Tobacco Flashcards
Benefits of smoking cessation?
These begin as soon as smoking is ceased.
Increase in life expectancy in conditions such as lung cancer, COPD, CHD
If pregnant and stop smoking in the first 3 months, harmful effects are minimal to the fetus
In 24 hrs, CO and nicotine are eliminated from the body.
Withdrawal Symptoms?
Irritability/aggression, depression, restlessness, poor concentration, increased appetite, light-headedness, disturbed sleep, nicotine cravings, weight gain
VBA on smoking
How to assess dependence on tobacco?
Less than 30 seconds
Ask about current and past smoking
Verbal and written information on risks and benefits
Advise on quitting - behavioural support, medication, e-cigarettes
Refer to local stop smoking service
Can assess dependence by asking:
- How many cigarettes per day?
- How long after they wake up they smoke their first cigarette?
Practical Advice?
Pharmacological Management ?
Follow up ?
Set a quite date, cravings can be set off by stress, drinking or seeing others smoke. Distraction strategies lie exercise or changing environment. Abrupt cessation rather than ‘puff’ rule.
NHS Stop Smoking service can offer behavioural support, advice, vouches for stopping smoking.
NRT - offered as patches for 16hrs/24hrs
Varenicline - started 7-14 days before quit date
Bupropion - started 7-14 days before quit date
2 weeks after NRT, 3-4 weeks after V or B. Measure CO 4 weeks after last smoking. Give advice on withdrawal symptoms and maintaining cessation
Harm reduction
Used if the patient is not ready to stop smoking.
Use of NRT in conjunction with smoking reduction may be offered. Nicotine dose will be high enough so it is not necessary to smoke.
Suggest e-cigarettes - don’t burn tobacco and produce tar or CO. Not completely risk free as the liquid and vapour can have harmful chemicals, but is better than smoking.
Delve into reasons for smoking, triggers, behaviours, previous attempts to quit.
