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Patient Care III > Tobacco Cessation > Flashcards

Tobacco Cessation Flashcards

1
Q

All smoking tobacco products contain:

A

carcinogens

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2
Q

List the nicotine content per single use for the following products:

a) Pipe tobacco:
b) Cigars
c) Hookah
d) Cigarette
e) E-cigarette

A

a) 30.08-50 mg
b) 13.3-15.4 mg
c) 1.04-2.24 mg
d) 1.2-1.8 mg
e) 0.0 -15.4 mg

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3
Q

When using a smoking tobacco product you are potentially inhaling more than:

A

7000 chemicals

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4
Q

Of the more than 7000 chemicals inhaled with a smoking tobacco product, ___ are known carcinogens

A

70

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5
Q

List the possible cancers associated with smoking tobacco products: (10)

A
  1. oropharynx
  2. larynx
  3. esophagus
  4. trachea, bronchus, lung
  5. acute myeloid leukemia
  6. stomach
  7. pancreas
  8. kidney and ureter
  9. cervix
  10. bladder
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6
Q

List the possible chronic diseases associated with smoking tobacco products: (11)

A
  1. stroke
  2. blindness, cataracts
  3. periodontitis
  4. aortic aneurysm
  5. CHD
  6. pneumonia
  7. vascular diseases
  8. respiratory effets
  9. COPD
  10. hip fractures
  11. reproductive effects
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7
Q

Health consequences casually linked to secondhand smoke exposure in children: (5)

A
  1. middle ear disease
  2. respiratory symptoms
  3. impaired lung function
  4. lower respiratory illness
  5. SIDS
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8
Q

Health consequences casually linked to secondhand smoke exposure in adults: (4)

A
  1. nasal irritation
  2. lung cancer
  3. CHD
  4. Reproductive effects in women (low birth weight)
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9
Q

The leading cause of cancer related death in US for both men and women:

A

lung cancer

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10
Q

____ accounts for more than 90% of lung cancer cases reported in men and 89% in women

A

smoking

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11
Q

Smoking accounts for more than___% of lung cancer cases reported in men and ___% in women

A

90%; 89%

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12
Q

Smoking effects on the mouth include: (10)

A
  1. bad breath
  2. periodontal (gum) disease
  3. sore throats/hoarseness
  4. reduced smell/taste
  5. unhealthy tissue
  6. delayed healing
  7. oral/throat cancer
  8. teeth staining
  9. poor response to dental treatment
    10 oral lesions
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13
Q

Smokeless tobacco products all contain:

A

carcinogens

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14
Q

List some examples of smokeless tobacco products and include their nicotine content per single use:

A
  1. Snus (8.0 mg)
  2. Chew (4.5mg)
  3. Snuff (3.6mg)
  4. Orbs (1.0mg)
  5. Stips (0.6mg)
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15
Q

Chewing tobacco (snuff) contains over ____ chemicals known to cause cancer

A

28

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16
Q

List some examples of carcinogens found in snuff: (6)

A
  1. cadmium: used in car batteries
  2. N-nitrosamines: cancer causing chemical
  3. Uranium-235: used in nuclear weapons
  4. Formaldehyde: used in embalming fluid
  5. Benzopyrene: cancer causing chemical
  6. Polonium 210: nucelar waste
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17
Q

smokeless tobacco effects on the mouth include: (7)

A
  1. bad breath
  2. irritates and inflames tissues
  3. oral cancer
  4. tooth decay
  5. painful ulcers
  6. staining
  7. periodontal/gum disease
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18
Q

Approximately ____ Americans are diagnosed yearly with oral/pharyngeal cancer and ____ succumb to the disease.

A

42,000; 8,000

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19
Q

___ % of the cases of oral/pharyngeal cancer diagnosed yearly can be attributed to tobacco use and/or heavy alcohol consumption

A

75%

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20
Q

___% of leukoplakia are caused by tobacco use

A

70%

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21
Q

ENDS stands for:

A

electronic nicotine delivery system

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22
Q

According to the CDC:

A) ____% of adults over 18 currently use e-cigs
B) ____% of high school students currently use e-cigs
C) ____% of middle school students currently use e-cigs

A

A) 4.7%
B) 14.1%
C) 3.3%

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23
Q

Of the 3.3% of middle school students using e-cigs, ___% of these students are using flavored e-cigs (fruit, candy, dessert flavors)

A

84.7%

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24
Q

According to the CDC regarding e-cigs, the device type of choice was:

A

disposables (55.3%)

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25
Q

Acting of inhaling and exhaling the aerosol, often referred to as vapor, which is produced by an e-cigarette or similar device

A

vaping

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26
Q

Does vaping produce tobacco smoke?

