Tobacco + Smoking Cessation Flashcards
what percentage of patients die from smoking-related complications?
50%
what is the leading cause of death by the majority of smokers who die? (2)
ischemic heart disease
stroke
what is the 2nd leading cause of death by the majority of smokers who die?
lung cancer
what is the 3rd leading cause of death by the majority of smokers who die?
COPD
at what age do most adult smokers try their first cigarette?
before age 18
what is the trend in youth smoking in the US?
going down
what is the life span advantage of quitting by age 30?
10 yr increase
what is the life span advantage of quitting by age 40?
8 year increase
what is the life span advantage of quitting by age 50?
6 year increase
what is the life span advantage of quitting by age 60?
3-4 year increase
when do most withdrawal symptoms develop?
within first 3 days
when do most withdrawal symptoms peak?
3 days - 1 week
when do most withdrawal symptoms wane?
by 1-2 weeks
when do cravings occur?
within several days
how to cravings progress over time?
decrease in frequency but not in intensity
how long after quitting can cravings still occur?
years afterwards
cravings are associated with what kind of behaviors?
cued behaviors
what are the 5 A’s?
Ask about smoking
Advise about smoking
Assess their willingness to quit
Assist those willing to quit
Arrange for follow up
when should you Ask about smoking so there is a greater change of discussion?
during vital signs
when should a follow up be arranged after quitting?
within the first week after quit day
not interested in quitting
precontemplation
what percentage of smokers are in the precontemplation stage?
30% of smokers
interested but not ready to quit
contemplation
taking steps toward quitting like setting a quit date
preparation
begins first day of smoking cessation; requires maintenance or relapse will occur
action
what is the last stage of change?
maintenance
what are the 5 motivational R’s during interviewing?
Relevance - patient identifies personal relevance of smoking cessation
Risks
Rewards
Roadblock - potential barriers to quitting
Repetition - follow up at each visit
what is the patient’s preparations for quitting? STARS
STARS
Set a quit date
Tell family, friends
Anticipate challenges
Remove tobacco products from environment
Support
what are 3 first-line pharmacotherapies for smoking cessation?
nicotine delivery systems
bupropion
varenicline
what are 2 second-line pharmacotherapies for smoking cessation?
clonidine
nortriptyline
treatment focus is to provide steady nicotine levels to eliminate withdrawal and reinforce “hits”
nicotine replacement therapy
how long is nicotine replacement therapy?
8-12 weeks
in which conditions is bupropion CI in? (2)
seizure
eating disorder
in which patients should bupropion be used with caution?
psych patients on antidepressants
how long is bupropion treatment?
7-12 weeks
blue bloater, tend to take deeper breaths but cannot secure optimal O2 levels
chronic bronchitis
pink buffer; thin, breathing rapidly with pursed lips
emphysema
