tobacco Flashcards by Caleb Houghton

what product has the highest nic content

cigars

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When inhale cigarette (directly or secondhand) inhaling more than _____ chemicals, _____ of these are hazardous ______ are known carcinogens

When inhale cigarette (directly or secondhand) inhaling more than 7,000 chemicals
Hundreds of these are hazardous
70 are known carcinogens

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______ cancer is the leading cause of cancer related death in US for both men and women

Lung cancer is the leading cause of cancer related death in US for both men and women

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what causes a majority of lung cancer

smoking

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SMOKING EFFECTS ON THE MOUTH
 breath?
 Perio?
 throat?
 Reduced senses?
 Unhealthy tissue
 Delayed?
 cancers?
 staining?
 Poor response to?
 lesions?
 Sores?

 Bad breath
 Periodontal (gum) disease
 Sore throat/hoarseness
 Reduced smell/taste
 Unhealthy tissue
 Delayed healing
 Oral cancer
 Throat cancer
 Teeth staining
 Poor response to dental treatment
 Oral lesions
 Sores on mouth, lips, tongue

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all smokeless product contain

carcinogens and nic

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SMOKELESS TOBACCO EFFECTS
ON THE MOUTH
breath?
 Irritates and inflames?
 cancer?
 Increased risk of?
 Painful?
 staining?
 disease?

SMOKELESS TOBACCO EFFECTS
ON THE MOUTH
 Bad breath
 Irritates and inflames tissue= Tissue changes
 Oral cancer
 Increased risk of tooth decay
 Painful ulcers
 Teeth staining
 Periodontal/Gum disease

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 Approximately _____ Americans are diagnosed with OPC (oral and/or pharyngeal cancer)
 ________die each year from disease

 Approximately 42,000 Americans are diagnosed with OPC (oral and/or pharyngeal cancer)
 8,000 die each year from disease

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 ____% of OPC can be attributed to tobacco use, heavy
alcohol consumption and in many cases both

75%

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prevalence of e cigs increasing where?

high schoolers and adolescents due to fruit flavors

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“VAPING”…..
 Act of inhaling and exhaling what? which is produced by?
 E-cigarettes do not produce? , but rather an? often mistaken for? , that actually consists of?
 Vapor is generated from?

“VAPING”…..
 Act of inhaling and exhaling the aerosol, often referred to as vapor, which is produced by an e-cigarette or similar device.
 E-cigarettes do not produce tobacco smoke, but rather an aerosol, often mistaken for water vapor, that actually consists of fine particles.
 Vapor is generated from a solid, semi-solid, or liquid substance

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components of vape pens

COMPONENTS
 Battery
 Heating element
 Atomizer
 Cartridge/pod
 Indicator light

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E-LIQUID INGREDIENTS

 Vegetable glycerin
 Propylene glycol
 Flavorings
 Nicotine**
 Other compounds/chemicals: Diacetyl and Benzoic acid

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e liquid ingredients deemed safe?

 Ingredients may be deemed safe for use and/or ingestion
 But not evaluated for inhalation and heat

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e liquid 3rd hand exposure?

 Can remain on surfaces for weeks to months
 Potential for 3rd hand exposure or accidental ingestion by
children

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e liquid effects in pregnancies

 May cause adverse effects during or after pregnancy
 Nicotine can cross the placenta

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nic salts
hit?
 More like a?
 nicotine concentrations?
 Potential to be more?
 nicotine solutions available?
 Each pod contains same amount of nicotine as?

“Smoother hit”
 More like a cigarette rush
 Higher nicotine concentrations
 Potential to be more addictive
 1.8 % - 5% nicotine solutions available
 Each pod contains same amount of nicotine as an
entire pack of cigarettes**

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AEROSOL composition

 Volatile organic compounds
 Nicotine
 Ultrafine particles
 Heavy metals – nickel, tin, lead

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why ?

HEALTH CONCERNS ASSOCIATED
 POPULARITY OF DEVICES
 Easy to get? how?
 Flavorings?
 design?
 11 to 17-year olds think?

 Easy to get: Via online, convenience stores*, Smoke/vape shops
 Flavorings make these devices appealing
 Discreet use/sleek design
 11 to 17-year olds think e-cigarettes are less
harmful than smoking

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HEALTH CONCERNS ASSOCIATED with vaping
 Increased heart rate due to? =Higher risk for?
 blood pressure?
 bronchitis?
 lung disease?
 “popcorn lung”?
 glycemic control?

