Smoking cessation

Question 1

5As of smoking cessation

Answer 1

Ask & establish tobacco use

Advice why it’s bad (scaremongering & impact on others)

Assess motivation to quit - quantitative (benefits of & steps to stopping)

Assist SSTTAARR
- Support your case: write a list of the reasons why you want to stop and keep them with you. Put away the money you would have spent on cigarettes for a treat or holiday.

• Set a time & a date for stopping, and stop completely.
• Tell everyone that you are giving up smoking. Get a stop buddy.
• Take one day at a time. Mark off each successful day on a calendar.
• Anticipate withdrawal: worse at 12-24 hours, gradually eases over 2-4 weeks. Anticipate an increase in appetite: try sugar-free gum and fruit.
• Avoid risky situations: e.g. avoid pub for a while.
• Remove tobacco, ashtrays, lighters, and all cigarettes. No turning back - declare war on smoking!
• Relapse. Don’t despair if you fail. Learn from your mistakes. May take 3 or 4 attempts. If you take a train to the wrong destination, you’re always better off getting off at the next station. What I mean is if you couldn’t help yourself and had the random cigarette after so much trying don’t beat yourself about it - think of it as a fighter’s rest - get up and pick up the courage again and do it all over. It really is about the journey AS WELL AS the destination so don’t be disheartened if you lost the odd battle every now and then.

Arrange follow up

Question 2

smoking scare mongering

Answer 2

greatest cause prem death UK

half smokers die of smoking related illness (COPD, cancer, strokes, MIs etc)

Question 3

effect of smoking on others

Answer 3

children - asthma, infections, academic achievements, become smokers

adults - 2nd hand smoking

Question 4

benefits of stopping

Answer 4

straight away!

chest infections & cols less

better smell, taste, financial

Question 5

steps to stopping - options & SEs

Answer 5

2 in 3 smokers want to stop - WILLPOWER

NRT
Bupropion
Varenicline

Question 6

NRT success & SEs

Answer 6

NRT - up to 25% quit (1.5 times better)

SEs: nausea, dizziness, flu-like, palpitations, dyspepsia, hiccups, insomnia, vivid dreams

Question 7

Bupropion CIs & SEs

Answer 7

Bupropion (Zyban) - up to 40% quit.

CIs: pregnancy // BF // bipolar // seizures // eating disorders // drug interactions

SEs: seizure (1/1000) // insomnia // dry mouth // hypersensitivity

Question 8

Varenicline (champix) effect, CIs, SEs, withdrawal symptoms

Answer 8

Reduce craving

CIs: pregnancy // <18

SEs: nausea // insomnia // dreams // headaches // flatulence

withdrawal: irritability // depression // insomnia

Question 9

follow up

Answer 9

2 weeks –> 4 weeks –> 3 months –> 1 year