Tobacco Cessation Flashcards
1 cause of preventable death in the U.S.
Tobacco Use.
480,000 deaths every year
In 2014, tobacco industries spent a total of 9 billion
On advertising and promotion for their products in the U.S.
Nicotine is considered to be more addictive than…
cocaine, heroin, or alcohol.
Nicotine inhaled via a cig can reach the brain in 5 heartbeats
High alkalinity of nicotine found in cigs greatly increases what?
Nicotine absorption and dependence
Risks of using smokeless tobacco.
Leukoplakia (white lesions in mouth)
Dental caries
Cancer
-Esophageal, pharynx, larynx, stomach, pancreatic
Average hookah sessions is equivalent to what?
Smoking a pack of cigs in 30 min
A single 30 min hookah session has been shown to cause..
Increases in COHb, blood pressure, heart rate, and respiratory rate.
Shows a decrease in pulmonary function tests.
Electronic cigs have seen an increase or decrease in the past few years?
967% increase.
Electronic cigs emit a propylene glycol vapor when activated.
Harms of E-cigs:
- Youth:
- Current smokers:
- Society & non-smokers:
- Nicotine poisoning, increase in initiation of conventional cig use, future disease risk.
- Slows cessation and may not allow for complete cessation. (benefit: reduced disease for those who switch to e-cigs)
3.Renormalization of nicotine and smoking.
Secondhand aerosol exposure
What percent of people want to quit smoking?
70%.
Counseling and medications are more effective together than alone
What percent of adult smokers began smoking before the age of 20?
80%
What is the tobacco control act?
Cigs can no longer contain flavors (except menthol)
Cig packaging can no longer contain the words “light”, “low”, or “mild”
Nicotine addiction is a chronic disease.
This addiction represents one of the most challenging addictions to break .
The average tobacco user will make 11 quit attempts before quitting for good.
Premature discontinuation of tobacco cessation medications often results in relapse.
What are the 5 A’s?
Ask, Advise, Assess, Assist, Arrange
Which medications for tobacco cessation can be combined?
Nicotine patch can be combined with bupropion, varenicline, and a short-acting NRT (gum, lozenge, inhaler, nasal spray)
Bupropion can be combined with a short-acting NRT (gum, lozenge, inhaler, nasal spray), a nicotine patch and varenicline.
Nicotine patch (long-acting) characteristics:
Match 1mg of nicotine in patch to # of cigs smoked/day
Patch must be rotated to a new location daily
Most common adverse effects: Application site irritation and vivid dreams
Nicotine gum (short-acting) characteristics:
Dose based on # of cigs/day or time to first cig
->20 CPD or <30 min to 1st cig = 4mg
Less than or equal to 20 CPD or greater than or equal to 30 min to 1st cig =2mg
Chew and park method for optimal drug release.
Nausea and upset stomach can occur, especially if used incorrectly
Nicotine lozenge characteristics:
Dose same as gum.
Delivers 25% higher dose of nicotine than gum
Use and adverse side effects similar to gum
Nicotine inhaler (short-acting) characteristics:
10 mg nicotine cartridges, each delivering 4 mg of nicotine
Nicotine is absorbed through the lining of the cheek
Each cartridge is designed for 20 min of active puffing
Cough and throat irritation are the most common side effects
Nicotine Nasal Spray (short-acting) characteristics:
Use 1 spray in each nostril every 1 to 2 hours PRN
Fastest delivery of nicotine of all currently available products
Nose and eye irritation are common but subside over time
Non-nicotine medications:
Bupropion sustained-release:
- Targets dopamine receptors
- Initiate 1 to 2 weeks prior to quit date
- Insomnia, diarrhea, and dry mouth are most common side effects
- Caution with seizure disorder or conditions that increase risk of seizure
Varenicline: (use this for as long as it takes)
- Nicotine partial agonist
- Initiate 1 week prior to quit date
- Vivid dreams and nausea are most common side effects
Extended duration treatment?
Refers to use of Rx beyond typical 12 week treatment duration
Recent article showed no benefit using nicotine patch beyond 24 weeks (adherence rates were low, smh)
Increasing treatment duration of varenicline from 12 to 24 weeks significantly reduced relapse and increased abstinence rates
Average smoker will gain how many pounds?
7 to 19 pounds within 8 years of quitting vs. continued smoker who will gain 4 to 5 pounds
The most effective tobacco cessation medication for delaying weight gain is…
Bupropion
Smoking prevalence rates are between _______ in people diagnosed with depression, bipolar disorder, or schizophrenia.
60-80%
Nearly half of all cigs smoked in the U.S. are consumed by people with mental illness.
1-800-QUIT-NOW
Statewide line linking patients to trained counselors.
Offers up to 8 weeks of nicotine patches, gum, or lozenges to qualified individuals.
