Tobacco abuse across the lifespan

Question 1

What does smoking increase the risk of?

Answer 1

Diminished overall health
Increased absenteeism from work
Increased health care utilization

Question 2

On average how many years do smokers die earlier than non-smokers?

Answer 2

10 years

Question 3

What are the cardiovascular health effects from cigarette smoking?

Answer 3

Narrowed vessels
Increased BP, HR, and clot formation

Question 4

What are the respiratory health effects from cigarette smoking?

Answer 4

Damages the airways and small air sacs

Question 5

What is the important statistic about smoking and cancer?

Answer 5

If nobody smoked 1 out of 3 cancer deaths in US would NOT happen

Question 6

How can cigarette smoke effect fertility?

Answer 6

There can be infertility issues
*Harder for women to become pregnant
*Affects men’s sperm count
*impact to infant (preterm birth, still birth, etc)

Question 7

How can cigarette smoke effect bone health?

Answer 7

Women past childbearing age at a greater risk of osteopenia and osteoporosis

Question 8

How can cigarette smoke effect oral health?

Answer 8

Cause tooth loss, tooth decay, gum disease

Question 9

How can cigarette smoke effect skin health?

Answer 9

cosmetic issues like increased wrinkles
Poor wound healing

Question 10

How can cigarette smoke effect the body’s immune system?

Answer 10

Inflammation and decreased immune function

Question 11

How can cigarette smoke affect vision?

Answer 11

Increases risk for cataracts
Increased age related macular degeneration

Question 12

How can cigarette smoke effect the endocrine system?

Answer 12

Cause T2DM and can make it harder to control

Question 13

What are the health effects of quitting smoking?

Answer 13

Within 2-5 years: stroke may reduce
Within 5 years: risks of cancers of the mouth drop by 50%
10 Years: risk of dying from lung cancer drops by 50%

Question 14

What does not prevent people from secondhand smoke?

Answer 14

Opening windows
Using air filters

Question 15

Is there a risk-free level of secondhand smoke?

Answer 15

No; even brief exposure can be harmful to health

Question 16

What are the harms of 2nd hand smoke to kids

Answer 16

Ear infections
asthma attacks
Respiratory problems

Question 17

What are the harms of 2nd hand smoke to adults

Answer 17

Heart disease
Lung cancer
Stroke

Question 18

How can 2nd hand smoke be measured?

Answer 18

Test saliva, urine, or blood to see if it contains cotinine

Question 19

What can chew or dip lead to?

Answer 19

Nicotine addiction
Cancers of the mouth
Or Leukoplakia

Question 20

What is the statistic about youth and tobacco use?

Answer 20

1 in 13 of todays Americans younger than 18 will die from smoking related illness

Question 21

What is the MC tobacco product among the youth

Answer 21

Electronic cigarettes (since 2014)

Question 22

What are some social and physical factor associated with youth tobacco product use?

Answer 22

Parental use
Mass media

Question 23

What are some social and environmental factors related to lowering smoking levels?

Answer 23

Being part of a religious group
Racial/ethnic pride
Higher academic achievement

Question 24

What are the five R’s to motivate smokers unwilling to quit?

Answer 24

Relevance: encourage patient to indicate why is quitting personally relevant
Risks: Have patient identify potential negative consequences of tobacco use
Rewards: identify potential benefits of smoking cessation
Roadblock: Identify barriers or impediments to quitting
Repetition: Repeat every time an unmotivated patient visits clinic setting

Question 25

What is physical dependence

Answer 25

physiologic state of adaptation to a substance

Question 26

What is tolerance to a drug?

Answer 26

person’s diminished response to a drug, which occurs when the drug is used repeatedly and the body adapts to the continued presence of the drug

Question 27

What is addiction?

Answer 27

compulsive drug use despite harmful consequences
In the absence of nicotine, smokers develop cravings & symptoms

Question 28

What are the 5 A’s approach for smoking cessation?

Answer 28

Ask about tobacco use and exposure
Advise quitting
Assess readiness to quit
Assist smokers ready to quit
Arrange follow up

Question 29

What is intra-treatment?

Answer 29

Supportive clinical environment

Question 30

What is extra-treatment?

Answer 30

Help patient develop social support in his/her environment outside of treatment

Question 31

What is the most effective treatment for smoking cessation?

Answer 31

Combination of behavioral and pharmacological

Question 32

What is the first line drug therapy for smokers?

Answer 32

Combination nicotine replacement (NRT)
Bupropion (wellbutrin)
Varenicline (Chantix)

Question 33

Should you use buproprion (wellbutrin) for patient who have a history of seizures?

Answer 33

NO

Question 34

What smoking cessation drug therapy can be used for pregnant women?

Answer 34

Nicotine replacement therapy

Question 35

What are the short-acting NRT?

Answer 35

nicotine gum
Nicotine lozenge
Nicotine nasal spray
Nicotine inhaler

Question 36

What are the long-acting NRT?

Answer 36

Transdermal nicotine patch

Question 37

How does varenicline work?

Answer 37

A partial agonist to relieve cravings and withdrawal
*As an antagonist to reduce effects of nicotine

Question 38

Which drug therapy for smoking is not recommended for pregnant women?

Answer 38

Varenicline (Chantix)
Burpropion SR (wellbutrin SR, Zyban)

Question 39

What is the dosage for varenicline?

Answer 39

Smoke for one week while starting medication
0.5mg once daily days 1-3
0.5mg twice daily days 4-7
*18+

Question 40

How does Bupropion SR work?

Answer 40

Enhancing the CNS

Question 41

What are the contraindication of Bupropion SR?

Answer 41

Seizure disorders
Eating disorders
TBI

Question 42

How do electronic cigarettes work?

Answer 42

Uses an electronic nicotine delivery system (ENDS) that aerosolizes nicotine

Question 43

when do most relapses occur?

Answer 43

In the first week of cessation