Flashcards in Tobacco Prevention/Intervention Deck (8)
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1
Trends/characteristics of groups of tobacco users
- 34% w/9-11yrs of education vs. 8% of people w/college degree or higher
- 40% American Indians vs. 21% of Caucasians
- 29% of those below the poverty vs. 21% above the poverty line
- 80-90% of incarcerated persons vs. 21% of the general US population
2
Effective health policy interventions
-
Higher cigarette taxes
-
S
moking bans
-
Warning labels
-
Increased access to nicotine replacement therapies
Higher cigarette taxes
S
moking bans
Warning labels
Increased access to nicotine replacement therapies
3
Tobacco use impact on mortality, cost, and health disparities
- premature mortality 2x > non-smokers
- half of smokers killed by smoking
- most common cause of preventable premature death
- half of those that die from tobacco use in US have mental illness
- health/productivity cost = $190 billion/year
- half of those that die from tobacco use in US have mental illness
4
Strategies to counsel patients to quit smoking
-
It’s never too late to quit!
-
Good benefits within a year, improved cough, SOB, taste, smell, lung function, 50% decrease in cardiac ris
k
-
Ask, advise, assess, assist, arrange
It’s never too late to quit!
Good benefits within a year, improved cough, SOB, taste, smell, lung function, 50% decrease in cardiac ris
k
Ask, advise, assess, assist, arrange
5
Strategies to aid behavior modification
-
Goal = total abstinence after the quit day.
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Engage family + friends to help
-
Anticipate challenges/triggers
-
Identify what has/hasn’t worked in past
-
Remove tobacco from environment: work/home!
-
Encourage partners to quit as well.
Goal = total abstinence after the quit day.
Engage family + friends to help
Anticipate challenges/triggers
Identify what has/hasn’t worked in past
Remove tobacco from environment: work/home!
Encourage partners to quit as well.
6
Nicotine replacement therapy options
- patch
- gum
- lozenge
- inhaler
- nasal spray
7
Quitting counseling options
- 1-800-QUIT-NOW = free counseling + free access to nicotine replacement
- Primary care physician
8
Drug therapy options to aid quitting smoking
-
Bupropion - inhibits reuptake of dopamine and norepi, reducing craving and symptoms of withdrawal
-
Black Box FDA warning
-
Varenicline (Chantix) - partial agonist at nicotine receptor, also antagonist - so no reward for smoking.
-
Statistically better than Bupropion in original trial 50% quit after 12 weeks.
-
Lots of psych side effects including suicidality
-
Black box warning by FDA
Bupropion - inhibits reuptake of dopamine and norepi, reducing craving and symptoms of withdrawal
-
Black Box FDA warning
Varenicline (Chantix) - partial agonist at nicotine receptor, also antagonist - so no reward for smoking.
-
Statistically better than Bupropion in original trial 50% quit after 12 weeks. -
Lots of psych side effects including suicidality -
Black box warning by FDA
