Smoking Cessation Lecture Powerpoint

Question 1

Leading preventable cause of death

Answer 1

Smoking

Question 2

Nicotine

Answer 2

Primary drug in cigarettes that causes addiction, raises heart rate and blood pressure thru causing swelling of cells lining veins and arteries reducing blood flow, harmful to developing brains

Question 3

Leading cancer resulting in death is ___, nearly 9-10 of them are caused by ____

Answer 3

lung cancer, smoking

Question 4

Smoking increases atherosclerotic disease because it…

Answer 4

….initiates the initial inflammatory response that results in foam cell activity

Question 5

Abdominal aortic aneurysm is associated with…

Answer 5

….smoking history of any kind

Question 6

Nicotine on a mg/mg basis is ___x more potent as heroin and has similar withdrawal rates to it

Answer 6

10x

Question 7

Mesolimbic dopaminergic system

Answer 7

Motivational behavior/reward system of the brain that is directly stimulated from dopamine release reward pathway

Question 8

Physiologic neurotransmitters released from smoking (6)

Answer 8

• Norepi
• B endorphin
• Acetylcholine
• serotonin
• glutamate
• vasopressin

Question 9

Components in stopping smoking (4)

Answer 9

• Patient motivation
• Physician interest
• Medications
• Support systems

Question 10

“The right moment” for smoking cessation

Answer 10

Idea that confronting smoking as a provider is most effective when a patient is suffering a significant medical event directly caused by their smooking

Question 11

PA role in smoking cessation (5)

Answer 11

• Admit nicotine is an addiction
• provide info
• show interest
• train office personnel
• select the opportunity

Question 12

The 5 A’s of smoking cessation

Answer 12

Ask
Advise
Assess
Assist
Arrange

Question 13

Stages of change (4)

Answer 13

Precontemplation: not seriously considering quitting smoking (provide info)
Contemplation: seriously considering stopping smoking within 3-6 months (talk about if they want to what steps they take)
Preparation: Seriously considering stopping within next week to month (have to make a plan to do it)
Action: has recently stopped smoking within last 6 months (encourage to prevent relapse)

Question 14

Average weight gain 1 year after quitting smoking

Answer 14

6 lbs

Question 15

Planning a smoking quitting program (6)

Answer 15

• Establish degree of nicotine dependency (either serum cotinine level or fagerstrom test)
• Establish a quit date
• Create a support group
• Establish behavioral modification
• Discuss relapse and weight gain
• Nicotine replacement (typically sustained initially alongside buproprion)

Question 16

Buproprion for smoking cessation

Answer 16

Anti depressant seen to significantly decrease withdrawal symptoms in a person quitting tobacco

Question 17

Chantix (varenicline tartrate) for smoking cessation

Answer 17

Non nicotine pill that acts as a nicotine receptor partial agonist that causes nicotine to which smoking is absolutely contraindicated upon max dose being achieved (corresponding to quit date), causes severe side effects from residual or any other nicotine, can cause suicidal ideation or rage (cannot operate heavy machinery)

Question 18

Low dependency nicotine addiction treatment

Answer 18

Nicotine replacement

Question 19

High dependency nicotine addiction treatment

Answer 19

Bupropion + nicotine replacement

Question 20

Advantages and disadvantages of nicotine gum

Answer 20

+more rapid
+adjunct
-heartburn or indigestion
-throat and mouth irritation

Question 21

Advantages and disadvantages of nicotine patch

Answer 21

+convenient
+best compliance
-skin irritation
-available over the counter

Question 22

Advantages and disadvantages of nicotine nasal spray

Answer 22

+fast acting

• irritation
• low compliance

Question 23

Advantages and disadvantages of nicotine inhaler

Answer 23

+simulates smooking

• low compliance
• less nicotine delivery