 Increased heart rate due to spike in adrenaline=Higher risk for heart attack
 Increased blood pressure
 Increase in bronchitis
 Increase in lung disease
 “popcorn lung” – bronchiolitis obliterans
 May cause blood sugar levels to rise

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vaping EFFECTS ON ORAL HEALTH
 Chemical vapors produced can alter or damage what cells?
 ulcerations?
 Oral cancer?
 Indicates an inflammatory response where/cells?
 May lead to greater risk for?
 throat?
 Dry?

 Chemical vapors produced can alter or damage epithelial cells
 Oral ulcerations
 Oral cancer may result
 Indicates an inflammatory response in the PDL fibroblasts
 May lead to greater risk for periodontal disease
 Sore throat
 Dry mouth

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vaping heat and chemicals effect in the mouth
 Dry?
 Bone?
 Inflam?
 Increased?
 Tooth?

 Dry mouth
 Bone loss
 Inflammation
 Increased plaque, calculus
 Tooth decay

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nic as a stim can induce what habit?

bruxism

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NICOTINE
 Distributed quickly through the ___________ and
crosses the ____________barrier
 Reaches the brain within __________seconds with inhalation
 Elimination half-life?
 Nicotine is metabolized in the?

 An alkaloid that is contained in the leaves of plants
 Distributed quickly through the bloodstream and
crosses the blood–brain barrier
 Reaches the brain within 8–20 seconds with inhalation
 Elimination half-life of nicotine is around two hours
 Nicotine is metabolized in the liver

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nic physio effects adrenal glands heart panc NTs released?

 The amount of nicotine absorbed by the body from smoking depends on:

 type of tobacco  whether the smoke is inhaled  whether a filter is used

smoke vs. smokeless tobacco and nic into body

more in smokeless

nic and braind dev

 Research indicates development of brain continues to occur until the age of 25  Nicotine changes the way synapses are formed  can harm the parts of the brain that control attention and learning  The nicotine in e-cigarettes and other tobacco products can also prime the adolescent brain for addiction to other drugs such as cocaine.

HOW (nic) IMPACTS YOUTH/YOUNG ADULTS

 Depression  Anxiety  Mood disorders  Addiction  Difficulty paying attention  Reduced impulse control

nic addiction cycle (increased usage)

TOBACCO DEPENDENCE: A 2-PART PROBLEM

WITHDRAWAL SYMPTOMS

# timeframes BENEFITS OF QUITTING SMOKING 20 min 8hrs 24hrs 48hr 3days 2-12 months 5yrs 10-15 yrs

quitting smokeless tobacco decreases risk for:  cancer?  teeth?  gums?  cholesterol?  bp?  infarctions?

 oral, head and neck cancer  tooth decay  progression of gum recession  high cholesterol  high blood pressure  heart attack or stroke

what product has the highest 1 year cessation rates

nic gum and lozenges

the 5 A's for user

how to ask about tobacco use

◼ “Do you ever smoke or use any type of tobacco?” ◼ “Do you use any form of e-cigarette or vaping device?” ◼ “Do you, or does someone in your household smoke?”

pack year figure

Number of cigs per day/20 x number of years of smoking = number of pack years

advising quitting

(clear, strong, personalized) ◼ Best results if you can personalize this and be open, non-judgmental

ways to assists with the quit at different stages

◼ Not ready to quit: provide motivation ◼ Ready to quit: design a treatment plan ◼ Recently quit: relapse prevention

Transtheoretical Change Model (Stages of Change)

arranging follow up care

greater success with more appts

Quit-line available 24 hours a day, 7 days a week?

1-800-quitnow

CESSATION OPTIONS  Cold Turkey (no additional help)  Replacement?  Medications*  Therapy?  Apps?  Combination?  Hypnotherapy?  Acupuncture?  Yoga, meditation?  Herbs?

 Cold Turkey (no additional help)  Nicotine Replacement Therapy (NRT’s)*  Medications*  Behavioral Therapy  Counselor/Coach, app/tech use, telephone counseling (1-800-QUITNOW)  Apps – QuitNow!, KWIT, Smoke Free, Quitters Circle, Quick Tracker  Combination Therapy: Multiple uses of NRTs, NRTs and medications  Hypnotherapy – Reveri app  Acupuncture  Yoga, meditation  Herbs

contraindications for pharm agents

Hypothyroidism Insulin-dependent diabetes Active peptic ulcer Anti-depressant medications

BUPROPION SR (ZYBAN) what is this? when to begin? when to double dose?

