Smoking Cessation Flashcards
Assessment process to determine when a patient is ready to make a lifestyle change
- Ask patient if they are ready to change behavior
- If No: Tell them that you are here if they ever change their mind
- If Yes: Proceed too number 2 - How do you think changing this behavior would benefit you?
- Give patients reasons why changing this behavior could be helpful - What would have to change for you to decide to change your lifestyle sooner
- This question probes patients’ perceptions about quitting and can reveal specific barriers to quitting that can be discussed and addressed.
How does Nicotine work?
- Nicotine stimulates the mesolimbic dopaminergic system in the midbrain, inducing pleasant or rewarding effects that promote continued use
- binds to the Alpha 4 Beta 2 nicotonic cholinergic receptors
What are withdrawl symptoms with regards to Nicotine?
(12) List 5
- intense cravings for nicotine
- tingling in the hands and feet
- sweating
- nausea and/or intestinal cramping
- headaches
- coughing, sore throat
- insomnia
- difficulty concentrating
- anxiety
- irritability
- depression
- weight gain
What are the 5 A’s for providing tobacco cessation?
- Ask about Tobacco Use
- Advise to quit
- Assess Readiness to Quit
- Assit with Quitting
- Arrange Follow-Up Counseling
What are the 5 R’s for a patient who is not ready to quit.
- Relevance
- Risks
- Rewards
- Roadblocks
- Repetition
What Strengths does Nicotine Gum come in?
2 mg and 4 mg strengths
How does the dosing work for Nicotine Gum?
The recommended dosage of nicotine gum is based on the “time to first cigarette” (TTFC) of the day. Having a strong desire or need to smoke soon after waking is viewed as a key indication of nicotine dependence
If the TTFC is 30 minutes or less – start with 4 mg gum
If the TTFC is more than 30 minutes – start with 2 mg gum
Weeks 1-6: 1 piece every 1-2 hours
Weeks 7-9: 1 piece every 2-4 hours
Weeks 10-12: 1 piece every 4-8 hours
What are some key things to know about Nicotine Gum replacement therapy.
Use proper chewing technique “chew and park”
People with TMJ disease should avoid using the nicotine gum. Consult with provider in patients with stomach ulcers or diabetes.
No acidic beverages (coffee, juices, wine)
Do not drink or eat anything 15 minutes before or while using nicotine gum
Do not use more than 24 pieces per day
What Strengths does Nicotine Lozenge come in?
2 mg and 4 mg strengths
What are some key things to know about Nicotine Lozenge replacement therapy.
- A nicotine lozenge delivers approximately 25% more nicotine than an equivalent dose of nicotine gum because of complete dissolution of the dosage form
- Do not use more than 20 lozenges per day
- Can cause mouth irratation, nausea, and hiccups
- Continuously using 1 lozenge after another can increase effects
How does the dosing work for Nicotine Lozenge?
The recommended dosage of lozenge gum is based on the “time to first cigarette” (TTFC) of the day. Having a strong desire or need to smoke soon after waking is viewed as a key indication of nicotine dependence
If the TTFC is 30 minutes or less – start with 4 mg lozenge
If the TTFC is more than 30 minutes – start with 2 mg lozenge
Weeks 1-6: 1 lozenge every 1-2 hours
Weeks 7-9: 1 lozenge every 2-4 hours
Weeks 10-12: 1 lozenge every 4-8 hours
How does Nicotine Transdermal Systems (Nicotine Patch) work?
Deliver continuous, low levels of nicotine through the skin over 24 hours
Dosing for Nicotine Transdermal Systems (Nicotine Patch)
- greater than 10 cigarettes/day:
a. 21 mg/day x 6 weeks
b. 14 mg/day x 2 weeks
c. 7 mg/day x 2 weeks - less than 10
a. 14mg x 6 weeks
b. 7 mg x 2 weeks
What are some side effects for Nicotine Transdermal Systems (Nicotine Patch)?
Possible side effects: local skin reactions, abnormal dreams, insomnia, and headache
How does Sustained-Release Bupropion help prevent smoking?
Blocking reuptake of dopamine and norepinephrine in the brain, decreasing the cravings for cigarettes and symptoms of nicotine withdrawal
