Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

BDS3 PMHP > Smoking Cessation > Flashcards

Smoking Cessation Flashcards

1
Q

smoking prevalence in adults

A

UK population
- 14.1%

Scotland
- 19% , roughly split sexes

Influence of deprivation
- 27% SIMD 1 v 9% SIMD 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

smoking prevalence in young people

A

Smoking rates for 13- and 15-year olds in Scotland currently very low.

Only 2% of 13-year olds and 7% of 15 year olds were regular smokers (< 1 cig/week)
- Different regular smoker definition in children

97% of 13-year olds and 88% of 15 year olds were non smokers

BUT 17% of children under 16 in Scotland report exposure to smoke in the home

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

tobacco control Scotland

A

Scotland very active
- Legislative and fiscal measures

Access to and supply of tobacco

  • Age of purchase: 16 to 18
  • Plain packaging of tobacco
  • Sale of tobacco not visible
  • Vending machines

Scotland aims to be tobacco free by 2034
- Chance if current trajectory continues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

access to and supply of tobacco in Scotland controls

A
  • Age of purchase: 16 to 18
  • Plain packaging of tobacco
  • Sale of tobacco not visible
  • Vending machines not anymore
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

dental role in smoking cessation

A

Tobacco has a profound effect on the mouth.

- Links with oral cancer, perio, implants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

3 levels of advice on quitting smoking

A

Very brief advice (VBA)
- 1 min - opportunistic

Brief advice

  • 3-10 min – engage at a slightly higher level
  • can include 5As

Detailed advice,

  • up to 30 min
  • with multiple sessions - -usually not time in dentistry
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

3As PHE

A
  1. ASK:
    establish and record smoking status
  2. ADVISE on personal benefits of quitting in light of findings in the mouth
  3. ACT:
    offer help and signpost to local stop smoking service

Smokefree and smiling helping dental patients to quit tobacco

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

5As brief

A

ASK your patient

ADVISE your patient

ASSESS your patient

ASSIST your patient

ARRANGE FOLLOW-UP for your patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

3As Scotland Dental (VBA)

A

Ask your patient about smoking

Advise your patient about smoking

Act by offering individualised help and referral to stop smoking services if appropriate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what to ASK

A

ASK about smoking status ( current, ex-, non)

  • Once a year, updated in notes
  • No of Cigs smoked per day
  • No of years a smoker
  • Age when started smoking
  • What products used ( cigs, cigars, rollups, smokeless)

Measurement of Lifetime exposure/ PACK YEARS

  • 1 pack (20) a day = 1 pack year
  • 10 cigarettes a day for 10 years = 5 pack years

Quitting history can be quite cyclical – find out where they are

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what to ask about Quitting history

A
  • Have you tried before?
  • How many attempts?
  • What helped you?
  • Are you interested now?
  • Would you be interested in getting further help and support?
  • If interested, proceed with advice and referral

can be quite cyclical – find out where they are

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how to work out pack years/measurement of lifetime exposure

A

need to know

  • No of Cigs smoked per day
  • No of years a smoker
1 pack (20) a day = 1 pack year
10 cigarettes a day for 10 years = 5 pack years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how to ACT (refer)

A

Depends on what is available locally re specialist services
- Quit your Way is the national branding

Pharmacy have greater reach, accessibility

Specialist services have greater success
- More experience

CONSIDER
- What patient wants
- Help/advice given, 
- Referral
Note outcome in patient’s record (important)
Refer Electronically
- NHS patients in GDH, for clinicians
Trakcare 
New request ( same as radiology)
Other
Smoking cessation services

No data yet about no of referrals/successful quits etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

oral side effects of tobacco (4 key)

A

Smoking causes many oral diseases including oral cancer, potentially malignant lesions
- smokers 2-4 times the risk of non-smokers

Smoking is a modifiable risk factor for periodontal disease
- relative risk for smokers 2-6 times that of non-smokers

Smoking increases dental treatment risks and problems
- Implants/extractions

Smokers have significantly greater medical risks, compromised health and more days of illness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

epidemiology and oral cancer

A

In the UK, in 2015-2017, there were 12,238 new cases of head and neck cancer

In Scotland, in 2016, there were 1,240 new cases

More men than women, though the ratio is decreasing

Links with deprivation

risk depends on age, genetics and exposure to risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

oral cancer aetiology

A

Tobacco and alcohol are main determinants
- if both are present, risks are synergistic.

a diet high in ACE vitamins thought to be protective.