A

no

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27
Q

The aerosol produced with vaping is often mistaken for:

A

water vapor

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28
Q

Vaping contains:

A

fine particles

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29
Q

Vapor is generated from:

A

a solid, semi-solid, or liquid substance

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30
Q

Components of an E-cig include:

A
  1. battery
  2. heating element
  3. atomizer
  4. cartridge/pod
  5. indicator light
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31
Q

E-cigarette E-liquid ingredients: (5)

A
  1. vegetable glycerine
  2. propylene glycol
  3. flavorings
  4. nicotine
  5. other compounds/chemicals (diacetyl; benzoic acid)
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32
Q

The ingredients in e-liquid may be deemed safe for ___ but are not evaluated for:

A

use and/or ingestion; inhalation and heat

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33
Q

E-liquid can remain on surfaces for:

A

weeks to months

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34
Q

Since e-liquid can remain on surfaces for weeks to months, there is the potential for:

A

3rd hand exposure or accidental ingestions by children

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35
Q

E-liquid may cause adverse effects during or after pregnancy because:

A

nicotine can cross the placenta

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36
Q

Nicotine salts can be described as a:

A

“smoother hit” (more like a cigarette rush)

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37
Q

Nicotine salts have higher:

A

nicotine concentrations

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38
Q

Since nicotine salts have higher nicotine concentrations, there is the potential for:

A

more addiction

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39
Q

What percentages of nicotine are in nicotine salts?

A

1.8%-5%

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40
Q

Each pod of nicotine salts contains:

A

same amount of nicotine as an entire pack of cigarettes

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41
Q

Describe the components of aerosols (4)

A
  1. volatile organic compounds
  2. nicotine
  3. ultrafine particles
  4. heavy metals (nickel, tin, & lead)
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42
Q

Health concerns associated with aerosols: (5)

A
  1. increased heart rate due to spike in adrenaline
  2. increased blood pressure
  3. increased bronchitis
  4. increased lung disease
  5. may cause blood sugar levels to rise
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43
Q

The increased heart rate due to spike in adrenaline associated with aerosols leads a person to higher risk for:

A

heart attack

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44
Q

Describe what a lung may look like with use of aerosols:

A

“popcorn lung” ( bronchiolitis obliterans)

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45
Q

AKA Popcorn lung:

A

bronchiolitis obliterans

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46
Q

Chemical vapors produced can alter or damage ____ which may result in ___ & ____

In addition they may cause ___ or ___

A

epithelial cells; oral ulcerations; oral cancer

sore throat or dry mouth

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47
Q

An alteration or damage of epithelial cells as a result of chemical vapor/aerosols indicates an ___ in the ____ which may lead to greater risk for ____

A

inflammatory response; PDL fibroblasts; periodontal disease

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48
Q

What are the effects of heat and chemicals on oral health? (5)

A
  1. dry mouth
  2. bone loss
  3. inflammation
  4. increased plaque and calculus
  5. tooth decay
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49
Q

What are the effects of nicotine as a stimulant on oral health?

A

increased bruxism

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50
Q

Other concerns in regards to vaping include: (4)

A
  1. burns from device batteries/explosions
  2. nicotine poisoning/overdoes
  3. secondhand aerosol exposure
  4. environmental concerns
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51
Q

Nicotine poisoning/overdose is a concern with e-cigarettes because:

A

pods can leak solution and nicotine is rapidly absorbed via the skin

52
Q

An alkaloid that is contained in the leaves of plants:

A

nicotine

53
Q

Nicotine is distributed quickly through the ____ and crosses the ___-

A

bloodstream; blood-brain barrier

54
Q

Nicotine reaches the brain within ___ seconds of inhalation

A

8-20 seconds

55
Q

The elimination half life of nicotine is around:

A

2 hrs

56
Q

Nicotine is metabolized in the:

A

liver

57
Q

Nicotine Effect:

  1. Nicotine stimulates the ____ which release ____ and this surge causes an immediate release of ___.
  2. Increased ___, ____, & ____
  3. The ____ produces less ___ causing increased ____
  4. _____ is released- feeling of contentment is higher.
  5. ____ & ____ are also released - concentration and memory
  6. Increased levels of ____, resulting in reduced ____
A
  1. adrenal glands; adrenaline; glucose
  2. HR, breathing activity & BP
  3. pancreas; insulin; blood glucose
  4. Dopamine
  5. acetylcholine & norepinephrine
  6. beta-endorphin; anxiety
58
Q

If you have a diabetic patient and you are counseling them on smoking cessation, what point might you hit on?

