Behavioral Medicine
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| No. 1 most preventable cause of death in the US and worldwide | smoking
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| impacts of smoking | fertility, pregnancy outcome, breast cancer, cataracts, macular degeration, cardiovascular problems
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| there is a __ year loss of life expectancy with smoking | 10
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| second hand smoke cause and increase in __ for exposed children | otitis media
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| within a year of quiting patients have a reduced | CHD risk (by 1/2)
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| within days of quiting smoking people __ better | smell
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| within a week or two after quitting smoking, people _________ better | taste
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| within weeks of quitting smokers have an increased __ | pulmonary function, increased exercise tolerance
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| within __ years after smoking cessation the CVD risk is the same as for a non-smoker | 15
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| all cause death rate reduced in __ years after smoking cessation | 2
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| cancer rate 50% reduced over __ years after smoking cessation | 10
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| if a 65 year old smoker quits he/she can add __ years to their life expectancy | 4
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| nicotine hits the brain in __ seconds | 11
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| after nicotine hits the brain __ is released along with other neurotransmitters | dopamine
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| nicotine withdrawal symptoms | anger, cravings, decreased concentration, hunger, wt gain, restlessness, drowsiness, fatigue, decreased task performance, sleep disturbance
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| the new model of behavior change | patient self-management
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| patient self-management includes | the activated patient, shared decision making with the provider, effective communication, self-efficacy to achieve desired behaviors and to manage symptoms
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| the five A's of self management | ask, advise, assess, assist, arrange
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| short cut to the five A's (3 A's) | ask, advise (tell), ask and refer
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| the fifth vital sign | asking about smoking (every visit)
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| what is the assess step in smoking cessation | is the patient ready to make a change
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| what are the stages of change | pre-contemplation, contemplation, preparation, action, maintenance
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| the pre-contemplation stage of change | the huh phase, not thinking about change, may be resigned, feeling no control, denial
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| the contemplation stage of change | the but phase, weighing benefits and costs of continuing/changing the behavior
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| the preparation stage of change | the I'm ready now phase, experiment with small changes
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| self-management skills | patient centered, attainable goals, problem solving, skills training
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| Assist patient in smoking cessation | get ready (set a quit date), get support, learn new skills and behaviors (BT and CBT), get meds and learn to use, be prepared for relapse or roadblocks
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| arrange follow up care within __ of quitting (in person, phone, electronic) | one week
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| how to set goals | set SMART goals, Specific, Measurable, Action oriented, Realistic, Timely
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| the five R's of smoking cessation | Relevance to patient, Risks, Rewards, Roadblocks, Repetition
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| questions to ask to get the smoker to see the disadvantages of not making a change | what would happen if you don't change? in what way does this concern you? why does this worry you?
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| questions to ask to get the smoker to see the advantages of change | what are the advantages of changing? how would you like for things to be different? what are the main reasons to change?
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| cigarettes are responsible for one in every deaths in the united states | 5
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| currently __% of US adults are smokers | 23
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| currently __% of US young adults are smokers | 26
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| smokers have __ the risk of fatal heart disease | twice
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| smokers have __x the risk of lung cancer | 10
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| in the US __% of cases of COPD occur among current or former smokers | 90
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| heavy smokers have a __ greater risk of age-related macular degeneration | 2.5
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| smokers die __ years earlier than never-smokers | 5-8
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| how are children of smokers affected | lower birth wts, more likely to be mentally retarded, have more frequent respiratory infections and less efficient pulmonary function, have a higher incidence of chronic ear infections, and more likely to become smokers themselves
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| only __% of smokers who attempt to quit are successful | 4
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| __% of smokers attempt to quit every year | 40
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| persons whose physicians advise them to quit are __times as likely to attempt quitting | 1.6
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| over 70% of smokers see a physician each year but only __% of them receive any medical quitting advice or assistance | 20
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| step 1 of the five A's of smoking cessation | ask: systematically identify all tobacco users at every visit
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| step 2 of the five A's of smoking cessation | advise: strongly urge all smokers to quit
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| step 3 of the five A's of smoking cessation | attempt: identify smokers willing to make a quit attempt
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| step 4 of the five A's of smoking cessation | assist: aid the patient in quitting
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| step 5 of the five A's of smoking cessation | arrange: schedule follow-up contact
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| weight gain occurs in __% of patients following smoking cessation | 80
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Created by:
Abarnard
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