Tobacco Cessation Flashcards
This ranks the dependence of a patient on smoking and categorizes it from very low to very high. 0-2 = very low dependence. 8-10 = very high dependence.
Fagerstrom Tolerance test
This measures the CO upon exhalation in ppm
CO monitor
Hg binds preferentially to (blank)
CO
Treatment options for smokers
- Medications
- Rapid smoking therapy
- Supportive behavioral therapy
Reduces cravings and withdrawal symptoms. Usually start 7-14 days before quit date.
Buproprion
Blocks nicotine receptors, making smoking less rewarding, so reduces urge to smoke. Start 7 days before quit date
Varenicline (Chantix)
How much more likely is a person who takes medication to quit smoking?
2 times!
Most effective option when using medication
Medication + intense counseling
Four things involved in behavioral therapy
- Enhance motivation
- Offer advice
- Support
- Relapse prevention
What is the correlation between session length/counseling intensity and quitting success?
Longer sessions, more likely to quit. More sessions, more likely to quit.
↑ smoke ↑ exposure to tobacco advertising ↓ access to tx ↓ use effective treatments ↓ success rates in quitting
Racial and ethnic minorities
↑ smoke ↑ mortality rates ↓ QOL they underestimate the effect of smoking on their health may smoke to cope with stress of illness
HIV positive
↑ smoke targeted by tobacco companies ↓ access to treatment ↑ misinformed about smoking cessation tx ↑ exposure to workplace smoking
Low SES
Particularly motivated to quit
Hospitalized patients
Rapid inhaling (every 6 seconds, until patient feels unable to continue – feel about to vomit or severely light headed) Rest for 5 min, and fill out form of aversive sx, then do another inhaling trial (at least 2 trials per session) Do a session every day or two, usually to 12 sessions, with no smoking in-between sessions Has shown long-term abstinence rates of 60-70%
Rapid smoking therapy
Each cigarette reduces life span by (blank) minutes
11
Ways to increase motivation
Express empathy
Develop discrepancy
Roll with resistance
Support self-efficacy
Discuss decisional balance
Reasons for staying the same vs. reasons for changing. Benefits and bad parts to each side.
How long does a typical craving last?
<5 minutes
Predictors of abstinence
Strong motivation to quit
Ready to quit within next few weeks
User is confident in their ability to quit
Supportive social network
Predictors against abstinence
High nicotine dependence
> 20 cigarettes per day,
1st cigarette within 30 min of waking in the morning
Psychiatric comorbidity and substance use
High stress level
Exposure to other smokers