A

That nicotine causes the pancreas to produce less insulin resulting in increased blood sugar or glucose

59
Q

The amount of nicotine absorbed by the body from smoking depends on: (3)

A
  1. type of tobacco
  2. whether smoke is inhaled
  3. whether a filter is used
60
Q

The amount of nicotine released into the body tends to be much greater in:

A

smokeless tobacco

61
Q

T/F: Vaping gets nicotine into the bloodstream quicker

A

True

62
Q

T/F: Smokeless tobacco (Chew) Vs. smoking provides a smaller nicotine hit

A

False

63
Q

Research indicates development of the brain occurs until the age of:

A

25

64
Q

Nicotine changes the way:

A

synapses are formed

65
Q

Since nicotine changes the way synapse are formed this means it can harm parts of the brain that control:

A

attention & learning

66
Q

The nicotine in e-cigs and other tobacco products can also prime the adolescent brain for:

A

addiction to other drugs such as cocaine (surgeon general)

67
Q

How does nicotine impact youth/young adults? (6)

A
  1. depression
  2. anxiety
  3. mood disorders
  4. addiction
  5. difficulty paying attention
  6. reduced impulse control
68
Q

Nicotine addiction is more than a “bad habit”, discuss the chain of events with nicotine addiction

A
  1. Use of nicotine
  2. stimulates dopamine release
  3. causes pleasurable feelings
  4. repeated use of nicotine
  5. tolerance develops
69
Q

Why does tolerance develop with nicotine addiction?

A

body creates more nicotine receptor sites over time

70
Q

Tobacco dependence can be described as a ___ problem

A

2-part

71
Q

Describe the parts of the problem with tobacco dependence:

A
  1. physiological- the addiction to nicotine
  2. behavioral- the habit of using tobacco
72
Q

The habit of using tobacco is considered:

A

behavioral

73
Q

The addiction to nicotine is considered a _____ problem

A

physiological

74
Q

Treatment for tobacco dependence should address:

A

the physiological AND behavioral aspects of dependence

75
Q

Medications for addiction for cessation with tobacco dependence would address what aspect of the problem?

A

Physiological

76
Q

List the withdrawal symptoms associated with tobacco cessation (and time line):

A
  1. Dizziness: 1-2 days
  2. Chest tightness: a few days
  3. cough/dry throat: a few days
  4. difficulty concentrating: a few days
  5. Cravings for tobacco: frequent in first 2-3 days
  6. Insomnia: 1 week
  7. constipation & stomach pain: 1-2 weeks
  8. Depressed mood/irritable: 1-4 weeks
  9. Hunger: up to several weeks
77
Q

What is the number one concern that patients will bring up with smoking cessation counseling?

A

hunger- because nicotine acts as a hunger suppressant

78
Q

What is the benefit of quitting smoking that begins 20 minutes after quitting?

A

Blood pressure returns to normal

79
Q

What is the benefit of quitting smoking that begins 8hrs after quitting?

A

Normal oxygen blood level

80
Q

What is the benefit of quitting smoking that begins 24 hours after quitting?

A

carbon monoxide eliminated from lungs; start to clear mucus

81
Q

What is the benefit of quitting smoking that begins 48 hours after quitting?

A

nicotine is eliminated and smell and taste are improved

82
Q

What is the benefit of quitting smoking that begins 3 days after quitting?

A

lung capacity begins to improve and breathing becomes easier

83
Q

What is the benefit of quitting smoking that begins 2-12 months after quitting?

A

circulation improves

84
Q

What is the benefit of quitting smoking that begins 5 years after quitting?

A

risk of lung cancer decreases

85
Q

What is the benefit of quitting smoking that begins 10-15 years after quitting?

A

reduced risk of other cancers

86
Q

Benefits of quitting smokeless tobacco include a decreased risk for: (6)

A
  1. oral head and neck cancer
  2. tooth decay
  3. progression of gum recession
  4. high cholesterol
  5. high blood pressure
  6. heart attack or stroke
87
Q

List the percentage of effectiveness the following forms of smoking cessation mechanisms provide at one year post cessation:

  1. nicotine transdermal patches
  2. nicotine gum and losanges
  3. non-nicotine chantix
  4. non-nicotine zyban
A
  1. nicotine transdermal patches - 23%
  2. nicotine gum and losanges- 27%
  3. non-nicotine chantix- 22-24%
  4. non-nicotine zyban- 16%
88
Q

What are the 5 A’s we as health care providers should use to help our patients?

A
  1. Ask- about tobacco use
  2. Advise- tobacco users to quit
  3. Assess- readiness to make a quit attempt
  4. Assist- with the quit attempt
  5. Arrange- follow-up care
89
Q

Give examples of how you might ASK about tobacco use:

A
  1. do you ever smoke or use any type of tobacco?
  2. do you use any form of e-cig or vaping device
  3. Do you or does someone in your household smoke?
90
Q

How do you figure up the pack year for a smoking patient?