sunlight

pre-existing mucosal abnormalities

HPV, younger age groups

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

potentially malignant lesions

A

Leukoplakia ‘defined as a white patch that cannot be rubbed off’
- Leukoplakia can occur 6x more frequently in smokers

Strong relationship between smoking and development of LK in floor of mouth
- Tobacco pools in bottom of mouth – thus more exposed

Malignant transformation rate varies (0.6-30%)
- Stop smoking may result in disappearance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

leukoplakia

A

‘defined as a white patch that cannot be rubbed off’

- Leukoplakia can occur 6x more frequently in smokers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

leukoplakia and smoking

A

Strong relationship between smoking and development of LK in floor of mouth
- Tobacco pools in bottom of mouth – thus more exposed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

erythroplakia

A

Patient has long history of chronic white and red lesions of soft palate

more likely for malignant transformation than white patches
- less common but more likely to be malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

smoking and periodontal disease

A

Smoking associated with increased rates of alveolar bone loss, attachment loss and pocket formation

40% of chronic periodontitis is attributable to smoking

Smoking demonstrates a dose-response with PDD, as shown by pack-years (1pack/day for a year = 1 pack year)

Has a masking effect on gingival symptoms of inflammation (bleed less)

Prevalence /severity of PDD in former smokers is less than current smokers

Treatment for PDD is more likely to succeed in non-smokers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

tobacco use and dental implants success

A

Failure rate of implants in smokers is at least 2x that in non-smokers

Implants more likely to fail in maxilla – not evenly distributed between maxilla and mandible

There is evidence that quitting, prior to implantation can improve success

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

smoking effect on gingival symptoms

A

masking effect (e.g. on bleeding)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

