Smoking cessation Flashcards
The effects of smoking on individuals
- Increases morbidity and mortality
- Increases risk of 15 types of cancer
- Increases risk of CVD
- Increases risk of respiratory disease
What is the difference between morbidity and mortality?
Morbidity: state of disease within a population OR unhealthy state of an individual.
Mortality: state of death within a population OR of an individual
DESCRIBE three main components in a cigarette
- Tar: contains carcinogens, causes narrowing of bronchioles, decrease activity of cilia and increase mucus secretion
- CO: Bind to Hb 200x more than O2
- Nicotine: disrupt brain activity, increase HR BP, increases calories burned, fertility problems.
Which component is addictive
Nicotine as it disrupts normal NT activity
Effect of smoking on public
- Passive smoking
- Children are vunerable
Benefits of smoking cessation
Smoking withdrawal symptoms
- Craving
- Cough
- Increased apetite
- Tired
- Lack of concentration
- Decreased HR
- Anxiety
- Mood swings
NICE guidelines for smoking cessation
Behavioural support – group and individual
Face to face meetings with counsellor alone or with group
Weekly meetings for at least 4 weeks after quit date
Combined with pharmacotherapy
Nicotine replacement therapy (NRT)
Bupropion
Varenicline
Very brief advice
When confronted with the urge to smoke: 5 D’S
Name some nicotine replacememt therapies
Sublingual tablets
Lozenge
Gum
Nasal spray
Patches
Inhalator
Quick mist mouth spray
Name POM for smoking cessation and dosing
- Buproprion (Zyban®): anti depressant, prolonged release tabs,
- Day 1-6 150mg OD, Day 7 onwards 150mg BD
- Varenicline (Champix®): only prescribed with behavioural support, a nicotine partial agonist
- Days 1 – 3: 0.5mg once daily
- Days 4 – 7: 0.5mg twice a day
- Days 8 – 12 weeks: 1mg twice a day
What Q’s should you ask when choosinh NRT
The number of cigarettes smoked per day
The time to 1st cigarette of the day
The speed at which nicotine is delivered from the NRT formulation
Ease of use
The importance of behavioural replacement
Ability to adjust and titrate the dose
Local irritant effects
Counselling for NRT
NRT is not a magic cure but does help you to cope with withdrawal symptoms
They do not deliver as much nicotine as cigarettes
You still need a lot of commitment to stop smoking permanently
After 1-2 months you can commence to taper off the medication
You must not smoke even one puff while using the medication
Use of e-cigs as intervention
- Electronic cigarettes resemble cigarettes and deliver nicotine to the use via inhalation
- In June 2013, the MHRA decided that all unlicensed nicotine-containing products (NCPs) are to be regulated as over-the-counter medicines to ensure public confidence in the safety and quality of these products
