Smoking Cessation

Question 1

What can you offer for smoking cessation?

Answer 1

nicotine replacement therapy (NRT), varenicline or bupropion

Question 2

NRT, varenicline or bupropion should normally be prescribed as part of a commitment to stop smoking on or before a particular date (target stop date)

Answer 2

true

Question 3

prescription of NRT, varenicline or bupropion should be sufficient to last only until how long after the target stop date?

Answer 3

2 weeks

Question 4

How long is course prescribed to last after stop date?

Answer 4

2 weeks of NRT therapy, and 3-4 weeks for varenicline and bupropion, to allow for the different methods of administration and mode of action.
Further prescriptions should be given only to people who have demonstrated that their quit attempt is continuing

Question 5

if unsuccessful using NRT, varenicline or bupropion, do not offer a repeat prescription within 12 months unless special circumstances have intervened

Answer 5

false

6 months

Question 6

What are adverse effects of NRT?

Answer 6

nausea & vomiting, headaches and flu-like symptoms

Question 7

What other forms of NRT are there?

Answer 7

um, inhalator, lozenge or nasal spray
NICE recommend offering a combination of nicotine patches and another form of NRT to people who show a high level of dependence on nicotine or who have found single forms of NRT inadequate in the past

Question 8

How does Varenicline & Bupropion work?

Answer 8

Varenicline : nicotinic receptor partial agonist

Bupropion: norepinephrine and dopamine reuptake inhibitor, and nicotinic antagonist

Question 9

Varenicline has been shown in studies to be more effective than bupropion

Answer 9

true

Question 10

Side effects & contraindications of varenicline?

Answer 10

nausea is the most common adverse effect. Other common problems include headache, insomnia, abnormal dreams

contraindicated in pregnancy and breast feeding

Question 11

varenicline should be used with caution in patients with?

Answer 11

history of depression or self-harm

Question 12

Bupropion has a small risk of?

Answer 12

Seizures

contraindicated in epilepsy, pregnancy and breast feeding. Having an eating disorder is a relative contraindication

Question 13

first line in pregnancy?

Answer 13

ognitive behaviour therapy, motivational interviewing or structured self-help and support from NHS Stop Smoking Services

Question 14

vidence for the use of NRT in pregnancy is mixed

Answer 14

true

Pregnant women should remove the patches before going to bed