Smoking Cessation Flashcards
What is the number one preventable cause of death in America?
smoking
Tobacco cessation intervention is cost effective relative to what 2 comparisons?
- other preventive interventions
2. costs incurred from medical treatments for conditions caused by smoking
How long does a smoking cessation intervention have to be to be broadly effective?
Brief < 3 min
On average, how many years of life do tobacco quitters gain?
11 to 12 years of life
What are the 5 A’s of tobacco intervention from the clinical practice guidelines?
Ask - about use Advise - to quit Assess - willingness Assist - in quitting Arrange - for follow up
What are the 4 elements of a quit plan? (STAR)
S - set a quit date
T- tell others
A- anticipate challenges
R - remove products and paraphernalia
How do you build motivation to quit? (5 Rs)
relevance, risks, rewards, roadblocks and repetition
what are 3 things you can do to tailor treatments to difficult to treat smokers?
Flexible quit date that encourages smoking reduction as an initial goal
Treatment sampling and practice quit attempts
Supplement standard behavioral counseling with mood management counseling
What are the 3 most common types of medications for smoking cessation?
nicotine replacement therapy (of which there are 5 types)
varenicline
bupropion
What intervention can double or triple quit rates?
pharmacotherapy
Pharmacotherapy for smoking cessation should not be combined, true or false
false - combinatorial therapy has the best results
Most smokers don’t want to quit, true or false
false - most do. On average 67.4 5 are interested in quitting and 55.4% have made a past-year quit attempt
Physician intervention on smoking is effective, true or false
True! but screening and assistance is under utilized by physicians
Physician intervention on smoking is not dose responsive, true or false
false - the more you intervene the more successful you are, and quitting is beneficial at any age
What are some flexible options for cessation?
smoking reduction
flexible quit date or preloading approach
treatment sampling/”Practice” attempts
managing negative mood
What is the mechanism of buproprion?
blocks reuptake of dopamine and or norepinephrine
** not safe in seizure patients
What are common bothersome side effects of smoking cessation pharmacotherapy?
- doesn’t work
- trades addictions
- cause cancer
- cause rashes
- increased heart attack risk
- insomnia
- nausea
- expensive
Insomnia - just don’t use it at night and make sure to put it on in the morning
Nausea - verenicline
dry mouth - bupropion
What is the mechanism of varenicline for smoking cessation?
alpha4beta2 agonist/antagonist of nicotinic acetylcholine receptor
Do any of the smoking cessation drugs have black box warnings for suicidal ideation?
NO! it’s been removed
Which trial showed that varenicline does not increase risk of suicide?
EAGLES trial compared varenicline, bupropion, patch and placebo, found 1;1;1;1 risk
What is the most effective drug out of the drugs available for smoking cessation?
varenicline
or combination NRT are the two best options
