Smoking Cessation

Question 1

What is the single largest cause of preventable disease & death in the US

Answer 1

smoking

Question 2

What is the safest level of exposure to secondhand smoke

Answer 2

There is none

Question 3

What are some of the health risks for smoking

Answer 3

• lung cancer
• colorectal & liver cancer
• CVD
• respiratory disease (COPD)

Question 4

Describe some of the disparities regarding smoking

Answer 4

MC in
- native american populations
- low SES
- SW US
- LGBTQ
- male
- mental health concerns

Question 5

When does most tobacco use begin

Answer 5

in adolescence

Question 6

Describe one reason that E-cigarettes are bad

Answer 6

unregulated nicotine amounts, nicotine linked to many negative mental health effects

Question 7

Describe the 5 A’s to treat tobacco use

Answer 7

• ASK about use
• ADVISE to quit
• ASSESS willingness
• ASSIST in a quit attempt
• ARRANGE follow-up

Question 8

What are some ways a provider can help assist in a smoking cessation attempt

Answer 8

• help with withdrawal (irritability, anxiety, restlessness)
• weight gain
• depression
• symptoms peak in first week and can last 2-4 weeks

Question 9

Describe the types of medications that can be prescribed in smoking cessation

Answer 9

combo therapy is most effective
- nicotine patch
- nicotine gum
- nicotine lozenge
- nicotine inhaler
- nicotine nasal spray
- bupropion (zyban)
- varenicline (chantix)

Question 10

Describe the FDA pregnancy drug classes

Answer 10

• Category A: no risk in human studies
• Category B: no risk in animal studies
• Category C: risk in animal studies but not human studies
• Category D: risk in in human studies but with some benefits
• Category X: risk outweighs benefit

Question 11

What FDA pregnancy drug class to most nicotine replacement therapies fit into

Answer 11

Class D: risk with some benefits still

Question 12

What FDA pregnancy drug class do Bupropion and Chantix fit into

Answer 12

Category C: risk in animals but not humans

Question 13

What special populations might Bupropion be cautioned or contraindicated in for smoking cessation

Answer 13

Mental Health
- Depression: chantix more effective than bupropion
- Schizophrenia: chantix more effective than bupropion & NRT
- Bipolar Disorder: NRT first line, AVOID bupropion as it may trigger mania

Question 14

Describe the considerations in smoking cessation assistance in pregnancy

Answer 14

• quitting reduces the risk of preterm birth, low birth weight, & infant mortality
• NRT increases the risk of birth defects
• intensive in person interventions should be offered

Question 15

How many times does the average smoker attempt to quit before they are successful

Answer 15

4-5 times

Question 16

Describe the USPSTF annual lung cancer screening guidelines

Answer 16

• adults 50-80 with 20 pack year history
• currently smoking or have quit in the last 15 years

(provide cessation counseling at every screening)

Question 17

Who is Bupropion contraindicated in for smoking cessation

Answer 17

Pts with a seizure history or eating disorder, abrupt cessation of alcohol, barbiturates, and benzos (lowers the seizure threshold)

Question 18

What is a risk associated with chantix for smoking cessation

Answer 18

increased risk of CV events in pts with cardiovascular disease - should be discussed with pts