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Block 2; Week 6 > Smoking Cessation > Flashcards

Smoking Cessation Flashcards

1
Q

What is the number one preventable cause of death?

A

smoking

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2
Q

According to the biopsychosocial model…why is it hard to quit smoking? Focus: Biological

A

Biological: nicotine is addictive

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3
Q

According to the biopsychosocial model->why is it hard to quit smoking? Focus: Psycholgical

A

Psychological:
Smoking paired w/ many activities in the day…vs. a drug that is taken once a day
individuals w/ mental health issues more likely to smoke–used as a coping mechanism for their stressful mental illness

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4
Q

According to the biopsychosocial model->why is it hard to quit smoking? Focus: Social

A

Social:
peer smoking
growing up around smokers
**most smokers begin in adolescence, not in older adulthood.

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5
Q

T/F Most smokers actually want to quit.

A

True. 70% want to quit.

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6
Q

44% of smokers _________ & _______ of them succeed.

A

try to quit smoking each year

3-7% succeed

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7
Q

What’s the good news for a patient who has relapsed?

A

66% of the patients who have relapsed in their efforts to quit smoking try again within 30 days.

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8
Q

What’s the good news for physicians with patients who smoke & who are insecure & want their patients to love them?

A
  • *patients whose docs help them quit smoking are more satisfied with their health care.
  • *physicians are a strong motivator for patients to quit smoking.
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9
Q

About what percentage of Americans use tobacco?

A

20%

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10
Q

What has been the trend in smoking, & in the proportion of smokers to former smokers from the 1960s to now? What has caused this trend?

A

Fewer smokers now: 44% to 20% of pop.
1960s: more smokers than former smokers
Now: more former smokers than current smokers
**Good trend: changes in public policy, advertising restrictions, knowledge of health effects.

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11
Q

In which populations is there still a high proportion of smokers?

A

Low SES
Low Education
Minority Populations
Mentally Ill

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12
Q

What are the reasons for why racial minorities are more likely to smoke?

A

more exposure to smoking advertisements
less access to treatments
use treatments less when available
Thus, have lower success rates of quitting.

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13
Q

What are the reasons for why HIV positive patients are more likely to smoke?

A

B/c of HIV they have high morality rates & low quality of life sometimes…
With all of these issues–they think what difference can smoking really make…
Smoking helps them cope with their difficult illness
**note this also applies to other chronic, terminal illnesses

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14
Q

What are the reasons for why LGBT people are more likely to smoke?

A

more targeted by tobacco companies
higher daily stress that they need to cope w/ b/c of prejudice & stigma
**tend to socialize in bars, area where smoking is permitted

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15
Q

What are the reasons for why people of a low SES are more likely to smoke?

A

more targeted by tobacco companies
less access to treatment
misinformation about smoking treatment
higher exposures to workplace smoking

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16
Q

Why do people with mental illnesses often smoke?

A

coping mechanism for the stress of their illness
underestimate the detrimental effects of smoking compared to their illness…
**particular issue w/ quitting: when they get rid of their coping mechanism they may not have another–their psychiatric symptoms could therefore worsen.

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17
Q

Why are hospitalized patients less likely to smoke?

A

motivation to quit smoking, esp. if they are in the hospital b/c of their habit
hospitals are a smoke free environment

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18
Q

How can you tell if someone uses tobacco?

A

see the signs: staining of fingers or teeth, smell it on their clothes, see them smoking
most importantly: ASK!

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19
Q

How can you tell how serious someone’s tobacco use is?

A

how many packs per day
chest exam
**Trick Q: any amount of smoking could be lethal in the long run.

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20
Q

What is the Fagelstrom Tolerance Test?

A

A test that asks questions about cravings for cigarettes & amount of cigs used per day…
Shows withdrawal & craving level…
A measure of how hard it will be to help this patient quit smoking.

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21
Q

What is the CO monitor & why is it an awesome tool to help people quit smoking?

A

It monitors the amount of CO in your breath, highly correlated to your hemoglobin that is bound w/ CO.
This can help people to view the initial severity of their condition & then see the decline in CO levels as they quit.

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22
Q

How much CO by volume is in a typical puff of a cigarette?

A

5% by volume

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23
Q

What binds preferentially to hemoglobin? Oxygen or CO?

A

CO!!!!

**fetal blood binds it even more preferentially than adults!

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24
Q

What are the 3 main symptoms of high %COHb & what is the primary risk?

A 
3 main symptoms:
headache
fatigue
breathlessness
Higher Risk:
for blood clots
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25
Q

How many cigarettes are in a pack?

A

20

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26
Q

Do a lot of people usu agree to use the CO monitor?

A

YEAH! 100% of the psychologist’s patients…

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27
Q

What is the half life of %COHb?

A

4-6 hours

28
Q

How long should you wait after smoking a cigarette before you use the CO monitor?

A

10 minutes.

29
Q

How long should you hold your breath before blowing into the CO monitor?

A

20 seconds

30
Q

T/F A cigar or a pipe will produce lower readings on the CO monitor than a cigarette.

A

False.

The cigars & pipes have higher readings.

31
Q

What are 2 reasons why reducing your number of cigarettes per day by half won’t decrease your CO levels by half?

A
  1. Compensatory Smoking: you have a higher craving so you hold the smoke in your mouth longer, delivering more nicotine etc.
  2. Environmental Contaminants.
32
Q

What are the 6 stages of change?

