Smoking Cessation Flashcards
How often should you ask someone if they have considered quitting smoking?
At every opportunity- very brief advice should be given regarding risk and benefits of stopping smoking. Advise on the options for quitting smoking which include behavioral support, medication and e-cigarettes.
What should be done for all people who wish to stop smoking?
Refer to a stop smoking service. NHS stop smoking services are delivered by people with expert knowledge in supporting people planning to quit smoking- the can organise behavioural support and provide people with stop smoking treatments
What can be given to patients to help them stop smoking?
Counselling and behavioural support
Nicotine replacement therapy
Advice about e-cigarettes
NICE state that a combination of NRT and behavioural support may be the best option.
What is the addictive substance in tobacco?
Nicotine
How might you encourage a patient to attend a stop smoking service?
Stopping smoking might seem really daunting at first and it can be a difficult process as your body has got used to nicotine. Because of this there is a stop smoking service which I’d encourage you to attend, there experts can offer you fantastic advice on how to successfully quit smoking. They can organise behavioural therapy, counselling, advice on smoking alternatives and provide nicotine replacement therapy to reduce cravings to start smoking again.
What support options are available to people wanting to quit smoking?
Group support
Behavioral therapy
One-one support
Home visits
What happens at the first appointment when referred to a stop smoking service?
At the first appointment you’ll meet you specialist advisor who will often follow you through and support you as you quit smoking. They’ll work closely with you and support you throughout.
How much more likely to stop smoking are you if you attend a stop smoking service?
Four times more likely to successfully stop smoking than if doing it on your own
https://www.youtube.com/watch?v=qvfGT8dowcs
What can be done for people who do not want to be referred onto a Stop Smoking Service?
Provide sources of information
Offer nicotine replacement
Provide appropriate follow up
What should you advise someone who wants to quit smoking?
It’s a great decision for their health
The best option is to be put in touch with an NHS stop smoking service
A combination of behavioural support and drug treatments is the most effective
Group counselling is particularly effective
Set a date when you want to have quite by and commit to it
Write down why you want to stop smoking and keep this with you
Avoid being around smokers
What you should tell patients about withdrawal symptoms from quitting smoking?
Likely to be their worst in the first few days but then they will get better-
Write down why you’re stopping smoking and add to this or read it when you feel like smoking
What should people do to manage cravings?
Distract themselves- talk to family or friends Do something different Exercise Remember why you've quit Avoid being around other smokers
What should you tell patients who think the occasional cigarette is okay?
This is a bad idea and it is best to totally abstain- a single puff from a cigarette can really increase chances of returning to normal
What are some symptoms for nicotine withdrawal?
Cravings Headache Anxiety Stress Irritability Poor concentration Restlessness Increased appetite
What sources should you refer people onto who want to stop smoking?
Smokefree national helpline
NHS stop smoking service
NHS website
NHS Choices
What drug treatments may be offered for people quitting smoking?
Best results when offered in conjunction with behavioural therapy or group support sessions
Nicotine Replacement Therapy
Varenicline
Bupropion
What should NRT, Verencliline or Bupropion usually be prescribed in addition to?
A definitive stop smoking date
Prescription should be around 2 weeks for NRT, and 3-4 weeks for Varenicline or Bupropion. Further prescriptions should only be given if they demonstrate that their attempt to stop smoking is continuous.
What are some adverse effects of nicotine replacement therapy?
Nausea and vomiting
Headaches
Flu-like symptoms
Should NRT, varenicline or bupropion ever be given in combination?
No only use one agent
What are some examples of nicotine replacement therapy?
Gum
Patches
Spray
Lozenge
PAtches should be offered in combination with other forms for people with a high level of dependence and if single form inadequate in the past.
How does varenicline work?
Nicotinic receptor partial agonist
When should varenicline be started?
One week before the target quit date
What are some side effects of varenicline?
Nausea
Headache
Insomnia
Abnormal dreams
What is a relative contraindication to varenicline?
History of depression, suicide attempts or self harm
What is an absolute contraindication to varenicline?
Pregnancy or breastfeeding
How does bupropion work?
NA and dopamine re-uptake inhibitor, nicotinic antagonist
When should bupropion be started?
1-2 weeks before the stop date
What are some absolute contraindications to bupropion?
Pregnancy and breast feeding
Epilepsy
Eating disorder is a relative CI.
What should be done for all pregnant women according to NICE guidance?
Screened for smoking using a carbon monoxide monitor- as it can be difficult to admit smoking in pregnancy due to expectations not to smoke
Refer for behavioural support, CBT and NRT. Both bupropion and varenicline are contraindicated if pregnant or breastfeeding.
What should be advised to patients wanting to use e-cigarettes?
NHS stop smoking services use effective measures to help people stop smoking. The effectiveness and long term health effects of e-cigarettes are not known at present. They cannot be prescribed or provided by NHS stop smoking services.
Have to fund e cigarettes yourself but you can still access stop smoking services.
What can be used to measure smoking status?
Carbon monoxide breath test
10ppm or less suggests the person is a non-smoker