)  150 mg sustained release tablet  Begin taking 1 week prior to quitting  Double dose after 3 days

zyban advantages

 Easy to use  Can be used with Nicotine Replacement Therapy

zyban adverse effects sleep, mouth, nerves, concentration, GI, convolutions?

Insomnia, dry mouth, nervousness/difficulty concentrating, rash, constipation, seizures

# starter and maintenence? How to write the prescription for zyban

Rx: Zyban Starter Pack Disp: 1 (one) package Sig: Take as directed 0 refills Rx: Zyban Maintenance Pack Disp: 1 (one) package Sig: Take as directed 2 refills

# dosage/ days and weeks frame VARENICLINE (CHANTIX®)

 0.5 mg and 1.0 mg tablet  Days 1-3: take one 0.5 mg tablet in the AM  Days 4-7: take 0.5 mg tablet twice daily  Weeks 2-12: take 1.0 mg tablet twice daily

chantix advantages

Easy to use and offers a new mechanism of action for patients who have failed with other agents (decreases dopamine for less withdrwl effects)

chantix adverse effects sleep, GI, nn, nausea?

Nausea, insomnia, vivid dreams, constipation, vomiting, Neuropsychiatric Symptoms (behavior changes, agitation, depressed mood, suicidal ideation or behavior)

# starter/maintence? chantix prescription

Chantix® Starting Month/Pack Disp: 1 (one) package Sig: Take as Directed 0 Refills Chantix® Continuing Month/Pack Disp: 1 (one) package Sig: Take as Directed 2 refills

chantix quitting methods

3 ways: fixed , flexible and gradual quit approaches

# dosage (wks; 1-6, 7-9, 10-12)? max per day? food? (GUM – NICORETTE, ZONNIC)

 Week 1-6: 1 piece every 1-2 hours  Week 7-9: 1 piece every 2-4 hours  Week 10-12: 1 piece every 4-8 hours  Max of 24 pieces per day. No food or beverage 15 min before or during use

nic gum pros

 May delay weight gain and satisfy oral cravings

nic gum cons

Mouth/jaw soreness, hiccups, dyspepsia

# dosages possible for dif cases? (wks: 1-6,7-9, 10-12)? max per day? food? (LOZENGE – COMMIT, ZONNIC)

 2 mg (smoke > 30 min after waking) and 4 mg (smoke ≤ 30 min after waking)  Week 1-6: 1 lozenge every 1-2 hours  Week 7-9: 1 lozenge every 2-4 hours  Week 10-12: 1 lozenge every 4-8 hours  Max. of 20 lozenges/day. No food or beverage 15 min. before or during use. Do not chew or swallow lozenge

advantages of the nic lozenge

May delay weight gain and satisfy oral cravings

cons of nic drop

Nausea, hiccups, cough, heartburn, headache, insomnia

# dosages (TRANSDERMAL PATCH - NICODERM CQ)

 7 mg, 14 mg, 21 mg (24-hour release)

pros of slapping on a nic patch

Provides consistent Nicotine for 24 hrs, easy to use.

cons of wearing a fucking patch releaseing nic on your skin 24hrs a day local, head, sleep?

Local skin reaction, headache, insomnia, vivid dreams (sex)

(NASAL SPRAY – NICOTROL NS)  dose per 50mcl  usual doses per hour?  doses/day?  Maximum doses/hr?  One dose = ?

 0.5 mg metered spray per 50 mcL  1-2 doses per hour  8-40 doses/day  Maximum 5 doses/hr  One dose = 2 sprays (1 per nostril)

pros of the sweet ass nic spray

Patients can titrate therapy to help with withdrawal

cons of spraying fucking nic into your nose

Nasal/throat irritation, rhinitis, tearing, sneezing, headache, cough

(ORAL INHALER – NICOTROL)  ___ mg cartridge – delivers ____ mg inhaled nicotine vapor  cartridges/day?  Begin with ___ cartridge every ____ hours  Best effects with?

 10 mg cartridge – delivers 4 mg inhaled nicotine vapor  6-16 cartridges/day  Begin with 1 cartridge every 1-2 hours  Best effects with continuous puffing for 20 min

pros of having a nic enhanced inhaler with blue tiger camo and no stock

Patients can titrate amount to manage withdrawal and mimics hand-to-mouth ritual

cons of the nic inhaler

Mouth/throat irritation, cough, headache, rhinitis, dyspepsia (indigestion)

umkc super cool smoking cessation program consists of

 Prep-work by the student  Initial Visit Appointment  Follow-Up Visit Appointment(s) maybe free hugs too idk

is smoking cool?

only if youre drunk or have a topcoat on then kinda