January 19, 2016 - Smoking Cessation Flashcards Preview

COURSE 3 > January 19, 2016 - Smoking Cessation > Flashcards

Flashcards in January 19, 2016 - Smoking Cessation Deck (16):
1

Harms of Smoking

A fuckton

Cancer, cardiovascular disease, respiratory disease, paediatric disease (if smoking while pregnant), and reproductive problems, among many more.

2

Leading Preventable Cause of Death and Disease

Smoking

3

A Lost Decade

Being a smoker reduces your life expectancy by 11-12 years.

4

Why is it Hard to Quit?

Only about 3% of smokers quit annually.

Smoking and getting the nicotine rush stimulates the dopamine pathway in your brain. This is the "reward" pathway that is critical for mood, motivation and attention, and good memory.

5

Nicotine Withdrawal

Begins within hours of stopping smoking, peaks within a few days, and lasts for weeks.

Symptoms of nicotine withdrawal include dysphoria and depressed mood, insomnia, irritability and frustration, anger and anxiety, difficulty concentrating, restlessness, and increased appetite.

6

Benefits of Quitting Smoking

Lung function begins to improve at 3 months

Coronary heart disease risk is reduced by 50% at 1 year

Stroke risk returns to the level of non-smokers in 5 years

Lung cancer risk is 30-50% of that of continuing smokers at 10 years

Cardiovascular heart disease returns to the level of non-smokers at 15 years

7

Years of Life Gained by Age

Regardless of the age the patient quits smoking at, they can expect to add years to their life.

If they quit at 30, they gain about 10 years

If they quit at 40, they gain about 9 years

If they quit at 50, they gain about 6 years

If they quit at 60, they gain about 4 years

8

Therapies With No Proven Benefit

Selective serotonin reuptake inhibitors (SSRI)

Laser treatment

Hypnosis

Acupuncture

9

Unproven Therapies to Quit Smoking

E-cigarettes

10

Proven Therapies for Quitting Smoking

1) Counselling is key

2) Pharmacologic aides - bupropion and NRT

11

The 5 A's

Ask - identify and document tobacco use

Advise - urge the smoker to quit

Assess - is the smoker ready to quit?

Assist - use counselling and pharmacotherapy

Arrange - schedule a follow-up within 1 week of quit date

12

5 Stages of Change

Pre-contemplative

Contemplative

Preparation

Action

Maintenance

13

Smoking Cessation Pharmacotherapy

1st Line - nicotine replacement (NRT), varenicline, and bupropion

2nd Line - Nortyptylline

14

Varenicline

Is a nicotine receptor partial agonist - it stimulates nicotine receptors more weakly than nicotine itself does.

It reduces cravings and decreases the pleasurable effects of smoking.

15

Bupropion

Used as an anti-depressant and a smoking cessation aid.

Roughly doubles the odds of smoking. Re-uptake/inhibition of dopanine/norepinephrine.

Cannot be used with seizures.

16

Combination Therapy

NRT and bupropion can be used in conjunction.

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