Smoking

Question 1

What are physiological effects of nicotine?

Answer 1

• activation of nicotinic ACh receptors in the brain
• causing dopamine release in the NAcc (nucleus accumbens)
• stimulant, tolerance and withdrawal

Question 2

What is the impact of smoking?

Answer 2

• the greatest single cause of illness and premature death in the UK
• 100,000 deaths/year due to smoking
• cancers, COPD, CHD
• a great economic impact of smoking

Question 3

What health problems are connected to smoking?

Answer 3

• cardiovascular problems (strokes, heart attacks, DVTs)
• other cancers (stomach, kidney, pancreas, bladder, mouth, throat,…)
• stomach ulcers
• impotence
• diabetes
• oral health (gum disease)
• cataracts

Question 4

What laws have been brought in since 1908?

Answer 4

• 1908 - Children Act - sale of tobacco under 16s prohibited
• 1950 - Richard Doll & Austin Bradford Hill - Smoking & Lung Carcinoma
• 1965 - Parliament bans cigarette advertising on TV
• 2007 - Smoking in public banned + legal min. raised to 18 in the UK
• 2015 - October (?) - Smoking in car with children banned in the UK

Question 5

Give some examples of smoking cessation techniques

Answer 5

NRT (Nicotine Replacement Therapy)
i patches, gums, nasal spray, microtab, inhalator
Non-nicotine pharmacotherapy
i Varenicline (Champix)
ii Bupropion (Zyban)
Transtheoretical Model (Change in behaviour, i Pre-contemplation, Contemplation, Preparation, Action, Maintenance, Relapse)

Question 6

What is the patient approach to cessation? 3As

Answer 6

ASK - your patient about smoking
ADVISE - your patient on cessation methods available
ASSIST - your patient and refer to local NHS Stop Smoking Service