Smoking Cessation Flashcards

1
Q

What is the single largest cause of preventable disease & death in the US

A

smoking

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2
Q

What is the safest level of exposure to secondhand smoke

A

There is none

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3
Q

What are some of the health risks for smoking

A
  • lung cancer
  • colorectal & liver cancer
  • CVD
  • respiratory disease (COPD)
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4
Q

Describe some of the disparities regarding smoking

A

MC in
- native american populations
- low SES
- SW US
- LGBTQ
- male
- mental health concerns

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5
Q

When does most tobacco use begin

A

in adolescence

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6
Q

Describe one reason that E-cigarettes are bad

A

unregulated nicotine amounts, nicotine linked to many negative mental health effects

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7
Q

Describe the 5 A’s to treat tobacco use

A
  • ASK about use
  • ADVISE to quit
  • ASSESS willingness
  • ASSIST in a quit attempt
  • ARRANGE follow-up
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8
Q

What are some ways a provider can help assist in a smoking cessation attempt

A
  • help with withdrawal (irritability, anxiety, restlessness)
  • weight gain
  • depression
  • symptoms peak in first week and can last 2-4 weeks
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9
Q

Describe the types of medications that can be prescribed in smoking cessation

A

combo therapy is most effective
- nicotine patch
- nicotine gum
- nicotine lozenge
- nicotine inhaler
- nicotine nasal spray
- bupropion (zyban)
- varenicline (chantix)

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10
Q

Describe the FDA pregnancy drug classes

A
  • Category A: no risk in human studies
  • Category B: no risk in animal studies
  • Category C: risk in animal studies but not human studies
  • Category D: risk in in human studies but with some benefits
  • Category X: risk outweighs benefit
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11
Q

What FDA pregnancy drug class to most nicotine replacement therapies fit into

A

Class D: risk with some benefits still

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12
Q

What FDA pregnancy drug class do Bupropion and Chantix fit into

A

Category C: risk in animals but not humans

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13
Q

What special populations might Bupropion be cautioned or contraindicated in for smoking cessation

A

Mental Health
- Depression: chantix more effective than bupropion
- Schizophrenia: chantix more effective than bupropion & NRT
- Bipolar Disorder: NRT first line, AVOID bupropion as it may trigger mania

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14
Q

Describe the considerations in smoking cessation assistance in pregnancy

A
  • quitting reduces the risk of preterm birth, low birth weight, & infant mortality
  • NRT increases the risk of birth defects
  • intensive in person interventions should be offered
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15
Q

How many times does the average smoker attempt to quit before they are successful

A

4-5 times

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16
Q

Describe the USPSTF annual lung cancer screening guidelines

A
  • adults 50-80 with 20 pack year history
  • currently smoking or have quit in the last 15 years

(provide cessation counseling at every screening)

17
Q

Who is Bupropion contraindicated in for smoking cessation

A

Pts with a seizure history or eating disorder, abrupt cessation of alcohol, barbiturates, and benzos (lowers the seizure threshold)

18
Q

What is a risk associated with chantix for smoking cessation

A

increased risk of CV events in pts with cardiovascular disease - should be discussed with pts