Nicotine dependence Flashcards
Smoking cessation may be associated with temporary withdrawal symptoms caused by nicotine dependence. list some of the symptoms of nicotine dependence
1) cravings
2) irritability
3) depression
4) restlessness
5) poor concentration
6) light-headedness
7) sleep disturbances
8) increased appetite
What is a big a concern for many people who stop smoking?
Weight gain - less likely to occur when drug treatment is used to aid smoking cessation
All smokers, including those who smoke e-cigarettes, should be advised to stop smoking and be offered support . What advice should be provided to patients?
1) Abrupt quitting offers the best chance of lasting success
2) Combination of drug treatment and behavioural support is likely to be the most effective approach
3) local NHS Stop Smoking Services provide: advice, drug treatment, and behavioural support
what are the most effective treatment options to aid smoking cessation?
1) Varenicline, or a combination of long-acting NRT (patch) and short-acting NRT (lozenges, gum,spray etc)
2) If above unsuitable, bupropion or single therapy NRT should be considered
what should the choice of drug treatment take into account, when deciding which treatment is most suitable for the patient?
1) preferences
2) previous experience of smoking-cessation aids
3) contra-indications
4) Side effects of each preparation
explain how nicotine replacement therapy should be used in the management of smoking cessation
1) Patches applied for 16 hours, with the patch removed overnight; if smokers experience strong nicotine cravings upon waking, a 24-hour patch used instead.
2) Short-acting preparations are used to prevent cravings; no evidence that one form of NRT is more effective than another.
Can NRT be used alongside varenicline or bupropion?
The use of NRT combined with varenicline or bupropion is not recommended, and both varenicline and bupropion should not be prescribed together.
Treatment should be available before the person stops smoking. Smokers should be prescribed enough treatment to last how many weeks?
To last 2 weeks after their agreed quit date and be re-assessed shortly before their supply finishes
what is the ‘harm reduction approach’?
1) for smokers who are unwilling or not ready to stop smoking yet. These patients may benefit from NRT
2) The amount of nicotine in NRT is much lower and less addictive than in smoking tobacco.
E-cigarettes deliver nicotine without the toxins found in tobacco smoke. Discuss the use of them to help stop smoking
1) substantially less harmful to health than tobacco smoking, but long-term effects are still largely unknown
2) Some find that e-cigarettes useful for smoking cessation, but they cannot be prescribed or provided
3) not licenced drugs, regulated by the Tobacco and Products Regulations 2016. In the UK, sale prohibited in children under 18 years of age.
when should pregnant women be referred their local NHS Stop Smoking Services?
1) All pregnant females who smoke or have stopped smoking in the last 2 weeks should be referred
2) Smoking cessation should also be encouraged for all members of the household.
3) Pregnant females who smoke should be advised to contact the NHS Pregnancy Smoking helpline
when should NRT be used in females?
1) If non-drug treatment options have failed NRT can be provided
2) Subsequent prescriptions should only be given to pregnant females who have demonstrated they are still not smoking
what components found in tobacco smoke increase the metabolism of some drugs and how do they do this?
Polycyclic aromatic hydrocarbons- by inducing hepatic enzymes, often requiring an increase in dose
