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, 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 effects
- COPD
- hip fractures
- reproductive effects
7
Q
Health consequences causally linked to secondhand smoke exposure in children include: (5)
A
- middle ear disease
- respiratory symptoms
- impaired lung function
- lower respiratory illness
- SIDS
8
Q
Health consequences causally linked to secondhand smoke exposure in adults include: (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 & 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 throat/hoarseness
- reduced smell/taste
- unhealthy tissue
- delayed healing
- oral/throat cancer
- teeth staining
- poor response to dental treatment
- 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 mg)
- chew (4.5 mg)
- snuff (3.6 mg)
- orbs (1 mg)
- strips (0.6 mg)
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: nuclear waste
17
Q
Smokeless tobacco effects on the mouth include: (7)
A
- bad breath
- irritates & inflames tissues (tissue changes)
- oral cancer
- tooth decay
- painful ulcers
- staining
- periodontal/gum disease
18
Q
Approximately _____ Americans are diagnosed yearly with oral/pharyngeal cancer
_____ succumb to the disease
A
42,000; 8000
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 leukoplakias 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
Act of inhaling & 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 solide, semi-solid, or liquid substance
30
Components of an E-cigarette include:
1. battery
2. heating element
3. atomizer
4. cartridge/pod
5. indicator light
31
E-cigarette E-liquid ingredients: (5)
1. vegetable glycerin
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 fro _____
use &/or ingestion; inhalation & heat
33
E-liquid can remain on surfaces for:
weeks to months
34
Because E-liquid can remain on surfaces for weeks to months, there is the potential for:
3rd hand exposure or accidental ingestion by children
35
E-liquid may caused 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?
1.8-5.0%
40
Each pod of nicotine salts contains:
the same amount of nicotine as an entire pack of cigarettes
41
Describe the components aerosols (4):
1. volatile organic compounds
2. nicotine
3. ultrafine particles
4. heavy metals (nickel, tin, lead)
42
Health concerns associated with aerosols include: (5):
1. increased HR due to spike in adrenaline
2. increased BP
3. increased bronchitis
4. increased lung disease
5. may cause blood sugar levels to rise
43
The increased HR due to the 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 ____ and _____
In addition they may cause _____ or ____
epithelial cells; oral ulcerations; oral cancer
sore throat; dry mouth
47
An alteration or damage to epithelial cells as a result of chemical vapors/aerosols indicates an ________ in the _____which may lead to a greater risk for _____
inflammatory response; PDL fibroblasts; periodontal disease
48
What are the effects of heat & chemicals on oral health: (5)
1. dry mouth
2. bone loss
3. inflammation
4. increased plaque & calculus
5. tooth decay
49
What are the effects of Nicotine as a stimulate on oral health?
Increase bruxism
50
Other concerns in regards to vaping include: (4)
1. burns from device batteries/explosions
2. nicotine poisoning/overdose
3. secondhand aerosol exposure
4. environmental concerns
51
nicotine poisoning/overdose is a concern with E-cigarettes because:
Pods can leak solution & 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 hours
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 released- concentration & memory
6. increased levels of ___ resulting in reduced ____
1. adrenal glands; adrenaline; glucose
2. heart rate, breathing activity & blood pressure
3. pancreas; insulin; blood glucose
4. dopamine
5. acetylcholine & norepinephrine
6. beta-endorphin; anxiety
58
If we have a diabetic patient and you are couseling them on smoking cessation what point might you hit on?
