Smoking

Question 1

Smoking facts

Answer 1

Leading cause of preventable death in NZ
Half of people who currently smoke and continue to smoke will die from tobacco, half at middle age.
400 chemicals (acetone, cyanide, ammonia, CO
Higher smoking prevalence in low income groups, Maori and pacific islanders

Question 2

Why do people smoke?

Answer 2

Predisposing: low SES, mental illness, ethnicity
Reasons: Addiction, strong behavioural rewards, experimentation, availability, marketing, reward, peer pressure, perceived stress relief

Question 3

Cause of smoking addiction

Answer 3

Nicotine is the cause of most physical withdrawal symptoms
Habit is reinforced by routine
Emotions trigger: anxious, boredom

Question 4

ABC pathway

Answer 4

A: ask and document if patient is a smoker
B: Give brief advice to everyone who smokes
C: Strongly encourage people who smoke to use cessation support

Question 5

Effective approach for substance abuse

Answer 5

Non judgemental; understanding why; appraising substance use; knowledge of support services; screen routinely

Question 6

Stages of change model

Answer 6

Pre-contemplation
Contemplation
Determination (where people re-enter and exit)
Action
Maintenance (can relapse here)
back to pre contemplation

Question 7

NRT products given

Answer 7

Patch (21,14,7mg)
Gum (4,2) regular use
Lozenge (2,1)

Question 8

NRT prescribing guide

Answer 8

1) Explain the products available
2) Assess when first cigarette is smoked (withinor after 1 hour of waking)
3) how many cigs are smoked (less or more than 10)
4) Recommend product strength

Question 9

Cessation support

Answer 9

Alcohol and drug helpline, health promotion agency, quitline