Tobacco Cessation Flashcards
(125 cards)
1
Q
All smoking tobacco products contain:
A
carcinogens
2
Q
List the nicotine content per single use for the following products:
a) Pipe tobacco:
b) Cigars
c) Hookah
d) Cigarette
e) E-cigarette
A
a) 30.08-50 mg
b) 13.3-15.4 mg
c) 1.04-2.24 mg
d) 1.2-1.8 mg
e) 0.0 -15.4 mg
3
Q
When using a smoking tobacco product you are potentially inhaling more than:
A
7000 chemicals
4
Q
Of the more than 7000 chemicals inhaled with a smoking tobacco product, ___ are known carcinogens
A
70
5
Q
List the possible cancers associated with smoking tobacco products: (10)
A
- oropharynx
- larynx
- esophagus
- trachea, bronchus, lung
- acute myeloid leukemia
- stomach
- pancreas
- kidney and ureter
- cervix
- bladder
6
Q
List the possible chronic diseases associated with smoking tobacco products: (11)
A
- stroke
- blindness, cataracts
- periodontitis
- aortic aneurysm
- CHD
- pneumonia
- vascular diseases
- respiratory effets
- COPD
- hip fractures
- reproductive effects
7
Q
Health consequences casually linked to secondhand smoke exposure in children: (5)
A
- middle ear disease
- respiratory symptoms
- impaired lung function
- lower respiratory illness
- SIDS
8
Q
Health consequences casually linked to secondhand smoke exposure in adults: (4)
A
- nasal irritation
- lung cancer
- CHD
- Reproductive effects in women (low birth weight)
9
Q
The leading cause of cancer related death in US for both men and women:
A
lung cancer
10
Q
____ accounts for more than 90% of lung cancer cases reported in men and 89% in women
A
smoking
11
Q
Smoking accounts for more than___% of lung cancer cases reported in men and ___% in women
A
90%; 89%
12
Q
Smoking effects on the mouth include: (10)
A
- bad breath
- periodontal (gum) disease
- sore throats/hoarseness
- reduced smell/taste
- unhealthy tissue
- delayed healing
- oral/throat cancer
- teeth staining
- poor response to dental treatment
10 oral lesions
13
Q
Smokeless tobacco products all contain:
A
carcinogens
14
Q
List some examples of smokeless tobacco products and include their nicotine content per single use:
A
- Snus (8.0 mg)
- Chew (4.5mg)
- Snuff (3.6mg)
- Orbs (1.0mg)
- Stips (0.6mg)
15
Q
Chewing tobacco (snuff) contains over ____ chemicals known to cause cancer
A
28
16
Q
List some examples of carcinogens found in snuff: (6)
A
- cadmium: used in car batteries
- N-nitrosamines: cancer causing chemical
- Uranium-235: used in nuclear weapons
- Formaldehyde: used in embalming fluid
- Benzopyrene: cancer causing chemical
- Polonium 210: nucelar waste
17
Q
smokeless tobacco effects on the mouth include: (7)
A
- bad breath
- irritates and inflames tissues
- oral cancer
- tooth decay
- painful ulcers
- staining
- periodontal/gum disease
18
Q
Approximately ____ Americans are diagnosed yearly with oral/pharyngeal cancer and ____ succumb to the disease.
A
42,000; 8,000
19
Q
___ % of the cases of oral/pharyngeal cancer diagnosed yearly can be attributed to tobacco use and/or heavy alcohol consumption
A
75%
20
Q
___% of leukoplakia are caused by tobacco use
A
70%
21
Q
ENDS stands for:
A
electronic nicotine delivery system
22
Q
According to the CDC:
A) ____% of adults over 18 currently use e-cigs
B) ____% of high school students currently use e-cigs
C) ____% of middle school students currently use e-cigs
A
A) 4.7%
B) 14.1%
C) 3.3%
23
Q
Of the 3.3% of middle school students using e-cigs, ___% of these students are using flavored e-cigs (fruit, candy, dessert flavors)
A
84.7%
24
Q
According to the CDC regarding e-cigs, the device type of choice was:
A
disposables (55.3%)
25
Acting of inhaling and exhaling the aerosol, often referred to as vapor, which is produced by an e-cigarette or similar device
vaping
26
Does vaping produce tobacco smoke?
