Smoking Flashcards
What are the main mediators of nicotine addiction in the brain?
Ventral tegmental area
Nucleus accumbens
Which receptor does nicotine have the highest binding affinity to?
Alpha-4-beta-2 nicotinic receptors
How quickly does inhaled nicotine reach the receptors?
7-10 seconds
What impact does smoking have of nicotinic receptors?
Smoking increases receptors x3-4 times, making it more addictive and harder to quit
What is chronic smoking?
Smoking is a chronic relapsing organic brain disease, and not a lifestyle choice
With combination therapy,. how more likely is a patient to quit?
4 times greater
What are the four main goals of behavioural support?
- Reduce motivation to smoke
- Bolster commitment to abstain
- Enhance ability to cope with cravings
- Ensure effective use of pharmacotherapy
Outline the standard NHS stop smoking services regime:
4-6 appointments over 6012 weeks
Outline the advantage of doctor delivered smoking cessation
- Doctors are independent prescribers, used to tailoring treatment
- Cessation advice can be more effective from doctors than counsellors and nurses
- Smokers know, trust and want help to stop from their doctor
What are the examples of NRT?
skin patches, gums and inhalators ,lozenges, mini lozenges, oral spray, nasal spray , oral film
Why are there multiple options for NRT?
- Allows choice in treatment
- What works for one doesn’t work for another
- Self determination-you guide, they decide
- If the quit attempt fails, theres other options
What is the reality of smoking cessation?
- 20-30% long term quit rate with support and treatment
- 3-5% long term quit rate with willpower alone
- 2 or 3 quit attempts with support and treatment for >50% smokers to stop long term
- This makes it very cost effective
What is the long-term quit rate with support and treatment?
20-30%
What is the long term quit rate with willpower alone?
3-5%
What are the 5 main causes of death in the UK?
Ischaemic heart disease, stroke, COPD, Cancer, Pneumonia
What suggests high addiction in terms of smoking?
When waking at night to smoke
Waiting for 2 hours after waking up, for a smoke, is considered to be what tier of addiction?
Mild addiction
How long does it take nicotine receptors to downregulate?
8-12 weeks
How would you test smoking cessation?
Carbon monoxide monitoring
What number of cigarettes smoked per day suggests high addiction?
> 20
What number of cigarettes smoked per day suggests moderate addiction?
10-20
What number of cigarettes smoked per day suggests lower addiction?
<10
When a patient wakes at night to smoke, what type of addiction is this?
Very high addiction
When a patient smokes <30 minutes from waking, what type of addiction is this?
High addiction
