Tobacco + Smoking Cessation

Question 1

what percentage of patients die from smoking-related complications?

Answer 1

50%

Question 2

what is the leading cause of death by the majority of smokers who die? (2)

Answer 2

ischemic heart disease
stroke

Question 3

what is the 2nd leading cause of death by the majority of smokers who die?

Answer 3

lung cancer

Question 4

what is the 3rd leading cause of death by the majority of smokers who die?

Answer 4

COPD

Question 5

at what age do most adult smokers try their first cigarette?

Answer 5

before age 18

Question 6

what is the trend in youth smoking in the US?

Answer 6

going down

Question 7

what is the life span advantage of quitting by age 30?

Answer 7

10 yr increase

Question 8

what is the life span advantage of quitting by age 40?

Answer 8

8 year increase

Question 9

what is the life span advantage of quitting by age 50?

Answer 9

6 year increase

Question 10

what is the life span advantage of quitting by age 60?

Answer 10

3-4 year increase

Question 11

when do most withdrawal symptoms develop?

Answer 11

within first 3 days

Question 12

when do most withdrawal symptoms peak?

Answer 12

3 days - 1 week

Question 13

when do most withdrawal symptoms wane?

Answer 13

by 1-2 weeks

Question 14

when do cravings occur?

Answer 14

within several days

Question 15

how to cravings progress over time?

Answer 15

decrease in frequency but not in intensity

Question 16

how long after quitting can cravings still occur?

Answer 16

years afterwards

Question 17

cravings are associated with what kind of behaviors?

Answer 17

cued behaviors

Question 18

what are the 5 A’s?

Answer 18

Ask about smoking
Advise about smoking
Assess their willingness to quit
Assist those willing to quit
Arrange for follow up

Question 19

when should you Ask about smoking so there is a greater change of discussion?

Answer 19

during vital signs

Question 20

when should a follow up be arranged after quitting?

Answer 20

within the first week after quit day

Question 21

not interested in quitting

Answer 21

precontemplation

Question 22

what percentage of smokers are in the precontemplation stage?

Answer 22

30% of smokers

Question 23

interested but not ready to quit

Answer 23

contemplation

Question 24

taking steps toward quitting like setting a quit date

Answer 24

preparation

Question 25

begins first day of smoking cessation; requires maintenance or relapse will occur

Answer 25

action

Question 26

what is the last stage of change?

Answer 26

maintenance

Question 27

what are the 5 motivational R’s during interviewing?

Answer 27

Relevance - patient identifies personal relevance of smoking cessation
Risks
Rewards
Roadblock - potential barriers to quitting
Repetition - follow up at each visit

Question 28

what is the patient’s preparations for quitting? STARS

Answer 28

STARS

Set a quit date
Tell family, friends
Anticipate challenges
Remove tobacco products from environment
Support

Question 29

what are 3 first-line pharmacotherapies for smoking cessation?

Answer 29

nicotine delivery systems
bupropion
varenicline

Question 30

what are 2 second-line pharmacotherapies for smoking cessation?

Answer 30

clonidine
nortriptyline

Question 31

treatment focus is to provide steady nicotine levels to eliminate withdrawal and reinforce “hits”

Answer 31

nicotine replacement therapy

Question 32

how long is nicotine replacement therapy?

Answer 32

8-12 weeks

Question 33

in which conditions is bupropion CI in? (2)

Answer 33

seizure
eating disorder

Question 34

in which patients should bupropion be used with caution?

Answer 34

psych patients on antidepressants

Question 35

how long is bupropion treatment?

Answer 35

7-12 weeks

Question 36

blue bloater, tend to take deeper breaths but cannot secure optimal O2 levels

Answer 36

chronic bronchitis

Question 37

pink buffer; thin, breathing rapidly with pursed lips

Answer 37

emphysema