Module 9: Smoking Cessation Study Questions

Question 1

What are the symptoms of nicotine withdrawal?

Answer 1

Symptoms of nicotine withdrawal for smokers include:

1. intense cravings for nicotine
2. tingling in the hands and feet
3. sweating
4. nausea and abdominal cramping
5. constipation and gas
6. headaches
7. coughing
8. sore throat
9. insomnia
10. difficulty concentrating
11. anxiety
12. irritability

Question 2

Describe and apply the Fagerstrom Test.

Answer 2

Asked 6 questions in regards to your nicotine addition questionnaire. 2-4 answer choices to choose from, each answer has a score associated with it.

• A high level of addiction will rank between 7 and 10 points.
• A medium level of addiction will rank between 4 and 6 points.
• A low level of addiction will rank between 0 and 3 points.

Question 3

Describe and apply the 5 A’s.

Answer 3

1. ASK every client at every visit about smoking in the last 6 months
2. ADVISE all smokers that not smoking is the single most important thing they can do for themselves
3. ASSESS their willingness to stop at this time (are they in the precontemplation or contemplation phase?)
4. ASSIST the smoker to stop by helping them to develop a quit plan, helping them obtain social support, and providing supplementary materials / resources, and
5. ARRANGE follow-up

Question 4

What are the 2 components of nicotine addiction?

Answer 4

a

Question 5

Explain the benefits of using the pharmaceutical options for smoking cessation.

Answer 5

NRT provides the body with nicotine to help minimize withdrawal symptoms and cravings but eliminates the toxic substances one gets from cigarettes. NRT has been shown to almost double quit rates and can be used to “reduce” smoking as well as stop smoking. In a new approach to treatment, NRT can be used while a client is still smoking, before their quit date, in an effort to reduce the number of cigarettes they are still smoking. All NRT products are available without a physician’s prescription at the majority of pharmacies.

Varenicline (Champix), is a new stop-smoking medication that was approved by Health Canada in April 2007. It acts as a partial agonist and binds to the receptor to partially stimulate dopamine release, which results in reduced cravings and withdrawal symptoms. Varenicline also acts as an antagonist and prevents the pleasurable effects of smoking by blocking nicotine receptors, which prevents the dopamine release associated with nicotine consumption. It has demonstrated greater efficacy over placebo and sustained release Bupropion.

Question 6

How would you use the main pharmaceutical options for smoking cessation? The important ones to know are NRT in its various forms, bupropion and varenicline.

Answer 6

Varenicline (Champix), is a new stop-smoking medication that was approved by Health Canada in April 2007. It acts as a partial agonist and binds to the receptor to partially stimulate dopamine release, which results in reduced cravings and withdrawal symptoms. Varenicline also acts as an antagonist and prevents the pleasurable effects of smoking by blocking nicotine receptors, which prevents the dopamine release associated with nicotine consumption. It has demonstrated greater efficacy over placebo and sustained release Bupropion. Unlike Bupropion, Varenicline is the first prescription medication formulated specially to treat tobacco addiction.

Question 7

How would you support relapse prevention?

Answer 7

Relapse is a process that is related to “urges” connected to physical withdrawal, habit and memory. The triggers that set off these urges are people, places, things, moods, and stress (Mayo Clinic, 2004).
To deal with the “urges” it is important to:

Think ahead: Identify types of situations that are hard
Prepare for the urge: Think about what to DO if urges occur during these identified situations
Cope with the urge: Things to DO or SAY to themselves in order to over come the urges (Mayo Clinic, 2004)
Learn cognitive and behavioural coping responses:
Cognitive – things you tell yourself - “This urge will pass.”
Rehearse reasons for quitting - “Smoking is not an option” (Mayo Clinic, 2004)
Behavioural – things you do:
Deep breaths, drink water, suck mints
Distract yourself
Leave the situation

Early: Avoid known high risk situations that are likely to cause urges.
Later: with abstinence, gradually increase exposure to places and people associated with past smoking.

But PREPARE for this exposure, and use coping responses.

Stress: Ways to deal with stress and Negative Mood:

Deal with the problem – recognize, think of solution, act
Do other activities – read, relax, exercise, deep breathing, visual imagery
Talk to someone – friend, group, professional
Accept temporary stress – make lifestyle changes

Schedule a follow-up contact within one week after the quit date. 4 – 8 counselling sessions are optimal. Congratulate success and encourage abstinence. Discuss with your client the benefits of quitting and the barriers. Refer them to www.quitnow.ca (Links to an external site.)Links to an external site. or 1-877-455-2233

The following are booklets available for smokers:

For Smokers Who Don’t Want to Quit – One Step at a Time (Canadian Cancer Society, 2007).
For Smokers Who Want to Quit – One Step at a Time (Canadian Cancer Society, 2007).
Booklets available for family and friends:

If You Want to Help a Smoker Quit – One Step at a Time (Canadian Cancer, 2007).
The Healthy Heart Society of B.C. has developed a Clinical Tobacco Intervention Program (CTIRP) for health care professionals. Clinical materials, including stop-smoking chart reminders, patient educational materials, and forms for use in clinical tobacco intervention