Mental Health – TEACH Tobacco Cessation, 2008).
Typical roadblocks or barriers to quitting might include:
Withdrawal symptoms Cost of nicotine replacement therapy Fear of failure Weight gain – reassure the client that the average weight gain after stopping smoking is 2.4 kg (Bridge and Turpin, 2004) Lack of support Depression Enjoyment of tobacco Other smokers in the household