treatment for perio disease and smokers

A

treatment for PDD is more likely to succeed in non-smokers

25
smoking and prevalence of PDD
Smoking associated with increased rates of alveolar bone loss, attachment loss and pocket formation 40% of chronic periodontitis is attributable to smoking Smoking demonstrates a dose-response with PDD, as shown by pack-years (1pack/day for a year = 1 pack year)
26
affect of smoking cessation on PDD
Prevalence /severity of PDD in former smokers is less than current smokers
27
other tobacco related oral lesions (5)
Staining of teeth, dental restorations and dentures, halitosis Nicotinic stomatitis (smokers palate) Smokers melanosis (pigmentation) Black hairy tongue – stain papilla on tongue Apthae tend to be less common in smokers - When they quit more likely to get ROU need support to stay off smoking due to discomfort Extractions take longer to heal
28
impact on legislations being put in place and prevalence of smoking
prevalence of smoking reduced in relation to the legislations introduced to help reduce
29
why do people smoke? (7)
Enjoyment ++++ Keep weight down/appetite depressant ++ Help concentrate +++ Relieve boredom ++++ Socialise +++ Cope with stress ++++ And to avoid discomfort, and manage withdrawal symptoms +++++
30
withdrawal symptoms of smoking
Nicotine cravings Sweating nausea /abdominal cramps headaches coughing sore throat insomnia difficulty concentrating anxiety irritability depression weight gain tingling in hands/feet
31
level of withdrawal symptoms of smoking
how long and how many you smoked will affect severity
32
nicotine dependence
…..is a chronic relapsing disease defined as a compulsive craving to use the drug despite harmful consequences exhibits tolerance - frequent smoker will need to smoke more to get the same level of hit as new smoker
33
nicotine
C6H12N2 Addictive element in both tobacco and ecigs 90% of non-smokers and 75% of smokers in Great Britain believe that nicotine is harmful to health - a fundamental misconception that we have not change - it is the many other toxicants in cigarettes that cause disease and death harmful as it is the addictive element but doesn’t actually cause harm
34
smokeless tobacco
Number of products up to 30, not homogenous products, very different Health risks will vary, can have 100 times the TSNA (tobacco specific nitrosamines) than cigarettes - Higher the TSNA the more lethal In the UK, smokeless forms such as snus (Sweden) and Skoal Bandits (US) banned - Toombak is most lethal form of smokeless tobacco, from ethopia
35
snus and skoal bandits
illegal to sell in UK
36
snus
Snus (Swedish) is a moist powder tobacco - Placed under upper lip - can cause recession around upper centrals - less lethal than tobacco
37
skoal bandits
american Dipping tobacco, moist (look like teabags) Place in buccal sulcus by 6s or above incisors
38
shisha
Hookah operates by water filtration and direct heat - Number of cafes in Glasgow, particularly west end Scented tobacco is crumbled into the bowl Compared to a single cigarette, 45 min of water pipe use approx doubles CO and triples nicotine exposure (equivalent to 10 cigs) ``` Smoking hookahs poses many health risks - TB airborne transmission - Hepatitis A. - Helicobacter pylori - Pulmonary aspergillosis (pipe sharing) NOT a safe alternative type ```
39
shisha/hookahs health risks
- TB airborne transmission - Hepatitis A. - Helicobacter pylori - Pulmonary aspergillosis (pipe sharing) NOT a safe alternative type
40
pharmacotherapy options fir smoking cessation (4)
Nicotine replacement therapy - Patches, gum, inhalers, nasal spray, lozenges, microtabs, oral strips Varenicline (Champix) Bupropion (Zyban) - 5-10 years old Role of e cigarettes
41
examples of nicotine replacement therapy
Patches, Gum, Tabs, Lozenges, Nasal sprays, Inhalators, Oral films
42
effectiveness of nicotine replacement therapy
Increases likelihood of successful quit attempt All forms of NRT increase success of quitting, by 50-70% - No difference between types of NRT Up to patient preference No benefit after 8 weeks - Short term therapy – don’t want to become addicted to NRT Side effects - Skin irritation ( patch) - Oral irritation gum/tabs No evidence that NRT increases heart attacks.
43
Varenicline (Champix) Vs Bupropion (Zyban)
Varenicline 2-3 x increase chances of quitting compared to willpower alone Quit rates for Champix better than Zyban
44
Varenicline (Champix) stats
Varenicline 2-3 x increase chances of quitting compared to willpower alone - 25% increased chance of serious adverse effect - Lower dose, lower risk of adverse effects - Most reported side effect is nausea, mostly mild, wears off If on champix need to be monitored
45
E-cigarettes use
Not for non smokers Ex-current smoker, users Banned for under 18s Aid to quitting ( some evidence) Less toxic alternative to cigarette smoking (evidence) BUT Recent spate of deaths in US (2019), and respiratory symptoms - NO similar outbreak in the UK, E liquids carefully controlled. (linked to 1 brand) ECIGS SAFER THAN CIGARETTES BUT SAFETY IN LONGER TERM NOT KNOWN
46
what is vaping
Vaping is the act of inhaling and exhaling the water vapour produced by an electronic device E-liquid in gaseous form Looks like thick smoke but dissipates more quickly Smells better
47
what is in the liquid in ECigs? (4)
Propylene glycol (PG) - Thinner, more flavour, throat hit - In asthma inhalers Vegetable glycerine (VG) - Thicker, big clouds, smooth - Cough medicine Natural/ artificial flavourings Nicotine level, mg/ml / 0.0% - 0%, 1.5/0.15%, 3, 6, 12, 18 mg/ml Also quote the % of PG and VG. - Culture wyld75% VG 25% PG - Vaporised Coconut PG 65% VG 35%
48
vegetable glycerine (VG) in vape liquid
- Thicker, big clouds, smooth | - Cough medicine
49
propylene glycol (PG) in vape liquid
- Thinner, more flavour, throat hit | - In asthma inhalers
50
heavy smoker nicotine level in vape liquid
12-18mg/ml mg/ml / 0.0%
51
light smoker nicotine level in vape liquid
no higher than 6mg/ml
52
nicotine level in vape liquid
mg/ml / 0.0% 0%, 1.5/0.15%, 3, 6, 12, 18 mg/ml
53
second hand smoke
(Environmental Tobacco Smoke, ETS) Term for smoke that non smokers are exposed to Children’s exposure, cars, play areas - concern
54
mainstream smoke
most smokers inhales then exhales
55
sidestream smoke
wafts off the end of a lit cigarette 85% of smoke in room is sidestream contains more carcinogens
56
third hand smoke
is carcinogen laden residue that builds up on surfaces Walls slightly brown in smokers home
57
aim of dental team in smoking cessation
raise awareness and refer. Referral can be: - proactive, where the care giver sends the referral to the specialist services, who then contact the patient, - reactive, where the dental team member puts the onus on the person to contact, giving forms
58
what to find out from pt re smoking
Type of tobacco used – chewing, cigarettes, cigars etc For cigarettes - - No of Cigs smoked per day - No of years a smoker - When started smoking Can calculate PACK YEARS - 1 pack (20) a day = 1 pack year - 10 cigarettes a day for 10 years = 5 pack years Heaviness of smoking Index (HSI) – check on internet - How many cigs/day? - How quickly light up? Quitting History - Have you tried before? How many attempts? - What helped you? Are you interested now? - What’s motivating you now? Help/advice given, referral, outcome Write in notes

BDS3 PMHP (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions