Smoking Cessation

Question 1

What are the three main populations in which smoking rate are high?

Answer 1

a

Question 2

What is the dopamine reward pathway?

Answer 2

Activates nicotinic cholinergic receptors to release dopamine at prefrontal cortex

Question 3

What neurotransmitters influence the addictiveness of smoking?

Answer 3

Dopamine, ACh, Norepi, Serotonin, and glutamate

Question 4

What enzyme is responsible for most smoking related drug interactions?

Answer 4

CYP1A2

Question 5

Name some smoking related drug interactions.

Answer 5

1. Increase hepatic metabolism of some RX
2. Caffeine clearance increased in smokers by 56%
3. Hormonal contraceptives increases risk of health problems

Question 6

What are the 5 A’s?

Answer 6

1. Ask about tobacco use
2. Advise to quit
3. Assess readiness to quit
4. Assist w/ quitting
5. Arrange follow up

Question 7

List 4 exclusions for self-treatment w/ NRT.

Answer 7

1. Problems w/ blood or heart
2. Under 18 yrs old
3. Pregnant
4. Peptic ulcer disease

Question 8

What are 2 mental toughness techniques that could be helpful?

Answer 8

Behavior + Cognitive

Question 9

What are the nicotine replacement products available? Include dosage form and strengths.

Answer 9

Nicotine gum + lozenge (2mg and 4mg)

Question 10

What is the dosing schedule for NRT gum?

Answer 10

If first cigarette for the day <30 min after waking = 2mg

If >30 min = 4 mg

Wk 1 to 6: 1 piece every 1-2 hrs

Wk 7 to 9: 1 piece every 2-4 hrs

Wk 10 to 12: 1 piece every 4 to 8 hours

Question 11

How do you use NRT gum?

Answer 11

“Chew and park”

Chew until tingling, park between gums and cheeks until tingling stops, then repeat

Question 12

Are E-cigs FDA approved for smoking cessation?

Answer 12

Nope

Question 13

What does nicotine gum and lozenge contain to improve absorption?

Answer 13

Buffering agents (sodium carbonate + potassium bicarb)