SDGs & Smoking cessation

Question 1

How does skmoking harm the body:

Answer 1

• Damage DNA caused know carcinogens
• Destruction of the alveolar space through chronic inflammatory response
• Accelerated atherosclerosis resulting in occlusion of arteries.

Question 2

Benefits of smoking cessation:

Answer 2

• 20min after the last cigarette, BP reduce to normal
• 24h later, risk of heark attack is reduced
• 2 weeks to 3 months, lung function may increase by 5%
• 1 year, risk for coronary artery disease reduce by half.
• 15year, risk for coronary artery disease = people who never smoke. AND between 5-15y. after, risk of stroke = people never smoked.

Question 3

Canada stats:
% of Canadians, % of Qc.
Highest rate %

Answer 3

18,1% of Canadians, 19,6% of Qc

62,0% Canadians living in Nunavut

Question 4

Withdrawal symptoms onset/peak/duration:

Answer 4

Onset: 24h
Peak: 48h
Duration: 1 month
Every craving becomes less intense each time.

Question 5

Craving can be present after:

Answer 5

classical conditioning

Question 6

Prochaska and DiClemente’s method:

Answer 6

Wheel of Change: Relapse, precontemplation, contemplation, preparation, action, maintenance, permanent change.

Question 7

Approach to practice: Components of smoking cessation interventions.

Answer 7

• Counselling

- Pharmacotherapy

Question 8

Today intervention is more about:

Answer 8

Preparation phase (of the wheel of change)

Question 9

Motivation interview should be done in which phase of the wheel of change?

Answer 9

Contemplation phase.

Question 10

Counselling Methods for smoking cessation:

Answer 10

• 5 A’s Model
• Motivational interviewing
• Behaviour change counselling

Question 11

5 A’S Model

Answer 11

Ask about tobacco use
Advise to quit
Assess willingness to make a quit attempt
Assist in quit attempt
Arrange f/u

Question 12

Motivational interviewing

Answer 12

Engage
Focus
Evoke
Plan

Question 13

Behaviour change counselling

Answer 13

Behaviour
Change
Strategies.

Question 14

Highest intensity of conselling methods for smoking cessation:

Answer 14

Behaviour change counselling

Question 15

Type of Nicotine Replacement Treatments (NRT)

Answer 15

Nicotine patch, Gum, Inhaler, Mouth spay, Lozenge

Question 16

Type of non-nicotine replacement treatments

Answer 16

Bupropion and Varenicline

Question 17

Most efficacy of pharmacotherapy: (smoking cessation rate %)

Answer 17

Patch + ad lib gum (36.5%)

Varenicline = Champix (33.2%)

Question 18

Setting a quit date abrupt is equal to:

Answer 18

reducing amount smoked before complete smoking cessation

Question 19

In general adult: best intervention?

Answer 19

Combination of counselling+pharmacotherapy

Question 20

In pregnant women: best intervention?

Answer 20

Counselling

Question 21

In youth: best intervention?

Answer 21

Motivational Interverviewing + Stages of change Interventions.

Question 22

The result of tx by hypnotherapy, acupuncture or laser?

Answer 22

Inconclusive.

Question 23

Electronic nicotine delivery systems (E-Cigarette) result?

Answer 23

Inconclusive.

Question 24

Smoking Cessation Intervention: (Integrated)

Answer 24

1. Explore Ambivalence, and assess willingness to quit (motivational interviewing)
2. Assess nicotine dependency
3. Establish a SMART goal
4. Reasons to attain the SMART goal
5. General strategies to attain the SMART goal
6. Social support
7. Tackling progress of the SMART goal
8. Rewarding efforts toward the SMART goal
9. Assessing Confidence

Question 25

How to assess nicotine dependency:

Answer 25

First cigarette: < or = 30min. (high dependency)
Nb of cigarettes/day
Past attempts (success, withdrawals, obstacles)
Comorbidity (mental health/other substance use)

Question 26

When smoking > or = 10 cig./day, tx associated:

Answer 26

can use combination NRT

Question 27

When smoking > or = 20 cig./day, tx associated:

Answer 27

can start with higher dose of gum or lozenge.

Question 28

Some General strategies to attain the SMART goal:

Answer 28

1. 3 A’s:
   - Avoid trigger situations
   - Alter trigger situations
   - Alternatives: hand-to-mouth (regular gum, straws), shork acting nicotine replacement, varenicline, bupropion.
2. Track smoking behaviour

Question 29

Obstacles during smoking cessation:

Answer 29

Weight Gain
Stress
Craving 4 D’s (delay,deep breath, drink water, do something else)
Withdrawals (pharmacotherapy)
Other Smokers (ask support, socialise with non-smokers)

Question 30

Others strategies:

Answer 30

Social support
Tracking progress
Rewards

Question 31

3 dimensions of SDGs:

Answer 31

1. Economy
2. Environmental sustainability
3. Social inclusion

Question 32

MDGs difference with SDGs:

Answer 32

MDGs is more people from rich countries had a advising role and expert role for devel. countries.
SDGs is more about all working together.

Question 33

Implementation needs to be

Answer 33

Unique and specific to each country.

Question 34

Eg. of issues (with the bathroom):

Answer 34

People are ashame –> go during night –> violence risk!

Question 35

Global health is

Answer 35

Population-based prevention with individual-level clinical care.

Question 36

Link between SDGs and Principles of Global Health: Accessibility eg.

Answer 36

(gender equality/ good-health and wll-being)
Eg. Female community health volunteers receiving training about maternity and do the home visit, prevention education –> Gives Power to Women.

Question 37

Link between SDGs and Principles of Global Health: Appropriate technology and skill eg.

Answer 37

(clean and sanitation/ industry, inovation and infrastucture)
Eg. mWater app (monitoring water with technology to assess water quality)

Question 38

Link between SDGs and Principles of Global Health: Intersectoral collaboration eg.

Answer 38

(Good-health and well-being/ Partnerships for the goals)
Mexico obesity rate increase so national agreement for nutritional health –> policy, collaboration of 15 government entities –> with same objective develop AND actions plan.