Nicotine & Smoking Cessation

This set of flashcards is designed to help you review key terms and concepts related to nicotine and smoking cessation. Each card contains a vocabulary term along with its definition to assist in preparing for your exam.

Smoking Cessation

The process of discontinuing tobacco smoking.

Very Brief Advice (VBA)

A concise and focused method of advising patients on smoking cessation.

Nicotine Replacement Therapy (NRT)

Products designed to help people stop smoking by providing a controlled dose of nicotine.

E-cigarettes

Devices that heat a liquid containing nicotine and flavorings to create vapor for inhalation.

Pharmacological Intervention

Use of medications to aid individuals in quitting smoking or reducing harm.

Health Inequalities

Differences in health outcomes and access to healthcare that can be seen in various demographic groups.

Quit Date

The specific date on which a person commits to stop smoking.

Carbon Monoxide Verification

A method to confirm smoking cessation by measuring levels of carbon monoxide in the breath.

Combined NRT

Using multiple nicotine replacement methods simultaneously, such as patches and gum.

Socio-economic status

An individual's economic and social position in relation to others.

Secondhand Smoke

Tobacco smoke that is inhaled by non-smokers, also known as passive smoking.

"Is smoking still a major problem in the UK?"

"Yes. Smoking remains the single biggest avoidable cause of death and disability in the UK."

"What proportion of people in the 2025 NHS Digital data had successfully quit smoking?"

"51.2% of people in the dataset had successfully quit (self-reported)."

"Which socioeconomic group had the highest representation among quitters?"

"Routine and manual occupations were the most represented among successful quitters."

"What percentage of quit attempts involved e-cigarettes or vapes in 2025?"

"Around 9% of total quit attempts involved e-cigarettes or vapes."

"What proportion of 15-year-old girls are current vape users?"

"Around 1 in 5 (21%) of 15-year-old girls are current vape users."

"What is the average reduction in life expectancy for smokers?"

"Smokers on average die about 10 years earlier than non-smokers."

"How is smoking linked to inequality in the UK?"

"Higher smoking prevalence is associated with almost every indicator of deprivation and marginalisation making smoking a major driver of health inequalities."

"Name four high-risk groups for smoking according to UK data."

"Examples: people with mental health conditions; LGBTQ+ individuals; people experiencing homelessness; people in the justice system; people in lower socioeconomic groups. Any four are acceptable."

"What is the general trend between ethnicity and smoking in England?"

"Overall ethnic minority groups tend to have lower smoking rates than the White British majority but within those groups men usually smoke more than women."

"Why might ethnicity-based smoking data in NHS datasets be skewed?"

"Ethnic minority groups are often underrepresented or poorly captured in NHS data so smoking data may be incomplete or biased towards White groups."

"Why do prisoners show very high quit success rates (e.g. around 96%)?"

"Because prisons and similar institutions often have strict no-smoking policies which effectively force abstinence and increase reported quit success."

"Why should clinicians ask what a person smokes rather than only if they smoke?"

"Not all smoking involves cigarettes or tobacco; people may smoke shisha or other products which still carry significant harm."

"By how much has shisha use increased in the UK since the public smoking ban?"

"Shisha use in the UK has increased by over 200% since smoking in public places was banned."

"Why is shisha not safer than cigarette smoking?"

"Shisha contains similar carcinogens to cigarettes produces high exposures to tar and carbon monoxide and contains heavy metals that can damage the kidneys and bladder."

"What are the three A’s of Very Brief Advice (VBA) for smoking cessation?"

"Ask Advise Act."

"Give two example questions you could use at the Ask stage of VBA."

"Examples: Do you smoke? Have you ever smoked? Can I just check what it is you smoke?"

"What is the key advice to give a smoker once you have identified that they smoke?"

"Encourage them to set a specific quit date and use combination support such as combination NRT with professional help or referral."

"What does Act mean in the Ask Advise Act framework?"

Act means offering help such as referring to stop smoking services or directly initiating treatment or support."

"Why is setting a quit date helpful for smoking cessation?"

"It improves motivation provides structure and is associated with higher success rates than vague intentions."

"What is considered the evidence-based best pharmacological option for smoking cessation?"

"Combination NRT for example a nicotine patch plus a fast-acting NRT product such as gum inhalator lozenge or spray."

"Why is single NRT therapy less effective than combination NRT?"

"Single NRT often fails to adequately replace nicotine and control cravings leading to higher relapse compared with combination NRT."

"Name three examples of nicotine replacement therapy (NRT) products."

"Examples: nicotine patch; nicotine gum; lozenge; inhalator; nasal spray; mouth spray. Any three are acceptable."

"Name two non-NRT prescription-only medicines used for smoking cessation."

"Varenicline and bupropion."

"Why are e-cigarettes or vapes not yet proactively recommended as first-line by prescribers?"

"Because although they are less harmful than cigarettes there is still uncertainty about their long-term risks and safety profile."

"What is the key health message about vaping for the general population?"

"Vaping is less harmful than smoking but is not risk-free and should ideally be used only as a stepping-stone to complete nicotine abstinence."

"What is the safest option for people of all ages in terms of smoking and vaping?"

"Not to smoke and not to vape at all."

"Why should under-18s not vape?"

"Because of unknown long-term harms nicotine addiction risk and the fact that they do not need nicotine for any therapeutic reason."

"What is the ultimate goal for a person using vapes to stop smoking?"

"To reduce nicotine strength and frequency over time until they stop vaping completely and are nicotine-free."

"What flavour of vape should be avoided during pregnancy and why?"

"Liquorice flavours should be avoided because liquorice root is associated with harmful effects on foetal development."

"Is vaping considered safe in pregnancy?"

"No. Vaping is not considered safe in pregnancy but if used it is still less harmful than cigarette smoking. The aim remains to stop entirely."

"What is the recommendation for smoking and vaping in people who are pregnant or planning pregnancy?"

"Aim for absolute zero tobacco and zero vaping exposure using safer methods such as NRT under guidance if needed."

"Why is second-hand vaping still discouraged around pregnant people?"

"Because the long-term effects of inhaling vapour and its chemicals are not fully known so avoiding exposure is the safest option."

"Why does smoking affect the metabolism of some medicines?"

"Components of tobacco smoke (not nicotine) induce liver enzymes such as CYP1A2 increasing the metabolism of certain drugs."

"What happens to levels of drugs like clozapine when a smoker suddenly stops smoking?"

"Drug levels increase because enzyme induction reduces, which can lead to toxicity if doses are not reduced."

"Name two psychotropic drugs whose levels are significantly affected by smoking status."

"Clozapine and olanzapine."

"Why do mental health inpatients often need dose adjustments when admitted to smoke-free wards?"

"Because they usually stop smoking in the smoke-free environment causing reduced enzyme induction and increased drug levels that may require dose reduction."

"Why is it useful to ask a patient why they want to stop smoking?"

"It helps identify personally meaningful motivations which strengthens commitment to behaviour change."

"What major milestone significantly increases the chance of long-term abstinence from smoking?"

"Reaching 12 weeks smoke-free; beyond this point the likelihood of staying quit long-term is much higher."

"Why ask a patient what they will gain from stopping smoking rather than only what they will miss?"

"Focusing on the gains supports positive psychology and motivation making behaviour change more likely to succeed."

"How is smoking linked to poverty at household level?"

"If some households stopped smoking a proportion would move above the poverty line showing a direct link between smoking and financial hardship."

"Why is it important to consider culture and ethnicity when asking about smoking?"

"Different cultures may use different tobacco or smoking products (e.g. shisha) have different beliefs about harms and show different gender patterns in smoking so advice must be tailored."