messadi - 1/12 - methods of quitting tobacco use

Question 1

tobacco dependence is a two part problem:

Answer 1

physiological

behavioral

Question 2

true or false

tobacco is a chronic brain disease

Answer 2

true

Question 3

true or false

change is a process and not a single step

Answer 3

true

Question 4

why do people choose NOT to quit? 7 reason

Answer 4

1. nicotine is stimulant and gives you energy affects DO and NE gives high
2. smoking is a social behavior
3. smoking helps with stress managment, and relaxation
4. smoking helps control body weight [esp women]
5. smoking elevates mood [antidepressant]
6. Automatic smoking
7. multiple failed quit attempts

Question 5

___ % try to quit and know to quit but only ___% succesfully quit

Answer 5

70 % know

3% succeed

Question 6

_____ _____ helps pts learn to cope with these difficult situations without having a cig

Answer 6

behavioral counseling

Question 7

nicotine pharmacodynamics: withdrawal effect

which 7 are MOST PROMINENT

Answer 7

anger/ irritable

anxiety

craving

difficulty concentrate

hugner/ weight gain

impatience

restlessness

Question 8

tobacco cessation intervention

waht are the 5 As

Answer 8

Ask

advise

assess

assist

arrange

Question 9

waht type of question is this:

do you ever smoke or live in a household with smoker?

Answer 9

ask question of the 5 A’s

Question 10

advise with a ____ , ___ , ___ way

Answer 10

clear

strong

personalized

Question 11

occasional or light smoking is still harmful

waht type of quesiton is this

Answer 11

adivse question

Question 12

assess ____ or ____ to make a quit to attempt

Answer 12

willingness

readiness

Question 13

assist when the pt is ____

Answer 13

ready to quit

Question 14

pt who are i nthe process of quitting ins in the ___ stage

pt who have been off tobacco for MORE THAN 6 MONTHS are in ____ stage

pt is ready to quit [in the next 30 days — ____ stage)

not ready to quit is _____ stage

Answer 14

action

maintenance

preparation

contemplation or pre-contemplation

Question 15

arrange for ___ ___. this can be the difference bt quitting and not for some pts

Answer 15

follow up couseling

Question 16

___ % of all smokers are addictied by the time they reach ____>

Answer 16

90%

19

Question 17

the additional “A” is what

Answer 17

anticipate

Question 18

benefits of quitting

2 weeks to 3 months

Answer 18

circulation improves

walking easier

lung function increase to 30%

Question 19

benefit of quit

1 - 9 months

Question 20

benefit of quitting 1 year

Question 21

benefit of quitting 5 years

Question 22

benefit of quit after 10 years

Question 23

benefit of quitting after 15 years

Question 24

what are the 2 methods for quitting:

1. non pharamlogical includes ___ and other ___
2. pharamological: ____

Answer 24

non pharmalogical : couseling and nondrug approaches

pharmalogical - FDA approved meds

Question 25

waht is the success rate of cold turkey and categorized as what type of method

Answer 25

5% non-pharm

Question 26

other non pharm methods or alternative methods 5 of them

Answer 26

1. 2. acunpuncuture and hypotherapy = NOT EFFECTIVE 3. massage therapy 4. aversion therapy [suggest smoke till they are sick] 5. formal cessation programs: - group programs telephone counseling

Question 27

what are the 1st line of therapy... psychotropics = antipsychotic meds NRT?

Answer 27

nicotine replacement therapy patches, inhaler, nasal spray, gum, lozenge

Question 28

true or false pt can continue to use all forms of tobaccon upon intiation of the NRT regimen

Answer 28

false STOP, as opposed to the pharmacological agents you can smoke up to 1 week before quitting

Question 29

true or false can the effectivnes of nicotine gum be reduced with food and drinks

Answer 29

true they should stop eating and drnking around 15 - 30 min before using gum

Question 30

lozenge delievers ___ % more nicotine than the gum

Answer 30

25%

Question 31

dosing of lozenge is based on ____ as an indicator or nicotine addiction

Answer 31

TIME to FIRST cig [ttfc]

Question 32

with the patch 1. nicotine is well absorbed across the skin 2. delivery to ____ avoids hepatic 1st pass metabolism 3. plasma nicotine is ____ ...

