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Smoking Cessation
Behavioral Medicine
| Question | Answer |
|---|---|
| No. 1 most preventable cause of death in the US and worldwide | smoking |
| impacts of smoking | fertility, pregnancy outcome, breast cancer, cataracts, macular degeration, cardiovascular problems |
| there is a __ year loss of life expectancy with smoking | 10 |
| second hand smoke cause and increase in __ for exposed children | otitis media |
| within a year of quiting patients have a reduced | CHD risk (by 1/2) |
| within days of quiting smoking people __ better | smell |
| within a week or two after quitting smoking, people _________ better | taste |
| within weeks of quitting smokers have an increased __ | pulmonary function, increased exercise tolerance |
| within __ years after smoking cessation the CVD risk is the same as for a non-smoker | 15 |
| all cause death rate reduced in __ years after smoking cessation | 2 |
| cancer rate 50% reduced over __ years after smoking cessation | 10 |
| if a 65 year old smoker quits he/she can add __ years to their life expectancy | 4 |
| nicotine hits the brain in __ seconds | 11 |
| after nicotine hits the brain __ is released along with other neurotransmitters | dopamine |
| nicotine withdrawal symptoms | anger, cravings, decreased concentration, hunger, wt gain, restlessness, drowsiness, fatigue, decreased task performance, sleep disturbance |
| the new model of behavior change | patient self-management |
| patient self-management includes | the activated patient, shared decision making with the provider, effective communication, self-efficacy to achieve desired behaviors and to manage symptoms |
| the five A's of self management | ask, advise, assess, assist, arrange |
| short cut to the five A's (3 A's) | ask, advise (tell), ask and refer |
| the fifth vital sign | asking about smoking (every visit) |
| what is the assess step in smoking cessation | is the patient ready to make a change |
| what are the stages of change | pre-contemplation, contemplation, preparation, action, maintenance |
| the pre-contemplation stage of change | the huh phase, not thinking about change, may be resigned, feeling no control, denial |
| the contemplation stage of change | the but phase, weighing benefits and costs of continuing/changing the behavior |
| the preparation stage of change | the I'm ready now phase, experiment with small changes |
| self-management skills | patient centered, attainable goals, problem solving, skills training |
| Assist patient in smoking cessation | get ready (set a quit date), get support, learn new skills and behaviors (BT and CBT), get meds and learn to use, be prepared for relapse or roadblocks |
| arrange follow up care within __ of quitting (in person, phone, electronic) | one week |
| how to set goals | set SMART goals, Specific, Measurable, Action oriented, Realistic, Timely |
| the five R's of smoking cessation | Relevance to patient, Risks, Rewards, Roadblocks, Repetition |
| questions to ask to get the smoker to see the disadvantages of not making a change | what would happen if you don't change? in what way does this concern you? why does this worry you? |
| questions to ask to get the smoker to see the advantages of change | what are the advantages of changing? how would you like for things to be different? what are the main reasons to change? |
| cigarettes are responsible for one in every deaths in the united states | 5 |
| currently __% of US adults are smokers | 23 |
| currently __% of US young adults are smokers | 26 |
| smokers have __ the risk of fatal heart disease | twice |
| smokers have __x the risk of lung cancer | 10 |
| in the US __% of cases of COPD occur among current or former smokers | 90 |
| heavy smokers have a __ greater risk of age-related macular degeneration | 2.5 |
| smokers die __ years earlier than never-smokers | 5-8 |
| how are children of smokers affected | lower birth wts, more likely to be mentally retarded, have more frequent respiratory infections and less efficient pulmonary function, have a higher incidence of chronic ear infections, and more likely to become smokers themselves |
| only __% of smokers who attempt to quit are successful | 4 |
| __% of smokers attempt to quit every year | 40 |
| persons whose physicians advise them to quit are __times as likely to attempt quitting | 1.6 |
| over 70% of smokers see a physician each year but only __% of them receive any medical quitting advice or assistance | 20 |
| step 1 of the five A's of smoking cessation | ask: systematically identify all tobacco users at every visit |
| step 2 of the five A's of smoking cessation | advise: strongly urge all smokers to quit |
| step 3 of the five A's of smoking cessation | attempt: identify smokers willing to make a quit attempt |
| step 4 of the five A's of smoking cessation | assist: aid the patient in quitting |
| step 5 of the five A's of smoking cessation | arrange: schedule follow-up contact |
| weight gain occurs in __% of patients following smoking cessation | 80 |
Created by:
Abarnard
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