Smoking Cessation

Question 1

• Cigarette smoking remains the greatest

single cause of

Answer 1

preventable illness and

premature death

Question 2

In the United States, smoking kills more

Answer 2

n 443,000 adults each year; this is

about 1 of every 5 deaths

Question 3

“5 A’s” Model for Treating

Tobacco Use and Dependence

Answer 3

• Ask (screen all patients for tobacco use)
• Advise tobacco users to quit
• Assess willingness to make a quit attempt
• Assist with quitting (offer medication and
provide or refer to counseling)
• Arrange follow-up contacts, beginning
within the first week after the quit date

Question 4

Initial Therapy Selection - First line

Answer 4

nicotine replacement therapy,

varenicline, and bupropion

Question 5

Initial Therapy Selection - AIM

Answer 5

reduce symptoms of nicotine

withdrawal

Question 6

Initial Therapy Selection

- choices based on

Answer 6

patient preference with

some contraindications to certain drugs

Question 7

Initial Therapy Selection - Most recommended

Answer 7

varenicline or a

combination of 2 NRT products

Question 8

gum doubles

Answer 8

the cessation success rate

Question 9

gum ADR

Answer 9

Mouth and throat
soreness, jaw muscle ache, eructation
(belching), and hiccups

Question 10

gum use

Answer 10

Chew the gum slowly and intermittently for

about 30 minutes

Question 11

gum education - avoid

Answer 11

Avoid eating or drinking while chewing and

for 15 minutes before chewing

Question 12

Nicotine Lozenges ADR

Answer 12

Adverse effects: Mouth irritation,

dyspepsia, nausea, and hiccups

Question 13

Nicotine Lozenges use

Answer 13

Allow lozenge to dissolve in mouth over 20

to 30 minutes

Question 14

Nicotine Lozenges no eating or drinking for

Answer 14

• No eating or drinking for 15 minutes before
dosing and while the lozenge is in the
mouth

Question 15

Nicotine Lozenges do not

Answer 15

chew or swallow the lozenge

Question 16

NicoDerm CQ and Nicotrol ADR

Answer 16

Adverse effects: Short-lived erythema,

itching, and burning occur under the patch

Question 17

NicoDerm CQ and Nicotrol applied

Answer 17

Applied once a day to clean, dry, nonhairy

skin of the upper body or upper arm

Question 18

NicoDerm CQ and Nicotrol application site

Answer 18

Application site should be changed daily

and not reused for at least 1 week

Question 19

Nicotine Inhaler ADR

Answer 19

Adverse effects: Dyspepsia, coughing,

throat irritation, oral burning, and rhinitis

Question 20

Nicotine Inhaler frequent puffing over

Answer 20

20 min

Question 21

Nicotine Inhaler should not be used with

Answer 21

patients with

asthma

Question 22

Nicotine Nasal Spray ADR

Answer 22

• Adverse effects: Rhinitis, sneezing,
coughing, watering eyes, and nasal and
throat irritation

Question 23

Nicotine Nasal Spray levels

Answer 23

rise rapidly

Question 24

Nicotine Nasal Spray provides some of the

Answer 24

subjective

pleasure associated with cigarettes

Question 25

Bupropion SR [Zyban,

Buproban] class

Answer 25

atypical antidepressant

Question 26

Bupropion SR [Zyban,

Buproban] reduces

Answer 26

Reduces the urge to smoke and some
symptoms of nicotine withdrawal, such as
irritability and anxiety

Question 27

Bupropion SR [Zyban,

Buproban] adr

Answer 27

Dry mouth and insomnia

Question 28

Bupropion SR [Zyban,

Buproban] less effect than

Answer 28

combination NRT or

varenciline

Question 29

Varenicline [Chantix, Champix] is a

Answer 29

• Partial agonist at nicotinic receptors

Question 30

Varenicline [Chantix, Champix] most effective

Answer 30

Most effective aid for smoking cessation

Question 31

Varenicline [Chantix, Champix] class

Answer 31

Atypical antidepressant

Question 32

Varenicline [Chantix, Champix] ADR

Answer 32

Adverse effects: Nausea, sleep disturbances,

headaches, abnormal dreams, constipation, dry m

Question 33

Varenicline [Chantix, Champix] serious

Answer 33

• Serious neuropsychiatric effects

Question 34

Varenicline [Chantix, Champix] can have

Answer 34

Cardiovascular events

Question 35

Varenicline [Chantix, Champix] us athorits have banned

Answer 35

U.S. authorities have banned the use of varenicline by
truck drivers, bus drivers, airplane pilots, and air traffic
controllers

Question 36

Products Not Recommended

Answer 36

• Naltrexone
• Silver acetate
• Beta blockers
• Benzodiazepines
• Antidepressants other than bupropion SR
and nortriptyline
• Electronic cigarettes (e-cigarettes)

Question 37

Follow-up

Answer 37

• Follow-up in-person or by phone in 1 to 2
weeks after initiation of any therapy to
monitor for adverse effects, reinforce
adherence to medication, and provide
support