Nicotine causes the pancreas to produce less insulin therefore increasing blood sugar
59
The amount of nicotine absorbed by the body fro 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 get nicotine into the bloodstream quicker
true
62
T/F: Smokeless tobacco (chew) vs. smoking provides less of a nicotine hit
false- provides a larger nicotine hit
63
Research indicates development of the brain occurs until the age of:
25
64
Nicotine changes the way ____ are formed
synapses
65
Because nicotine changes the way synapses are formed, this means it can harm parts of the brain that control:
attention & learning
66
The nicotine in E-cigarettes and other tobacco products can 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 event with nicotine addiction:
1. use of nicotine
2. stimulates dopamine release
3. causes pleasurable feelings
4. repeated use of nicotine
5. tolerance develop
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?
phyisological
76
List the withdrawal symptoms associated with tobacco cessation: (& duration)
1. dizziness: 1-2 days
2. chest tightness: a few days
2. cough/dry throat: a few days
4. difficulty concentrating: a few days
5. cravings for tobacco: frequent in first 2-3 days
6. insomnia: 1 weeks
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- bc nicotine acts as a hunger suppressant
78
What is the benefit of quitting smoking that begins 20 minute after quitting?
Blood pressure returns to normal
79
What is the benefit of quitting smoking that begins 8 hours 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 mucous
81
What is the benefit of quitting smoking that begins 48 hours after quitting?
nicotine is eliminated & smell & taste improve
82
What is the benefit of quitting smoking that begins 3 days after quitting?
lung capacity begins to improve & 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:
1. oral, head & neck cancer
2. tooth decay
3. progression of gum recession
4. 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 1 year post cessation:
1. nicotine transdermal patches
2. nicotine gum & lozenges
3. non-nicotine Chantix
4. non-nicotine Zyban
1. nicotine transdermal patches: 23%
2. nicotine gum & lozenges:27%
3. non-nicotine Chantix:22-24%
4. non-nicotine Zyban:16%
88
What are the 5As we as healthcare providers can use to help our patients?
1. ask- about tobacco use
2. advice- 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-cigarette or vaping device
3. do you, or does someone in you household smoke?
90
How do you figure up the pack year of a smoking patient?
cigs per day / 20x number of years smoking = # packs per year
91
Figure up the pack year for the following scenario:
Patient smokes 1 pack per day & has been smoking for 3 years
20 / 20 x 3 = 3 pack years
92
Research uses _____ to determine the damage caused by smoking
pack years
93
When ADVISING users to quit smoking, you should be:
clear, strong, personalized
94
Give an example of how you might ADVISE someone to quit smoking:
"I realize that quitting is difficult. I am happy to work with you to design a specialized treamtne plan for cessation, WHEN YOU ARE READY"
95
The best results when ADVISING someone on smoking cessation come if you can:
personalize the plan, be open & non-judegmental
96
Is it 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:
a quit date
98
How might you ASSIST, in the following situations?
1. not ready to quit:
2. ready to quit:
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 their 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 you understand that slip ups happen and you want to help guide them back on track/figure out a better plan for them
100
What model describes the stages of change (with smoking cessation):
Transtheoretical change model
101
Name the step of the transtheoretical change model being described below:
-no to intention to change
Pre-contemplation
102
Name the step of the transtheoretical change model being described below:
-aware problem exists but no commitment to action
contemplation
103
Name the step of the transtheoretical change model being described below:
-intent on taking action to address the problem
preparation
104
Name the step of the transtheoretical change model being described below:
-active modification of behavior
action
105
Name the step of the transtheoretical change model being described below:
-sustained change, new behavior replaces old
maintenance
106
Name the step of the transtheoretical change model being described below:
-not falling back into previous behavior
termination
107
Name the step of the transtheoretical 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 (holds patient accountable)
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% estimated quit rate
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 & personalized support available from trained quit coaches
1-800-quit now
Smokefree.gov
115
List all of the 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/coach
-app/tech use
-telephone counseling (1-800-QUITNOW)
-apps (QuitNow!) (KWIT) (Smoke Free) (Quitters Circle) (Quit 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. anti-depressant medications
119
What type of pharmacotherapy agents should we recommend?
FDA approved
120
What are the top three pharmacotherapeutic options for smoking cessation?
-gum
-lozenge
-transdermal patch
121
Give some examples of pharmacotherapeutic gums for smoking cessation:
1. nicorette
2. zonnic
3. generic form
122
Nicorette gum, Zoning gum & the generic versions of both are _____ products
OTC
123
Give some examples of pharmacotherapeutic 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
