Treating Tobacco Addiciton Flashcards
Describe the epidemiology of tobacco related disease
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Describe the health risks of smoking
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Describe addicted
- Cigarette smoking is a chronic relapsing disorder that starts in adolescence 2. Nicotine causes the addiction, not the harm from tobacco
Markers of Addiction:
• use despite knowledge of harmful consequences
• cravings during abstinence
• failure of attempts to stop
• withdrawal symptoms during abstinence
Describe teh physiology o nicotine addiction
- Nicotine acts on nicotinic acetylcholine receptor stimulating dopamine release1-3
- This results in the satisfaction associated Nucleus Accumbens with smoking1-3 (nAcc)
- Following chronic nicotine exposure, ACh enter upregulated state - increases affinity and functional sensitivity to an agonist4
- A drop in nicotine levels leads to craving and withdrawal1,5
- 1-2 puffs of a cigarette binds to 50% ACh receptors6
- ACh receptors take between 6-12 weeks to desensitise after the last cigarette7
Describe the speed of nicotine delivery
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What are the 3 as
Ask if smoke, advise health benefits of stopping and best way to quit, act - give info, refer, prescribe
What are the treatment to help with tobacco addiction
Varenicline - partial agonist of ach reception. Great for reducing desire to smoke - more likely to quit,
Long acting nicotine replacements - eg patches, take a while
Short acting - gum, sprays, lozenges
Generally give a long acting patch, and then a short acting for how often why would smoke
What is harm reduction
‘there are other ways of reducing the harm from smoking, even though this may involve continued use of nicotine’ NICE PH45
E-cigarettes are part of a harm reduction strategy
What are the controversies for and against e cigarettes
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Describe e cigarettes
Ss • Smoking tobacco kills
• Harm reduction strategy can help those who can’t
quit tobacco
• E-cigarettes part of a harm reduction strategy
