Smoking Cessation Flashcards
What does a cigarette consist of?
Filler, filter, tobacco, additives, paper
Cig smoke contains > how many known carcinogens?
40
e.g. nicotine, tar, arsenic, hydrogen cyanide
What is the average amount of life lost by a smoker?
7.5 years
What cancer is related most to smoking? What other cancers are also related to smoking?
Lung
Upper resp, bladder, pancreas, oesophagus, kidney
What endocrine condition is associated with smoking?
T2DM
What MSK condition is associated with smoking?
Osteoporosis
What dermatological condition is associated with smoking?
Psoriasis
What ophthalmological condition is associated with smoking?
Macular degeneration
What GI conditions are associated with smoking?
Peptic ulcers
Crohn’s disease
What effects does smoking have on the unborn foetus?
1/3 increased risk of miscarriage, stillbirth, neonatal death
What is the effect of second hand smoke on children?
More likely to have - respiratory infections, bronchitis, bronchiolitis, pneumonia, cot death, otitis media
What are the health benefits of smoking cessation?
Live longer (7.5 years)
Reduces CV disease
Reduces risk of lung cancer (to only slighter higher than that of a non-smoker)
What laws were introduced to protect kids from passive smoking?
Can't sell to u18 Can't smoke in car with kids in it No proxy purchase No vending machines Standardised packaging - warning + pictures Ban on distinguishable flavours Smoking in public places band
What should patients trying to quit smoking be offered?
NRT (nicotine replacement therapy), varenicline or bupropion
Give prescription until 2 weeks after target stop date (2 weeks of NRT or 3-4 weeks of varenicline/bupropion)
If unsuccessful with NRT/varenicline/bupropion should you prescribe another course?
No not for 6 months unless special circumstances
What AEs are associated with NRT?
Nausea, vomiting
Headache
Flu like symptoms
What do NICE recommend for NRT?
Combination of nicotine patches and another form of NRT (gum, inhalator, lozenge, nasal spray) for those with a high dependence/failed single NRT before
What kind of drug is varenicline?
A nicotinic receptor partial agonist
When should you start varenicline?
1 week before target stop date
What is the recommended course of treatment of varenicline?
12 weeks
What are common AEs of varenicline?
Nausea
Headache
Insomnia
Abnormal dreams
Who should varenicline be used in caution in?
Those with hx of depression/self harm
When is varenicline CI?
Pregnancy
Breast feeding
Which of bupropion and varenicline is more effecitve?
Varenicline
What kind of drug is bupropion?
NE and dopamine reuptake inhibitor and nicotonic antagonist
What is there a small risk of when taking bupropion?
Seizures
When is bupropion CI?
Epilepsy
Pregnancy
Breast feeding
What did NICE recommend in 2010 about pregnant woman and smoking?
Test all pregnant women for smoking using CO detectors
All those who smoke/have stopped smoking in the last 2 weeks or those with a CO reading of 7ppm or above should be referred to NHS Stop Smoking Services
What is the first line smoking cessation treatment for pregnant women?
CBT, motivational interviewing, structured self-help and support from NHS Stop Smoking Services
Mixed evidence for NRT