no
27
The aerosol produced with vaping is often mistaken for:
water vapor
28
Vaping contains:
fine particles
29
Vapor is generated from:
a solid, semi-solid, or liquid substance
30
Components of an E-cig include:
1. battery
2. heating element
3. atomizer
4. cartridge/pod
5. indicator light
31
E-cigarette E-liquid ingredients: (5)
1. vegetable glycerine
2. propylene glycol
3. flavorings
4. nicotine
5. other compounds/chemicals (diacetyl; benzoic acid)
32
The ingredients in e-liquid may be deemed safe for ___ but are not evaluated for:
use and/or ingestion; inhalation and heat
33
E-liquid can remain on surfaces for:
weeks to months
34
Since e-liquid can remain on surfaces for weeks to months, there is the potential for:
3rd hand exposure or accidental ingestions by children
35
E-liquid may cause adverse effects during or after pregnancy because:
nicotine can cross the placenta
36
Nicotine salts can be described as a:
"smoother hit" (more like a cigarette rush)
37
Nicotine salts have higher:
nicotine concentrations
38
Since nicotine salts have higher nicotine concentrations, there is the potential for:
more addiction
39
What percentages of nicotine are in nicotine salts?
1.8%-5%
40
Each pod of nicotine salts contains:
same amount of nicotine as an entire pack of cigarettes
41
Describe the components of aerosols (4)
1. volatile organic compounds
2. nicotine
3. ultrafine particles
4. heavy metals (nickel, tin, & lead)
42
Health concerns associated with aerosols: (5)
1. increased heart rate due to spike in adrenaline
2. increased blood pressure
3. increased bronchitis
4. increased lung disease
5. may cause blood sugar levels to rise
43
The increased heart rate due to spike in adrenaline associated with aerosols leads a person to higher risk for:
heart attack
44
Describe what a lung may look like with use of aerosols:
"popcorn lung" ( bronchiolitis obliterans)
45
AKA Popcorn lung:
bronchiolitis obliterans
46
Chemical vapors produced can alter or damage ____ which may result in ___ & ____
In addition they may cause ___ or ___
epithelial cells; oral ulcerations; oral cancer
sore throat or dry mouth
47
An alteration or damage of epithelial cells as a result of chemical vapor/aerosols indicates an ___ in the ____ which may lead to greater risk for ____
inflammatory response; PDL fibroblasts; periodontal disease
48
What are the effects of heat and chemicals on oral health? (5)
1. dry mouth
2. bone loss
3. inflammation
4. increased plaque and calculus
5. tooth decay
49
What are the effects of nicotine as a stimulant on oral health?
increased bruxism
50
Other concerns in regards to vaping include: (4)
1. burns from device batteries/explosions
2. nicotine poisoning/overdoes
3. secondhand aerosol exposure
4. environmental concerns
51
Nicotine poisoning/overdose is a concern with e-cigarettes because:
pods can leak solution and nicotine is rapidly absorbed via the skin
52
An alkaloid that is contained in the leaves of plants:
nicotine
53
Nicotine is distributed quickly through the ____ and crosses the ___-
bloodstream; blood-brain barrier
54
Nicotine reaches the brain within ___ seconds of inhalation
8-20 seconds
55
The elimination half life of nicotine is around:
2 hrs
56
Nicotine is metabolized in the:
liver
57
Nicotine Effect:
1. Nicotine stimulates the ____ which release ____ and this surge causes an immediate release of ___.
2. Increased ___, ____, & ____
3. The ____ produces less ___ causing increased ____
4. _____ is released- feeling of contentment is higher.
5. ____ & ____ are also released - concentration and memory
6. Increased levels of ____, resulting in reduced ____
1. adrenal glands; adrenaline; glucose
2. HR, breathing activity & BP
3. pancreas; insulin; blood glucose
4. Dopamine
5. acetylcholine & norepinephrine
6. beta-endorphin; anxiety
58
If you have a diabetic patient and you are counseling them on smoking cessation, what point might you hit on?
