Tobacco Flashcards
What is the single biggest cause of preventable morbidity and mortality in the NHS?
Tobacco related disease.
What diseases are associated with smoking?
Cardiovascular disease: MI and stroke, Lung cancer. Infantile sudden death. Influenza. Basically everything.
What is cigarette smoking?
A chronic relapsing disorder that starts in adolescence. The nicotine causes the addiction not the harm of the tobacco.
What are the markers for addiction?
- Use despite knowledge of harmful consequences.
- Craving during abstinence.
- Failure of attempts to stop.
- Withdrawal symptoms during abstinence.
What is the physiology of nicotine?
Nicotine acts on nicotinic acetylcholine receptor stimulating dopamine release.
Creates satisfaction.
Following chronic nicotine exposure, ACh enters the unregulated state which increases the affinity and functional sensitivity to an agonist.
How long does it take for ACh receptors to desensitise after the last cigarette?
6-12 weeks.
How can you help patients to stop smoking?
- Ask: smoker/non-smoker.
- Advice.
- Act.
How can you treat a smoking addiction?
- Champix: ACh agonist to decrease desire to smoke.
- Nicorette gum.
- Spray.
What is a harm reduction strategy for smoking?
E-cigarettes. Decrease smoking with continuous nicotine use.
What re the different types of nicotine devices?
- First Generation: looks like a cigarette.
- Second Generation: pen like.
- Third Generation: power steering.
- Fourth Generation: heat not burn.
What are the advantages of using an e-cigarette?
- Nicotine is a minor health risk.
- Negligible compared to tobacco.
- Allows patients to ease off smoking and eventually quit.
What are the disadvantages of using an e-cigarette?
- Continues to use nicotine.
- Long term effects unknown.
- Dual use perpetuates smoking.
