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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, 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 effects
  9. COPD
  10. hip fractures
  11. reproductive effects
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7
Q

Health consequences causally linked to secondhand smoke exposure in children include: (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 causally linked to secondhand smoke exposure in adults include: (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 & 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 throat/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 mg)
  2. chew (4.5 mg)
  3. snuff (3.6 mg)
  4. orbs (1 mg)
  5. strips (0.6 mg)
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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: nuclear waste
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17
Q

Smokeless tobacco effects on the mouth include: (7)

A
  1. bad breath
  2. irritates & inflames tissues (tissue changes)
  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

_____ succumb to the disease

A

42,000; 8000

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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 leukoplakias 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

Act of inhaling & 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 solide, semi-solid, or liquid substance

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30
Q

Components of an E-cigarette 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 glycerin
  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 fro _____

A

use &/or ingestion; inhalation & heat

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33
Q

E-liquid can remain on surfaces for:

A

weeks to months

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34
Q

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

A

3rd hand exposure or accidental ingestion by children

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35
Q

E-liquid may caused 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

1.8-5.0%

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40
Q

Each pod of nicotine salts contains:

A

the same amount of nicotine as an entire pack of cigarettes

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41
Q

Describe the components 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 include: (5):

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

The increased HR due to the 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 ____ and _____

In addition they may cause _____ or ____

A

epithelial cells; oral ulcerations; oral cancer

sore throat; dry mouth

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47
Q

An alteration or damage to epithelial cells as a result of chemical vapors/aerosols indicates an ________ in the _____which may lead to a greater risk for _____

A

inflammatory response; PDL fibroblasts; periodontal disease

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48
Q

What are the effects of heat & chemicals on oral health: (5)

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

What are the effects of Nicotine as a stimulate on oral health?

A

Increase 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/overdose
  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 & 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 hours

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 released- concentration & memory
  6. increased levels of ___ resulting in reduced ____
A
  1. adrenal glands; adrenaline; glucose
  2. heart rate, breathing activity & blood pressure
  3. pancreas; insulin; blood glucose
  4. dopamine
  5. acetylcholine & norepinephrine
  6. beta-endorphin; anxiety
58
Q

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

A

Nicotine causes the pancreas to produce less insulin therefore increasing blood sugar

59
Q

The amount of nicotine absorbed by the body fro 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 get nicotine into the bloodstream quicker

A

true

62
Q

T/F: Smokeless tobacco (chew) vs. smoking provides less of a nicotine hit

A

false- provides a larger nicotine hit

63
Q

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

A

25

64
Q

Nicotine changes the way ____ are formed

A

synapses

65
Q

Because nicotine changes the way synapses are formed, this means it can harm parts of the brain that control:

A

attention & learning

66
Q

The nicotine in E-cigarettes and other tobacco products can 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 event with nicotine addiction:

A
  1. use of nicotine
  2. stimulates dopamine release
  3. causes pleasurable feelings
  4. repeated use of nicotine
  5. tolerance develop
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

phyisological

76
Q

List the withdrawal symptoms associated with tobacco cessation: (& duration)

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 weeks
  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- bc nicotine acts as a hunger suppressant

78
Q

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

A

Blood pressure returns to normal

79
Q

What is the benefit of quitting smoking that begins 8 hours 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 mucous

81
Q

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

A

nicotine is eliminated & smell & taste improve

82
Q

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

A

lung capacity begins to improve & 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:

A
  1. oral, head & 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 1 year post cessation:

  1. nicotine transdermal patches
  2. nicotine gum & lozenges
  3. non-nicotine Chantix
  4. non-nicotine Zyban
A
  1. nicotine transdermal patches: 23%
  2. nicotine gum & lozenges:27%
  3. non-nicotine Chantix:22-24%
  4. non-nicotine Zyban:16%
88
Q

What are the 5As we as healthcare providers can use to help our patients?

A
  1. ask- about tobacco use
  2. advice- 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-cigarette or vaping device
  3. do you, or does someone in you household smoke?
90
Q

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

A

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

91
Q

Figure up the pack year for the following scenario:

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

A

20 / 20 x 3 = 3 pack years

92
Q

Research uses _____ to determine the damage caused by smoking

A

pack years

93
Q

When ADVISING users to quit smoking, you should be:

A

clear, strong, personalized

94
Q

Give an example of how you might ADVISE someone to quit smoking:

A

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

95
Q

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

A

personalize the plan, be open & non-judegmental

96
Q

Is it 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

a quit date

98
Q

How might you ASSIST, in the following situations?

  1. not ready to quit:
  2. ready to quit:
  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 their 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 you understand that slip ups happen and you want to help guide them back on track/figure out a better plan for them

100
Q

What model describes the stages of change (with smoking cessation):

A

Transtheoretical change model

101
Q

Name the step of the transtheoretical change model being described below:

-no to intention to change

A

Pre-contemplation

102
Q

Name the step of the transtheoretical change model being described below:

-aware problem exists but no commitment to action

A

contemplation

103
Q

Name the step of the transtheoretical change model being described below:

-intent on taking action to address the problem

A

preparation

104
Q

Name the step of the transtheoretical change model being described below:

-active modification of behavior

A

action

105
Q

Name the step of the transtheoretical change model being described below:

-sustained change, new behavior replaces old

A

maintenance

106
Q

Name the step of the transtheoretical change model being described below:

-not falling back into previous behavior

A

termination

107
Q

Name the step of the transtheoretical 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 (holds patient accountable)

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% estimated quit rate

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 & personalized support available from trained quit coaches

A

1-800-quit now

Smokefree.gov

115
Q

List all of the 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/coach
-app/tech use
-telephone counseling (1-800-QUITNOW)
-apps (QuitNow!) (KWIT) (Smoke Free) (Quitters Circle) (Quit 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. anti-depressant medications
119
Q

What type of pharmacotherapy agents should we recommend?

A

FDA approved

120
Q

What are the top three pharmacotherapeutic options for smoking cessation?

A

-gum
-lozenge
-transdermal patch

121
Q

Give some examples of pharmacotherapeutic gums for smoking cessation:

A
  1. nicorette
  2. zonnic
  3. generic form
122
Q

Nicorette gum, Zoning gum & the generic versions of both are _____ products

A

OTC

123
Q

Give some examples of pharmacotherapeutic 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
A

Patient Care III (19 decks)

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