Treating Tobacol Addiction Flashcards
What is the prevalence of smoking?
17.7%
How does it change depending on socio-economic group?
Disease of the poor - prevalence lot higher (25.1%)
In the higher, working socio-economic group the prevalence is only 11.9%.
What diseases are increased risk with smoking?
Lung cancer
COPD
Soooo many others! Still birth Mental health CVD Influenza Cancer
Why is smoking an addiction?
Cigarette smoking is a chronic relapsing disorder that starts in adolescence
Nicotine causes the addiction, not the harm from tobacco.
What are the markers of addiction?
Use despite knowledge of harmful consequences
Cravings during abstinence
Failure of attempts to stop
Withdrawal symptoms during abstinence
Describe the physiology of nicotine
Nicotine acts on nicotinic acetylcholine receptor stimulating dopamine relapse.
This results in the satisfaction associated with smoking
Following chronic nicotine exposure, ACh enter unregulated state - increases affinity and functional sensitivity to an agonist.
A drop in nicotine levels leads to craving and withdrawal
1-2 puffs of a cigarette binds to 50% of ACh receptors
ACh receptors take between 6-12 weeks to desensitise after last cigarette.
How is speed of nicotine delivery changed depending on method of delivery?
Cigarette fastest
spray and e-cigarettes
Gums / inhalers / tablets slowest
Why do most people quit?
Health related problems Advice from health professional Restrictions Poster Advert Family / friend
What are the three A’s?
ASK and record smoking status
ADIVSE patient of health benefits “stop smoking is the best thing you can do for your health”
ACT on a patients response “build confidence, give information, refer, prescribe, succeed with local NHS stop smoking services”
What pharmacological smoking cessation medications are their?
Gum
Patches
Varenicline
Tablets
Inhalers
E-cigarettes
What are the arguments against e-cigarettes?
Continues nicotine use Long term effects unknown Dual use perpetuates smoking ‘Renormalise smoking’ Promotes nicotine in the young Gateway to tobacco Products unsafe E-cigarettes made by tobacco companies Joint marketing of tobacco and e-cigs
What are the arguments for e-cigarettes?
Nicotine is a minor health risk Negligible compared to tobacco Quit rates continue to decrease Normalises e-cigs not tobacco Compared to tobacco, favourable Experimenters are same group About to be regulated Bigger reach for harm reduction Regulations coming into place Part of harm reduction strategy
