Smoking cessation Flashcards
Which 2 questions are the most important indicators of dependence in smokers?
How many cigarettes do you smoke per day?
How soon after waking up do you smoke your first cigarette?
What is the best way to stop smoking?
Combination of behavioural support + medication
Which 3 medications can be used to aid smoking cessation?
Nicotine replacement therapy (NRT)
Varenicline
Bupropion
How should medication for smoking cessation be prescribed?
Prescribed as part of a commitment to stop smoking on or before a target date
Prescription sufficient for only 2w after target stop date + review
If unsuccessful with using medication to stop smoking, when can the next prescription be offered?
After 6 months
Give 3 adverse effects of NRT
N+V
Headaches
Flu-like Sx
How is NRT prescribed in those with a high level of dependence?
Combination of nicotine patches + another form of NRT (gum, inhaler, lozenge, nasal spray)
What is the mechanism of action of varenicline?
Nicotinic receptor partial agonist
How is Varenicline taken?
Start 1w before target stop date
Review at 3-4w
Recommended course: 12w
List 4 adverse effects of varenicline
Nausea (most common)
Headache
Insomnia
Abnormal dreams
In which patients should varenicline be used with caution?
Hx depression/ self harm
Renal impairment
Epilepsy
What is the first line intervention for smoking cessation in pregnancy?
CBT, motivational interviewing or structured self-help
+
support from NHS stop smoking services
Which smoking cessation medication is safe in pregnancy and breastfeeding?
Nicotine replacement therapy
(Bupropion + Varenicline contraindicated)
What is the mechanism of action of bupropion?
Norepinephrine + dopamine reuptake inhibitor
+
Nicotinic antagonist
How should Bupropion be initiated?
Start 1-2w before target stop date
review at 3-4w
Recommended course: 7-9w
