Tobacco Cessation

Question 1

Define ‘smokeless tobacco’ (NICE Guidelines 2012)

Answer 1

Any type of product containing tobacco that is placed in the mouth or nose & not burned

• used in England mostly by people of South Asian origin

Question 2

Types of smokeless tobacco.
(3 marks)

Answer 2

1) Tobacco +/- flavourants

2) Tobacco & various alkaline modifiers

3) Tobacco & slaked lime (alkaline modifier) & areca nut – Betel Quid

Question 3

Health risks of smokeless tobacco:

Answer 3

Ø Gum disease
Ø Oral submucous fibrosis
Ø Lukoplakia
Ø Oral cancer
Ø Preterm low birth weight babies
Ø Cardiovascular disease

Question 4

What does a cigarette contain?

Answer 4

• NICOTINE (an alkaloid - extremely powerful drug)
• TAR (sticky brown substance inhaled when the smoker draws on a lighted cigarette)
• CO (binds to haemoglobin much more readily than oxygen but reduces oxygen in their blood by 15%)

Question 5

What does VBA consist of?
(3 parts)

Answer 5

Ask = establish & record smoking/smokeless tobacco status

Advise = advise on benefits of quitting e.g. saves money, health reasons ; this triggers to thinking of quitting

Act = offer help by recommending local stop smoking service

Question 6

3 key signs of addition:

Answer 6

• Continued use despite harmful effects
• Withdrawal symptoms which urge them to restart during abstinence
• Failure of attempts to stop

Question 7

Withdrawal symptoms of tobacco

Answer 7

• Cravings & restlessness
• Difficulty to concentrate & trouble sleeping
• Feeling hungry & anxious

Question 8

Gold standard for smoking sensation effectiveness:

Answer 8

Combination of behavioural support & stop smoking medication or an e-cigarette

Question 9

Nicotine medications:

Answer 9

• Varenicline (‘Champix’)
• Combination nicotine replacement therapy (NRT; nicotine patch + faster-acting NRT product)