Smoking Cessation Flashcards
(33 cards)
How was tobacco made popular?
- Native Americans cultivated plant and smoked in pipes
- Christopher Columbus brought back to Europe
- popular in mid 16th century
- American tobacco plantations/slave labour
- unknown health effects
When did we find out tobacco was bad?
- 1930 - statistical correlation with cancer
- 1944 - American Cancer Society
- talked about ‘ill effects of smoking’ but no definitive evidence
What was found in the Doctors Study of 1951-2001?
- lung cancer and coronary thrombosis occurred markedly more often in smokers
How many smokers worldwide?
1.1 billion
…% of smokers are from low/middle income countries
80
Tobacco kills … people each year
… non-smokers are exposed to second hand smoke
6 million
600,000
In the UK in 1948, … % of men smoked.
What was the split between manufactured cigarettes and cigars/pipes?
- 82
- 65% cigs, 35% pipes
In 1948, what percentage of women smoked?
Did they smoke pipes?
What was the peak?
- 41%
- no
- 45% in mid 1960s
What is the strongest link to smoking status?
socio-economic status
What is the success rate of someone quitting smoking ‘un-aided’?
4%
What is the success rate of someone quitting smoking with NHS specialist stop smoking services?
15%
How many smokers try to quit every year?
a third
How many smokers ‘relapse’ after quitting (4-52 weeks)?
70%
Medications for quitting
- nicotine replacement therapy (NRT)
- varenicline (Champix)
- bupropion (Zyban)
- mecamylamine
- cystisine
- nortriptyline
- clonidine
Psychological support for quitters
- behavioural support
- one-to-one
- group sessions
- telephone services
How does nicotine replacement therapy work?
- provides nicotine to user instead of from cigarettes
- avoids toxins, carbon monoxide, tar
- increases success chance by 50-70%
- one product delivers half the nicotine a smoker would get
- combination approach is best - patch is faster acting
How does Champix work?
- partial agonist acting on alpha4beta2 nicotinic receptor
- reduces withdrawal and reduces ‘rewards’ of smoking
- doubles success of quitting
How does Zyban work?
- reduces withdrawal symptoms and urges to smoke
- by inhibiting neuronal uptake of dopamine and noradrenaline
- by non-competively inhibiting nicotinic acetylecholine receptor
- has effects on serotonin reuptake
How can a doctor give brief smoking advice?
- ask and record smoking status
- advise on the best way to quit (combine medication and specialist support)
- act on patient response (build confidence, give ingo, refer, prescribe)
People are … times more likely to quit with support
4
How often should people be asked if they smoke?
- if they are a current, ex or non smoker
- once a year
- medical history updatedf
Why do we no longer warn of dangers and simply support?
- can raise defensive reaction and raise anxiety levels
- takes time and can generate a convo about it which is more appropriate with a dedicated stop smoking consultation teeam
Key oral issues caused by smoking
- oral neoplasia
- periodontitis
- ANUG
- oral mucosal disease
- dental caries
- dry sockets in wound healing
- staining
- halitosis
Why does smoking contribute to periodontitis?
- biggest risk factor
- impairs vasculature and inflammatory response so immune impairment too
- effects microbiota
- in 50% of chronic cases, 2-8 times more, 5x tooth loss