A 
Precontemplation
Contemplation
Preparation
Action
Maintenance
Lapse/Relapse
33
Q

About how many times on average does a person attempt to quit before it sticks?

A

7

34
Q

T/F The more times a person attempts to quit smoking, the more likely they will be to succeed.

A

True. This is good news!!!

35
Q

What stage is someone who wants to quit smoking in?

A

precontemplation/contemplation

36
Q

A person who is setting a quit date & researching nicotine patches is in which stage?

A

Preparation

37
Q

A person who is 3 days in to their quitting…is in what stage?

A

Action

38
Q

A person who has not smoked for a year & is continually doing things to keep up their good habits is in which stage?

A

Maintenance

39
Q

What is the difference b/w a lapse & a relapse?

A

Lapse: “I smoked 2 cigarettes yesterday, doctor.”
Relapse: “I’m not trying to quit anymore…I’m back to a pack a day.”

40
Q

What is the Abstinence Violation Effect?

A

When you are trying to completely abstain from something & then you don’t succeed–>you feel awful about yourself. You feel defeated. **But don’t worry–>you can still do it!
Go back to pre contemplation!!

41
Q

According to the biopsychosocial model…what are biological ways to help a person quit smoking?

A

medications

42
Q

According to the biopsychosocial model…what are psychological ways to help a person quit smoking?

A

motivational interviewing
triggers/alternative responses
aversion therapy
relapse prevention

43
Q

According to the biopsychosocial model…what are social ways to help a person quit smoking?

A

support of friends & family
increased contact w/ non-smokers
try to control your social environment

44
Q

What are the 3 main medication options?

A

Nicotine Replacement
Buproprion (Zyban, Wellbutrin)
Varenicline (Chantix)

45
Q

What is the safest options for meds?

A

Nicotine Replacement…the fewest amount of side effects b/c they are already on nicotine replacement!!

46
Q

What are the 4 general types of nicotine replacement meds? What do they do for the patient?

A 
Patches
Lozenges
Gum
Inhaler
**reduces cravings & withdrawal symptoms
47
Q

What is the most dangerous med to use? What is its main side effect?

A

Varenicline (Chantix)

Main side effect: aggression

48
Q

What does Buproprion do? What are the other 2 names for this med?

A

Zyban
Wellbutrin
**reduces cravings & withdrawal symptoms
**start taking this med 1-2 weeks before quit date

49
Q

What does Varenicline do? What is the other name for this med?

A

Chantix
blocks nicotine receptors
reduces urge to smoke b/c makes it less enjoyable
**start taking 1 week before the quit date

50
Q

What are the stats on whether or not taking meds helps a person quit smoking?

A

If a person takes meds while they are trying to quit smoking, they are twice as likely to succeed.

51
Q

What is the most statistically effective way to quit smoking?

A

Meds + Intense Counseling (8 or more sessions)

52
Q

What’s the deal w/ nicotine replacement therapy–we know it can be abused–>does that make it bad?

A

NO

  • *people who use it even 5 years after quitting smoking have improved their health
  • *people who use it while smoking are more likely to quit in the next year
53
Q

What treatment therapy option has success rates of 60-70%?

A

Rapid Smoking Therapy

54
Q

What is the process of rapid smoking therapy?

A

rapid inhaling, every 6 seconds until you want to vomit
wait 5 minutes & write down what you feel
do the same thing again
Don’t smoke until the next session the next day.
Repeat for at least 12 sessions.

55
Q

What is the less aversive form of rapid smoking therapy?

A

Hold the smoke in your mouth until it tastes gross.

56
Q

What is the order of the ideal 8 session behavior therapy plan?

A

1: motivation
2: identify triggers
3: create an action plan
4: set a quit date
5: implement the action plan
6: 1st follow up: relapse prevention
7: 2nd follow up: prevent weight gain
8: 3rd follow up: become more physically active

57
Q

Why is becoming more physically active a part of the smoke quitting plan?

A
  • *helps prevent weight gain from smoking cessation
  • *helps reinforce the benefits of smoking cessation & reminds of the issues w/ smoking
  • *creates an image for the patient of being healthy
58
Q

On average how many years of life could you gain if you quit smoking?

A

7 years

59
Q

What are some ways to increase the motivation to quit smoking?

A 
Express empathy
Develop discrepancy b/w values & actions
Roll w/ resistance
Support self efficacy
Goal--get them to express change talk.
60
Q

What is the decisional box worksheet activity?

A

Have the patient fill out reasons to maintain their smoking behavior & reasons why they should quit smoking…help them with a few ideas
Have them take the list home to their family & have them add reasons
**End w/ reasons to change.

61
Q

How long does a typical craving last?

A

Less than 5 minutes

62
Q

T/F There is a strong dose-response relationship b/w counseling intensity & quitting success.

A

True.

63
Q

Are E-cigs safe? Should you recommend them? If your patient is set on using them–should you support them?

A

Not proven to be safe yet.
Shouldn’t recommend them over NRT.
If patient is set on it, encourage them. Just emphasize–not a longterm solution.

64
Q

What’s good about E-cigs? What’s bad about them?

A
  • *NO CO

* *more nicotine delivered directly to the lungs.

65
Q

T/F the most effective therapy focuses on the negative aspects of smoking…

A

False. Most effective therapy focuses on the positive.

Block 2; Week 6 (4 decks)

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