Smoking Cessation

Question 1

What are most smoking related deaths from?

Answer 1

lung cancer
coronary heart disease
chronic obstructive pulmonary disease

smoking is the leading cause of preventable death and disease

Question 2

What are the areas of the body aggravated by smoking?

Answer 2

heart and circulation 
respiratory 
stomach/digestive system
mouth 
ligaments, muscles, bones
eyes 
skin
reproductive functions

Question 3

What ingredients within a cigarette cause cancer?

Answer 3

no evidence to suggest that nicotine causes cancer

it is the other chemicals in cigarette smoke which are responsible for the majority of the harmful effects of smoking
- methanol, butane, arsenic, ammonia, carbon monoxide, tar

Question 4

Why is it hard for someone to stop smoking?

Answer 4

cravings/withdrawal symptoms
- nicotine is highly addictive = pharmacological dependence

behavioural dependence
- hand to mouth action

Question 5

Why is nicotine addictive?

Answer 5

it reaches the brain within 10 seconds of entering the body

initial feeling of pleasure, reduces stress and creates an immediate sense of relaxation

short half-life of nicotine means smokers regularly seek to restore nicotine levels

Question 6

What are withdrawal symptoms of smoking?

Answer 6

irritation 
agitation/aggression
restlessness/ poor concentration
increased appetite 
light-headedness
disturbed sleep
nicotine cravings
weight gain

Question 7

What are the health benefits to smoking cessation?

Answer 7

circulation improves
ability to taste and smell improves
physical appearance improves
- skin loses its greyish pallor and wrinkles
coughing and wheezing decline
risk of heart attack and lung cancer decreases

life expectancy will increase

Question 8

What is the cycle of change for smoking cessation?

Answer 8

thinking go stopping 
deciding to try
trying to stop
stopping 
a - staying stopped
b - relapse and repeat

Question 9

What are the types of nicotine replacement therapy (NRT)?

Answer 9

transdermal patch
mouth spray 
gum 
inhalator 
microtablets 
lozenge
nasal spray 
oral strips

Question 10

What are the types of transdermal patches? What is the method of application?

Answer 10

16 hour patches = light to moderate smokers
- applied in the morning and removed at night
24 hour patches = heavier smokers
- worn day and night

is a self-adhesive, transdermal delivery system of nicotine which delivers a controlled amount over a period of time

must be applied to clean, hairless area of skin
must alternates site of application

must start on a higher dose and weaned off over weeks

Question 11

What are the advantages and disadvantages of transdermal patches?

Answer 11

advantages 
- convenient, discreet and easy to use
- does not require multiple applications throughout the day
- can be used alongside smaller/lighter dosage forms = gum, lozenge 
disadvantages
- sleep disturbances
- skin irritation
- nausea

Question 12

What are the advantages and disadvantages of nicotine mouth spray?

Answer 12

advantages

• preferable for heavy smokers
• rapid delivery and uptake into the body
• can be used alongside patches

disadvantages

• mouth and throat irritation/inflammation
• dry mouth
• taste disturbances
• increased saliva production

Question 13

What are the advantages and disadvantages of nicotine gum?

Answer 13

advantages

• convenient, discreet and easy to use
• can be used alongside patches

disadvantages

• must chew sufficient pieces and for a sufficient duration to get an effect
• irritation of the throat
• increase saliva production
• food and acidic drink should be avoided for 15 minutes before and after = can decrease effectiveness
• more difficult to chew than normal gum

Question 14

What are the advantages and disadvantages of nicotine inhalator?

Answer 14

advantages
- only NRT which takes into account the hand to mouth action = behavioural dependence

disadvantages

• mouth piece must be cleaned regularly
• requires frequent inhalation
• irritation of the mouth and throat
• expensive
• visible to other, not discreet

Question 15

What are the advantages and disadvantages of nicotine sublingual tablets and lozenges?

Answer 15

advantages

• can be used alongside patches
• convenient, discreet and easy to use
• suitable for low and heavy smokers

disadvantages

• dry throat and irritation
• sore mouth
• indigestion
• unpleasant taste
• food and acidic drink should be avoided for 15 minutes before and after = can decrease effectiveness

Question 16

What are the advantages and disadvantages of nicotine nasal sprays?

Answer 16

advantages
- suitable for heavy smokers

disadvantages

• visible to other, not discreet
• must be primed if not use frequently = shaken, spray until a mist forms
• expensive
• irritation of the nose, watery eyes and sneezing

Question 17

What are the advantages and disadvantages of oral strips?

Answer 17

advantages

• suitable for heavy smokers/high dependence
• convenient, discreet and easy to use

disadvantages

Question 18

What are reasons for NRT failure?

Answer 18

unrealistic expectations
incorrect dose 
misconceptions surrounding nicotine 
not used full treatment regime/duration 
willpower fades away

Question 19

What is combination therapy? What is its purpose?

Answer 19

most effective therapy
- use of a transdermal patch and a flexible format
= gum, lozenges, sublingual tablets

nicotine patches
- give continuous levels of nicotine throughout the day tp relieve background withdrawal

flexible format
- relieves breakthrough cravings when they strike

Question 20

What are the methods of smoking cessation?

Answer 20

nicotine replacement therapy

• combination therapy
• used alone

cut down then stop

• for smokers who are not ready for an immediate halt
• reduction in smoking instead by using NRT alongside

immediate stop
- choose a date then stop

safer alternative

• e-cigarette
• shisha