A

number of cigs per day / 20x number of years smoking = number of packs per year

91
Q

Figure up the pack year for the following scenario:

Patient smokes 1 pack per day and has been smoking for 3 years:

A

20/ 20 x3 = 3 pack years

92
Q

Research uses ____ to determine the damage caused by smoking:

A

pack years

93
Q

When ADVISING users to quite smoking, you should be:

A

clear, strong, personalized

94
Q

Give and example of how you might ADVISE someone to quite smoking:

A

“I realize that quitting is difficult. I am happy to work with you to design a specialized treatment plan for cessation WHEN YOU ARE READY”

95
Q

The best results when ADVISING one on smoking cessation come if you can:

A

personalize the plan, be open and non-judgemental

96
Q

Is important to have an open-ended or close-ended conversation with your patient regarding smoking cessation?

A

open-ended

97
Q

When ASSESSING the patients readiness to quit, you need to help the patient come up with:

A

quit date

98
Q

How might you ASSIST in the following situations?

  1. Not ready to quit:
  2. Ready to quite:
  3. Recently quit:
A
  1. provide motivation
  2. design a treatment plan
  3. relapse prevention
99
Q

T/F: When a patient relapses it is important to really drive in the idea that smoking is detrimental to there health, be direct, stern, and make them feel slightly guilty to motivate them.

A

False: Don’t make them feel guilty, try to relate to them to let them know that slip ups happen and you understand and want to help guide them back on track/ figure out a better plan for them

100
Q

What model describes stages of change (with smoking cessation)

A

Transtheoretical change model

101
Q

Name the step of the trans theoretical change model being described below:

No intention to change:

A

pre-contemplation

102
Q

Name the step of the trans theoretical change model being described below:

Aware problem exists but no commitment to action:

A

contemplation

103
Q

Name the step of the trans theoretical change model being described below:

Intent on taking action to address the problem:

A

preparation

104
Q

Name the step of the trans theoretical change model being described below:

Active modification of behavior:

A

action

105
Q

Name the step of the trans theoretical change model being described below:

Sustained changes, new behavior replaces the old:

A

maintenance

106
Q

Name the step of the trans theoretical change model being described below:

Not falling back into previous behavior:

A

termination

107
Q

Name the step of the trans theoretical change model being described below:

Falling back into previous behavior pattern:

A

relapse

108
Q

What are the order of steps to a successful outcome to the theoretical change model:

A
  1. pre-contemplation
  2. contemplation
  3. preparation
  4. action
  5. maintenance
  6. termination
109
Q

Why must we ARRANGE follow-up care with smoking cessation patients?

A

success rate tends to be higher with follow ups

110
Q

0-1 follow ups following smoking cessation, correlates to:

A

12.4% estimated quit rate

111
Q

2-3 follow ups following smoking cessation, correlates to:

A

16.3% estimated quit rate

112
Q

4-8 follow ups following smoking cessation, correlates to:

A

20.9% estimated quit rate

113
Q

more than 8 follow ups following smoking cessation, correlates to:

A

24.7 %

114
Q

A quit-line available 24 hours a day, 7 days a week, that is a free service available in multiple languages. It is confidential, and personalized support is available from trained quit coaches:

A

1-800-QUIT NOW or Smokefree.gov

115
Q

List all smoking cessation options:

A
  1. cold turkey (no additional help)
  2. nicotine replacement therapy (NRTs)
  3. medications
  4. behavioral therapy
  5. combination therapy
  6. hypnotherapy
  7. acupuncture
  8. yoga/meditation
  9. herbs
116
Q

Describe what behavioral therapy entails in smoking cessation:

A
  • counselor/coah, app/tech use, telephone counseling (1-800 quit NOW)
  • apps- QUITNOW!, KWIT, Smoke free, Quitters Circle, Quick tracker
117
Q

What tobacco users can benefit from pharmacotherapy?

A

All tobacco users

118
Q

When should you check with a physician before recommending pharmacotherapy agent?

A
  1. hypothyroidism
  2. insulin dependent diabetes
  3. active peptic ulcer
  4. antidepressant medications
119
Q

What type of pharmacotherapy agents should we recommend?

A

FDA approved

120
Q

What are the top 3 pharmacotherapy options for smoking cessation?

A
  • gum
  • lozenge
  • transdermal patch
121
Q

Give some examples of pharmacotherapeutic gums for smoking cessation:

A
  1. Nicolette
  2. Zonnic
  3. Generic
122
Q

Nicorette gum, Zonnic gum, and the generic versions of both are ____ products

A

OTC

123
Q

Give some examples of pharmotherapeutic Lozenges used for smoking cessation:

A
  1. commit
  2. zonnic
  3. generic form
124
Q

Give some examples of transdermal patch nicotine replacement therapies:

A
  1. nicoDerm CQ
  2. Generic form
125
Q

What are the adverse effects for nicotine replacement gum (Nicorette, Zonnic,

A

Patient Care III (16 decks)

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