That nicotine causes the pancreas to produce less insulin resulting in increased blood sugar or glucose
59
The amount of nicotine absorbed by the body from smoking depends on: (3)
1. type of tobacco
2. whether smoke is inhaled
3. whether a filter is used
60
The amount of nicotine released into the body tends to be much greater in:
smokeless tobacco
61
T/F: Vaping gets nicotine into the bloodstream quicker
True
62
T/F: Smokeless tobacco (Chew) Vs. smoking provides a smaller nicotine hit
False
63
Research indicates development of the brain occurs until the age of:
25
64
Nicotine changes the way:
synapses are formed
65
Since nicotine changes the way synapse are formed this means it can harm parts of the brain that control:
attention & learning
66
The nicotine in e-cigs and other tobacco products can also prime the adolescent brain for:
addiction to other drugs such as cocaine (surgeon general)
67
How does nicotine impact youth/young adults? (6)
1. depression
2. anxiety
3. mood disorders
4. addiction
5. difficulty paying attention
6. reduced impulse control
68
Nicotine addiction is more than a "bad habit", discuss the chain of events with nicotine addiction
1. Use of nicotine
2. stimulates dopamine release
3. causes pleasurable feelings
4. repeated use of nicotine
5. tolerance develops
69
Why does tolerance develop with nicotine addiction?
body creates more nicotine receptor sites over time
70
Tobacco dependence can be described as a ___ problem
2-part
71
Describe the parts of the problem with tobacco dependence:
1. physiological- the addiction to nicotine
2. behavioral- the habit of using tobacco
72
The habit of using tobacco is considered:
behavioral
73
The addiction to nicotine is considered a _____ problem
physiological
74
Treatment for tobacco dependence should address:
the physiological AND behavioral aspects of dependence
75
Medications for addiction for cessation with tobacco dependence would address what aspect of the problem?
Physiological
76
List the withdrawal symptoms associated with tobacco cessation (and time line):
1. Dizziness: 1-2 days
2. Chest tightness: a few days
3. cough/dry throat: a few days
4. difficulty concentrating: a few days
4. Cravings for tobacco: frequent in first 2-3 days
6. Insomnia: 1 week
7. constipation & stomach pain: 1-2 weeks
8. Depressed mood/irritable: 1-4 weeks
9. Hunger: up to several weeks
77
What is the number one concern that patients will bring up with smoking cessation counseling?
hunger- because nicotine acts as a hunger suppressant
78
What is the benefit of quitting smoking that begins 20 minutes after quitting?
Blood pressure returns to normal
79
What is the benefit of quitting smoking that begins 8hrs after quitting?
Normal oxygen blood level
80
What is the benefit of quitting smoking that begins 24 hours after quitting?
carbon monoxide eliminated from lungs; start to clear mucus
81
What is the benefit of quitting smoking that begins 48 hours after quitting?
nicotine is eliminated and smell and taste are improved
82
What is the benefit of quitting smoking that begins 3 days after quitting?
lung capacity begins to improve and breathing becomes easier
83
What is the benefit of quitting smoking that begins 2-12 months after quitting?
circulation improves
84
What is the benefit of quitting smoking that begins 5 years after quitting?
risk of lung cancer decreases
85
What is the benefit of quitting smoking that begins 10-15 years after quitting?
reduced risk of other cancers
86
Benefits of quitting smokeless tobacco include a decreased risk for: (6)
1. oral head and neck cancer
2. tooth decay
3. progression of gum recession
3. high cholesterol
5. high blood pressure
6. heart attack or stroke
87
List the percentage of effectiveness the following forms of smoking cessation mechanisms provide at one year post cessation:
1. nicotine transdermal patches
2. nicotine gum and losanges
3. non-nicotine chantix
4. non-nicotine zyban
1. nicotine transdermal patches - 23%
2. nicotine gum and losanges- 27%
3. non-nicotine chantix- 22-24%
4. non-nicotine zyban- 16%
88
What are the 5 A's we as health care providers should use to help our patients?
1. Ask- about tobacco use
2. Advise- tobacco users to quit
3. Assess- readiness to make a quit attempt
4. Assist- with the quit attempt
5. Arrange- follow-up care
89
Give examples of how you might ASK about tobacco use:
1. do you ever smoke or use any type of tobacco?