Answer 32

true 2. systemic circulation 3. lowers

Question 33

true false apply to the same area each day do use the same area again for at least 1 week

Answer 33

false, do NOT APPLY same area false, do NOT use the same area for at least 1 week

Question 34

remove patch before an ___ procedure remove the patch during ____ time of the day.

Answer 34

MRI procedure night time

Question 35

\_\_\_ and ___ you can titrate the dose, but ___ you cant

Answer 35

lozenge and gum you can titrate dose patch you can NOT titrate dose

Question 36

the fastest nicotine replacement product taht goes to the brain is

Answer 36

nicotine spray

Question 37

nicotine inhaler, delievers ___ mg of nicotine absorbed through the ___ \_\_\_

Answer 37

4 mg buccal mucosa

Question 38

\_\_\_\_ is contraindicated in pt with seizures and is used as a reuptake inhibitor for ____ and \_\_\_

Answer 38

bupropion NE dopamine

Question 39

true or false pt with any other antidepressants, alcohol, or eating disorders [greater risk for seizures] are also contraindicated for use of bupropion

Answer 39

true

Question 40

Bupropion sr: pts should begin therapy _______ weeks _____ to their quit date to ensure that therapeutic plasma levles of the drgu are achieved.

Answer 40

1 to 2 weeks PRIOR

Question 41

if by 12 weeks, no diff in pt so doesnt stop smoking or doesnt see the effect of the bupropion, you should \_\_\_\_

Answer 41

stop use and 12 weeks is the cut off time

Question 42

true or false 1. bupropion might benefical for pts wtih depression 2. but if they are takig other anit depressants than shouldnt use bupropion

Answer 42

true true

Question 43

varenicline is a ___ neuronal nicotinic ____ receptor agonist

Answer 43

alpha4beta2 Ach R agonist [competively inhibits nicotine from binding]

Question 44

\_\_\_\_\_ has neuropsychiatric symptoms and throughts of suicide

Answer 44

varenicline

Question 45

\_\_\_ also is a partial nicotinic agonist like varenicline

Answer 45

lobeline [indian leaf]

Question 46

waht are the short acting formulation and what is the one long acting

Answer 46

short term: gum inhaler nasal spray long acting = patch

Question 47

which two are the most expensive products as opposed to the cigs

Answer 47

inhaler and bupropion

Question 48

to max success, interventions should include ___ and ___ meds

Answer 48

counseling one or more meds

Question 49

first line meds that increase long term smoking cessation reates include:

Answer 49

1. bupropion SR 2. nicotine replacement therapy [gum inhaler, lozenge, patch, nasal spray] 3. varenicline

Question 50

in smokers, clinicians may rely on the abscence of bleeding on probing as a MARKER of health in the same way as when assening non-smokers true or false

Answer 50

false, smokers will not have bleeding less inflammation but doesnt not mean they have less periodontal disease

Question 51

waht % of the periodontitis cases among adults int he US is associated with smoking 12. 7 25. 1 41. 9 64. 3

Answer 51

41.9

Question 52

a patient has a fagerstrom scale of 8 this indicates a high plaque rate high nicotine dependence low nicotine dependence stong correlation with oral cancer incidence

Answer 52

high nicotine dependence

Question 53

the basis for dosing nicotine lozenges is the number of cig smoked daily the time of first cig smoked the number of years the smokers have been smoking the numbr of previeous quitting attempt

Answer 53

the time of first cig smoked

Question 54

waht is the annual death rate attributed to smoking in the US 805, 000 443,000 11,000 1 mil

Answer 54

443,000

Question 55

cigars has less nicotine content than cigarettes true or false

Answer 55

false can have 20x more than cigs and 440mg nicotine than cigs

Question 56

which statement is the **least** correct about Cannabis - its use has decrease in the USA in the last 25 years - increase in the last 10 years - role in oral cancer development is still controversial - used in the most age groups including teenagers

Answer 56

wrong: use has decreased in the uSA in the last 25 years INCREASED IN THE LAST 25 YEARS