Tobacco Prevention Flashcards
The only consumer product when used as directed kills its consumer
Tobacco
1 preventable cause of death in US
Most US deaths from behavioral causes due to ___
smoking
almost half of americans who die prematurely from tobacco abuse have ___
chronic mental illness
percentage of adults who smoke cigarettes
despite decr in smoking over last 50 years, little change in smoking since then
Which patient populations are most susceptible to tobacco addiction
1) those with least info about health risks and least access to cessation
2) lower SES groups and less education
3) mental illness/substance abuse (HIV)
4) American Indians
Health consequences of tobacco
1) 4000+ toxins
2) incr risk of everything
3) no decr in COPD and CAD despite 50% decr in smoking
Most common disease assoc with cigarette smoking
Lung cancer
CAD
COPD
Most common cancers assoc with smoking
1) lung
2) oral cavity, larynx, pharynx
3) esophagus
4) bladder
Lung cancer is ___
dose response
use >40 cigarettes have doubled the risk of developing cancer compared to smokers
what is the only inverention that will slow down or stop decline in pulm function
smoking cessation
20% of death from CAD attributable to ___
tobacco
smoking and pregnancy
smoking during pregnancy can lead to
1) perinatal deaths
2) low birth weight infants
3) pre-term
4) infertility, miscarriage, SIDS
Consequences of second hand smoke
1) incr risk of COPD, heart disease … and MORTALITY
2) childhood exposure
incr pulm infection, asthma, SIDS
17% of excess mortality due to additional things beyond most common 21 diagnoses
so wide range beyond what you would think
Health benefits of quitting 1 month 1 year 5 years 10 years 15 years
improved cough, SOB
improved lung fxn, 50% decr
cardiac disease improved to never smokers
bladder, oral, cervical CA improved
lung CA 15 years decr
MPOWER
1) Monitor tobacco use and prevention policies
2) Protect from second-hand smoke
3) Offer help in quiGng
4) Warn about dangers: product labels and mass media campaigns
5) Enforce bans on adver>sing and promo>on
6) Raise taxes
factors that incr risk of teens starting to smoke
1) exposure to 2nd hand smoke or smoker in household
Effect of taxes on tobacco use
1) young people and poor most price
Why is quitting smoking so difficult?
Nicotine addiction
1) nicotine addictive = bind to CNS receptors, incr dopamine and norepeinephine –> euphoria and relaxation
2) Withdrawal symptoms = depression, anxiety intense for 72 hrs last 6-8 weeks
3) Social habit and craving hard to break
Can we really make a difference?
75% smokers want to quit but only 30% received any counseling
never too late to quit
5 A’s AHQR guidelines
1) Ask = every visit; screening
2) Advise = personalized, smoking is best thing on health
3) Assess willingness
4) Assist = if patient is willing to quit; counseling and pharmacotherapy
5) arrange =
First line pharamcotherapy for smoking
1) nicotine replacement therapy
2) bupropion (Zyban, Wellbutrin)
3) Varenicline (Chantix)
Nicotine replacement therapy forms
1) patch = long acting, slower onset, schedule
2) gum = long acting, slower, schedule
3) lozenge = shorter acting, PRN
4) inhaler = shorter acting, PRN
5) nasal spray = shorter acting, PRN
ALL SAME!!!!!
Effects of nicotine replacement
1) alleviates symptoms of withdrawal (BEST TO COMBINE MULTIPLE FORMS)
2) long-term safe because no incr in death, MI, or arrhythmia