2. do you use any form of e-cig or vaping device
3. Do you or does someone in your household smoke?
90
How do you figure up the pack year for a smoking patient?
number of cigs per day / 20x number of years smoking = number of packs per year
91
Figure up the pack year for the following scenario:
Patient smokes 1 pack per day and has been smoking for 3 years:
20/ 20 x3 = 3 pack years
92
Research uses ____ to determine the damage caused by smoking:
pack years
93
When ADVISING users to quite smoking, you should be:
clear, strong, personalized
94
Give and example of how you might ADVISE someone to quite smoking:
"I realize that quitting is difficult. I am happy to work with you to design a specialized treatment plan for cessation WHEN YOU ARE READY"
95
The best results when ADVISING one on smoking cessation come if you can:
personalize the plan, be open and non-judgemental
96
Is important to have an open-ended or close-ended conversation with your patient regarding smoking cessation?
open-ended
97
When ASSESSING the patients readiness to quit, you need to help the patient come up with:
quit date
98
How might you ASSIST in the following situations?
1. Not ready to quit:
2. Ready to quite:
3. Recently quit:
1. provide motivation
2. design a treatment plan
3. relapse prevention
99
T/F: When a patient relapses it is important to really drive in the idea that smoking is detrimental to there health, be direct, stern, and make them feel slightly guilty to motivate them.
False: Don't make them feel guilty, try to relate to them to let them know that slip ups happen and you understand and want to help guide them back on track/ figure out a better plan for them
100
What model describes stages of change (with smoking cessation)
Transtheoretical change model
101
Name the step of the trans theoretical change model being described below:
No intention to change:
pre-contemplation
102
Name the step of the trans theoretical change model being described below:
Aware problem exists but no commitment to action:
contemplation
103
Name the step of the trans theoretical change model being described below:
Intent on taking action to address the problem:
preparation
104
Name the step of the trans theoretical change model being described below:
Active modification of behavior:
action
105
Name the step of the trans theoretical change model being described below:
Sustained changes, new behavior replaces the old:
maintenance
106
Name the step of the trans theoretical change model being described below:
Not falling back into previous behavior:
termination
107
Name the step of the trans theoretical change model being described below:
Falling back into previous behavior pattern:
relapse
108
What are the order of steps to a successful outcome to the theoretical change model:
1. pre-contemplation
2. contemplation
3. preparation
4. action
5. maintenance
6. termination
109
Why must we ARRANGE follow-up care with smoking cessation patients?
success rate tends to be higher with follow ups
110
0-1 follow ups following smoking cessation, correlates to:
12.4% estimated quit rate
111
2-3 follow ups following smoking cessation, correlates to:
16.3% estimated quit rate
112
4-8 follow ups following smoking cessation, correlates to:
20.9% estimated quit rate
113
more than 8 follow ups following smoking cessation, correlates to:
24.7 %
114
A quit-line available 24 hours a day, 7 days a week, that is a free service available in multiple languages. It is confidential, and personalized support is available from trained quit coaches:
1-800-QUIT NOW or Smokefree.gov
115
List all smoking cessation options:
1. cold turkey (no additional help)
2. nicotine replacement therapy (NRTs)
3. medications
4. behavioral therapy
5. combination therapy
6. hypnotherapy
7. acupuncture
8. yoga/meditation
9. herbs
116
Describe what behavioral therapy entails in smoking cessation:
- counselor/coah, app/tech use, telephone counseling (1-800 quit NOW)
- apps- QUITNOW!, KWIT, Smoke free, Quitters Circle, Quick tracker
117
What tobacco users can benefit from pharmacotherapy?
All tobacco users
118
When should you check with a physician before recommending pharmacotherapy agent?
1. hypothyroidism
2. insulin dependent diabetes
3. active peptic ulcer
4. antidepressant medications
119
What type of pharmacotherapy agents should we recommend?
FDA approved
120
What are the top 3 pharmacotherapy options for smoking cessation?
- gum
- lozenge
- transdermal patch
121
Give some examples of pharmacotherapeutic gums for smoking cessation:
1. Nicolette
2. Zonnic
3. Generic
122
Nicorette gum, Zonnic gum, and the generic versions of both are ____ products
OTC
123
Give some examples of pharmotherapeutic Lozenges used for smoking cessation:
1. commit
2. zonnic
3. generic form
124
Give some examples of transdermal patch nicotine replacement therapies:
1. nicoDerm CQ
2. Generic form
125
What are the adverse effects for nicotine replacement gum (Nicorette, Zonnic,
