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Smoking Cessation

Behavioral Medicine

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