Tobacco Cessation Flashcards
What are the assessments for smoking?
Fagerstrom Tolerance Test
CO Monitor
What are the treatments for smoking?
motivation and medication
How many chemicals are in tobacco smoke?
more than 7000 (69 cause cancer)
Why do people smoke biologically?
nicotine is addictive
Why do people smoke psychologically
mental health issues increase liklihood to smoke and harder for them to quit
Why do people smoke socially?
begin young and peer smoking
Do most smokers want to quit?
Do they typically succeed?
yes (usually encouraged by providers)
no : (
Some specific pop. love to smoke, what are they?
LGBT (lesbian, gay, bisexual, transexual) Low SES Racial and ethnic minorities HIV positive psychiatric comoribity
Who want to quit?
hospitalized patients
What is the fagerstrom tolerance test?
asks questions to assess dependence of cigarettes (0-2 very low, 3-4 low, 5 medium, 6-7 high, 8-120 very high)
What is a CO monitor?
measures CO in the breath
What likes CO the most?
fetal hemoglobin : (
Which gives higher CO readings, cigarettes, cigars or pipes?
cigars and pipes
HOw long should you wait to after a cigarette to test CO level?
10 minutes
Does giving CO feedback increase motivation to quit smoking?
yes
a typical puff of a cigarette has (blank) CO by volume
5%
What are these symptoms of?
Headache, fatigue, breathlessness, poor concentration, dizziness, palpitations, chest pain, visual disturbance, nausea, diarrhea, abdominal pain
Increases risk of blood clots
cigarettes, lack of O2
Will cutting down number of cigs by half lead to half the CO level?
no
What stage are people at where they are thinking about changing?
contemplation
If you are taking steps toward change where are you at?
preparation
If you are changing where are you at?
action
If you are maintaining your change where are you at?
maintanence
If you failed to maintain your change where are you at?
lapse/relapse
What is a lapse?
Relapse?
1 or 2 time slip up
go back to where you started
How many times do smokers have to go through the stages of change?
definitely more than once typically around 7
The more a person attempts to quit smoking, the more likely the will be able to (blank)
quit (cuz learn from their mistakes)
What is the abstinence violation effect?
It is when people try to abstain completely and then do not succeed so feel really bad and decide to never change
So how do we help people quit smoking?
medications, motivations, triggers/alternatives/ aversion, relapse prevention, support of firends/family, increase contact with non smokers, control of social environment
What are three treatment options?
medications
rapid smoking therapy (aversion)
supportive behavioral therapy
What are 3 medications?
nicotine replacement (helps with withdrawal) buproprion (reduce cravings) varencicline (chantix) blocks nicotine receptor -makes smoking less rewarding
What is the safest medical treatment?
nicotine replacement (due to reduced side effects)
What is the main side effect that is scary about chantix (varencicline)
severe aggression
is medication more helpful or hurtful when helpin people quit?
2x more helpful to have meds
how many long-term quitters still use nicotine gum after a year
1/3
If you give NRT even before people are ready to quite what typically happens?
after 12 months people will become abstinent
What is rapid smoking therapy?
make pnt rapidly inhale every 6 seconds until patient cannot continue to make them have an adversion to cigarettes. Make them write down adversive symptoms and then make them do it again. typically down every day for 12 days
HIGHLY EFFECTIVE!!!! AN NO INCREASED HEALTH RISKS!!!
What do you do during the first eight cessation smoking sessions.
Session 1 – Motivation
Session 2 – Identifying Triggers
Session 3 – Creating an Action Plan
Session 4 – Preparing for the quit date
Session 5 – Implementing the Action Plan
Session 6 – 1st follow-up, Relapse Prevention
Session 7 – 2nd follow-up, Prevent Weight Gain
Session 8 – 3rd follow-up, Becoming more physically active
How long does it take for a smokers heart to become like a non smokers heart after they quite?
lungs?
15 years
10 years
How do you increase motivation to quite smoking for your pnts?
empathy, develop discrepancy, roll w/ resistance, support self-efficacy, get them to do “change talk”
the more counseling the more likely your patient will (blank)
quit
What denotes high nicotine dependence?
greater than 20 cigs a day
1 cig w/in 30 min of waking in the morning
E cigs, are they helpful?
NO!
If tobacco user currently unwilling, try to increase (blank) for future attempts
motivation
Counseling and Meds are most effective when (blank)
combined
(blank) increase abstinence rates (recommend unless contraindicated)
Medications
Efficacy increases w/ (blank) intensity
treatment
is brief treatment effective?
yes
Who should you encouarge to quit smoking?
everyone
Is cigarette smoking a chronic disease?
yes
What are the five A’s of assessment?
ask, advise, assess, assist and arrange
