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Smoking Cessation
Lozenge, gum and patch
| Question | Answer |
|---|---|
| Health benefit of quitting: 2w-3mo | Circulation improves Walking becomes easier Lung function increases up to 30% |
| Health benefit of quitting: 1-9mo | Lung cilia regain normal function Ability to clear lungs of mucous increases Coughing/fatigue/shortess of breath decrease |
| Health benefit of quitting: 1year | Excess risk of CHD decreases to half that of a continuing smoker |
| Health benefit of quitting: 5years | Risk of stroke is reduced to that of people who have never smoked |
| Health benefit of quitting: 10years | Lung cancer death rate drops to half that of a continuing smoker Risk of cancer of mouth, throat, esophagus, bladder, kidney, pancreas decrease |
| Health benefit of quitting: 15years | Risk of CHD is similar to that of people who have never smoked |
| Electronic Cigarettes: How do they work? | Battery warms cartridge that contains nicotine and delivers the vaporized nicotine |
| Electronic Cigarettes: Does the FDA support them as safe? | No |
| Nicotine Dependence: What is the test used to determine nicotine dependence? | Fagerstrom Test |
| Nicotine Dependence: What to the ranges mean? (0-2, 3-4, 5, 6-7, 8-10) | 0-2: very low 3-4: low 5: medium 6-7: high 8-10: very high |
| Nicotine Dependence: What does a score of 5+ signify? | Substantial nicotine dependence |
| Nicotine Dependence: How do you treat physiological dependence? | Use meds for cessation |
| Nicotine Dependence: How do you treat behavioral dependence? | Use a behavior change program |
| What are some withdrawal effects? | Irritability, frustration, anger, anxiety, difficulty concentrating, restlessness, impatience, depressed mood, depression, insomnia, impaired performance, increased appetite, weight gain, cravings |
| Drug interactions with smoking: What meds will it interfere with? | Hormonal contraceptives: CV side effects, stroke, MI, Thromboembolism |
| Drug interactions with smoking: what can smoking do to drugs in the body? | enhance metabolism of other drugs, resulting in reduced pharmacologic response |
| What are the 5 A's? | Ask Advise Assess Assist Arrange |
| What are the 5 A's for? | The entire process of quitting smoking |
| What are the 5 R's? | Relevance Risks Rewards Roadblocks Repetition |
| What are the 5 R's for? | Methods for increasing motivation to quit |
| Transtheoretical model of change: what are the 5 stages? | Pre-contemplation Contemplation Preparation Action Maintinence |
| Transtheoretical model of change: What is pre-contemplation? | Not thinking of quitting within the next 6 months |
| Transtheoretical model of change: What is contemplation? | Considering quitting in the next 6mo but not 30 days Are aware of the need to quit and the benefits of quitting |
| Transtheoretical model of change: What is Preparation? | Ready to quit in the next 30 days Patients are ready to take action |
| Transtheoretical model of change: What do you do during preparation? | Set a quit date in 2-14 days identify triggers offer follow up assistance throughout quit attempt |
| Transtheoretical model of change: What is action? | Actively trying to quit for good, quit within the last 6 mo |
| Transtheoretical model of change: What happens in Action? | Withdrawal symptoms, risk for relapse |
| Transtheoretical model of change: What is maintenance? | Patient has been tobacco free for 6+ mo |
| Transtheoretical model of change: What happens during maintenance? | talk about slips, encourage healthy behaviors, offer tips for relapse prevention |
| Non-Pharm therapy: What are some methods of non pharm therapy? | Cold turkey acupuncture hypnotherapy massage therapy |
| Nicotine gum: Precautions | Patients with CV disease Recent MI (within 2 weeks) Serious arrhythmias Serious or worsening angia |
| Nicotine gum: Dosing | 2mg-smoke after 30 mins of waking 4mg-smoke within 30 mins of waking |
| Nicotine gum: Dosing schedule | 1-6w: 1 piece q 1-2 hours 7-9w: 1 piece q 2-4 hours 10-12w: 1 piece q 4-8 hours |
| Nicotine gum: What decreases the effectiveness of the gum? | Coffee, wine, juices, soft drinks |
| Nicotine gum: How long should you wait if you drink something before you chew gum? | 15 minutes |
| Nicotine gum: Side effects and cautions | Mouth soreness, hiccups, dyspepsia, jaw muscle ache, MAY STICK TO DENTAL WORK |
| Nicotine Lozenge: Dosage | 2mg-smoke after 30 mins of waking 4mg-smoke within 30 mins of waking |
| Nicotine Lozenge: Dosing schedule | 1-6w: 1 piece q 1-2 hours 7-9w: 1 piece q 2-4 hours 10-12w: 1 piece q 4-8 hours DONT USE MORE THAN 20 A DAY |
| Nicotine Lozenge: How many do you use/day and for how long? | 9/day for 6 weeks |
| Nicotine Lozenge: What decreases the effectiveness of the lozenge? | Coffee, wine, juices, soft drinks |
| Transdermal Patch: What strength does it come in? | 7, 14, 21 mg/day |
| Transdermal Patch: Dosing for light smoker (10 or less a day) for Nicoderm CQ and generic | 10 or less cigarettes a day Step 2 - (14mg for 6 weeks) Step 3 - (7mg for 2 weeks) |
| Transdermal Patch: Dosing for heavy smoker (more than 10 a day) for Nicoderm CQ | Step 1 - (21mg for 6 weeks) Step 2 - (14 mg for 2 weeks) Step 3 - (7 mg for 2 weeks) |
| Transdermal Patch: Dosing for heavy smoker (more than 10 a day) for generic | Step 1 - 21 mg for 4 weeks Step 2 - 14 mg for 2 weeks Step 3 - 7 mg for 2 weeks |
| Transdermal patch: Where to put it? | Upper body |
| Transdermal patch: What to do if skin stays red for 4 days or longer? | Refer to PCP |
Created by:
carlypentland
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