Smoking and health

Question 1

What are the health risks of smoking?

Answer 1

• Cancers incl. lung cancer
• Cardiovascular disease
• Mental health conditions
• Sudden infant death
• Influenza

Question 2

What kind of a disease is tobacco?

Answer 2

• Non communicable disease
• Worldwide distribution
• > 1 billion smokers worldwide
• > 8 million deaths annually
• Devastating financial impact

Question 3

What are the health effects of tobacco?

Answer 3

• Predominantly chronic
• Lung
• Cardiovascular
• Malignancy
• Pregnancy
• 50% mortality

Question 4

What sort of disorder is cigarette smoking?

Answer 4

• Chronic relapsing disorder
• Starts in adolescence
• Nicotine causes addiction, not tobacco

Question 5

What are the markers of addiction?

Answer 5

• Use despite knowledge of harmful consequences
• Cravings during abstinence
• Failure of attempts to stop
• Withdrawal symptoms during abstinence

Question 6

Outline the physiology of nicotine

Answer 6

• Acts on nicotinic ACh receptor stimulating dopamine release
• Results in satisfaction associated with smoking
• Following chronic exposure, ACh receptors enter upregulated state
• Increases affinity and functional sensitivity to an agonist
• A drop in nicotine levels leads to craving and withdrawal

Question 7

What are the likely outcomes for a tobacco addict?

Answer 7

• Go between trying to quit and relapsing
• May eventually quit long-term
• If they don’t manage to quit, will end up dead

Question 8

What is the intended outcome of smoking cessation?

Answer 8

• Prevent premature death

Question 9

What is the intended outcome of using a statin in smokers?

Answer 9

• Prevent 1 CVS death over 5 years

Question 10

What may prompt someone to stop smoking?

Answer 10

• Family/friends
• Health professionals
• Advert/poster
• Health problem

Question 11

What are the 3 As of smoking?

Answer 11

• Ask and record smoking status
• Advise patient of health benefits
• Act on patient’s response - build confidence, inform, refer, prescribe

Question 12

What are some pharmacological treatments to help people to stop smoking?

Answer 12

• Nicotine tablets (champix)
• Nicotine oral spray
• Nicotine patches
• Nicotine chewing gum
• Vaping

Question 13

What is meant by harm reduction with regard to smoking?

Answer 13

• There are other ways of reducing the harm from smoking even though this may involve continued use of nicotine

Question 14

Should we encourage people to vape?

Answer 14

• If you smoke, use vapes for as long as it takes to quit smoking and a low risk of relapse to smoking, then stop vaping
• Vaping can be combined with NRT and varenicline to quit smoking
• If you don’t smoke, don’t vape
• Vaping is much less harmful than smoking