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KCS: Theme 7 Communication > Smoking Cessation > Flashcards

Smoking Cessation Flashcards

1
Q

How was tobacco made popular?

A
  • Native Americans cultivated plant and smoked in pipes
  • Christopher Columbus brought back to Europe
  • popular in mid 16th century
  • American tobacco plantations/slave labour
  • unknown health effects
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2
Q

When did we find out tobacco was bad?

A
  • 1930 - statistical correlation with cancer
  • 1944 - American Cancer Society
  • talked about ‘ill effects of smoking’ but no definitive evidence
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3
Q

What was found in the Doctors Study of 1951-2001?

A
  • lung cancer and coronary thrombosis occurred markedly more often in smokers
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4
Q

How many smokers worldwide?

A

1.1 billion

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5
Q

…% of smokers are from low/middle income countries

A

80

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6
Q

Tobacco kills … people each year
… non-smokers are exposed to second hand smoke

A

6 million
600,000

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7
Q

In the UK in 1948, … % of men smoked.
What was the split between manufactured cigarettes and cigars/pipes?

A
  • 82
  • 65% cigs, 35% pipes
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8
Q

In 1948, what percentage of women smoked?
Did they smoke pipes?
What was the peak?

A
  • 41%
  • no
  • 45% in mid 1960s
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9
Q

What is the strongest link to smoking status?

A

socio-economic status

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10
Q

What is the success rate of someone quitting smoking ‘un-aided’?

A

4%

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11
Q

What is the success rate of someone quitting smoking with NHS specialist stop smoking services?

A

15%

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12
Q

How many smokers try to quit every year?

A

a third

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13
Q

How many smokers ‘relapse’ after quitting (4-52 weeks)?

A

70%

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14
Q

Medications for quitting

A
  • nicotine replacement therapy (NRT)
  • varenicline (Champix)
  • bupropion (Zyban)
  • mecamylamine
  • cystisine
  • nortriptyline
  • clonidine
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15
Q

Psychological support for quitters

A
  • behavioural support
  • one-to-one
  • group sessions
  • telephone services
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16
Q

How does nicotine replacement therapy work?

A
  • provides nicotine to user instead of from cigarettes
  • avoids toxins, carbon monoxide, tar
  • increases success chance by 50-70%
  • one product delivers half the nicotine a smoker would get
  • combination approach is best - patch is faster acting
17
Q

How does Champix work?

A
  • partial agonist acting on alpha4beta2 nicotinic receptor
  • reduces withdrawal and reduces ‘rewards’ of smoking
  • doubles success of quitting
18
Q

How does Zyban work?

A
  • reduces withdrawal symptoms and urges to smoke
  • by inhibiting neuronal uptake of dopamine and noradrenaline
  • by non-competively inhibiting nicotinic acetylecholine receptor
  • has effects on serotonin reuptake
19
Q

How can a doctor give brief smoking advice?

A
  • ask and record smoking status
  • advise on the best way to quit (combine medication and specialist support)
  • act on patient response (build confidence, give ingo, refer, prescribe)
20
Q

People are … times more likely to quit with support

A

4

21
Q

How often should people be asked if they smoke?

A
  • if they are a current, ex or non smoker
  • once a year
  • medical history updatedf
22
Q

Why do we no longer warn of dangers and simply support?

A
  • can raise defensive reaction and raise anxiety levels
  • takes time and can generate a convo about it which is more appropriate with a dedicated stop smoking consultation teeam
23
Q

Key oral issues caused by smoking

A
  • oral neoplasia
  • periodontitis
  • ANUG
  • oral mucosal disease
  • dental caries
  • dry sockets in wound healing
  • staining
  • halitosis
24
Q

Why does smoking contribute to periodontitis?

A
  • biggest risk factor
  • impairs vasculature and inflammatory response so immune impairment too
  • effects microbiota
  • in 50% of chronic cases, 2-8 times more, 5x tooth loss
25
Q

Dangers of smokeless tabacco

A
  • chewed/suceed across many South Asian communities
  • increased rates of oral and pancreatic cancer
26
Q

What are shisha pipes?

A
  • hookah, narghile, waterpipe, hubblebubble smoking
  • smoking tobacco through a bowl with hose/tube
  • tobacco sweetened with fruit or malasses sugar
  • contains same chemicals as tobacco smoke - carbon monoxide, nicotine, tar, heavy metals
27
Q

Why is shisha so dangerous?

A
  • same chemicals as tobacco - carbon monoxide, nicotine, tarm heavy metals
  • 1 hr session is 100 cigarettes
  • tobacco-free shisha still produces carbon monoxide and toxins from coal/charcoal
28
Q

Can e-cigs aid smoking cessation?

A
  • moderate-certainty evidence that EC’s with nicotine increase quit rates compared to NRTs
  • and compared to EC’s without nicotine
  • didn’t detect clear evidence of harms from nicotine EC but follow-up was 2 years
29
Q

Regarding vaping, advice for smokers

A
  • stop smoking completely
  • expert support and e-cig doubles chance of quitting successfully
30
Q

Regarding vaping, advice for people who vape nicotine

A
  • if still smoking, stop and switch completely to vaping
  • then come off nicotine when confident they’ll be no smoking relapse
31
Q

Regarding vaping, advice for those who’ve never smoked

A

don’t vape

32
Q

Regarding vaping, advice for those who vape CBD

A
  • should stop if have symptoms or concerns
  • less tightly regulated
33
Q

Regarding vaping, advice for those who vape THC

A
  • can be hazardous
  • if you feel unwell or have difficulties breathing, go to A and E and tell them exactly what you were using

KCS: Theme 7 Communication (3 decks)

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