Smoking cessation

Question 1

Ask and assess current level of smoking?

Answer 1

• Establish age of onset, amount and frequency of smoking.
• Establish whether patient has tried quit in the past
• Establish what caused them to stop and restart smoking
• ICE about smoking

Question 2

Advise to stop smoking

Answer 2

advantages - save money, better health
dangers - increased risk of lung cancer, cvd complications
never too late to stop

Question 3

Assists in stoping smoking

Answer 3

• cut down gradually
• referral to smoking clinic
• side effects of stopping smoking e.g. cravings, frustration
• identify how to stop temptation e.g. keeping busy
• help from fam and friends
• treatment - nicotine replacement patches lowers craving, nicotine lozenges, (NRT is a medication that provides you with a low level of nicotine, without the tar, carbon monoxide and other poisonous chemicals present in tobacco smoke.)

Question 4

What is the first line intervention of smoking cessation for pregnant women?

Answer 4

1) Cognitive behaviour therapy, motivational interviewing or referral to NHS Stop Smoking services
2) Nicotine replacement therapy as nicotine patches, prescribe for only 2 weeks till target stop date.

Question 5

What are the adverse effects of nicotine replacement therapy NRT?

Answer 5

• adverse effects include nausea & vomiting, headaches and flu-like symptoms
• Recommended to use combination of nicotine patches and another form of NRT e.g. gum, inhaler, lozenge or nasal spray who have high dependence on nicotine

Question 6

What treatment therapies for smoking cessation are CI in pregnancy (2)?

Answer 6

• varenicline

- bupropion

Question 7

What are the treatment therapies available for smoking cessation?

Answer 7

• NRT
• Varenicline
• Bupropion

Question 8

What is the CI for bupropion?

Answer 8

epilepsy as can cause seizures, pregnancy, breast feeding.

Question 9

What is the CI of varenicline?

Answer 9

pregnancy and breast feeding.

Question 10

What is the investigation to identify mothers who smoke during pregnancy?

Answer 10

Carbon monoxide tests are routine tests to identify mothers who smoke during pregnancy, as many pregnant women may not declare that they smoke for various reasons. In this scenario, the mother has presented to the GP about her smoking problem so there is no reason to perform this test.