Module 9.3 (Smoking Cessation)

Transtheoretical Theory of Change:

- no intent to change in the next 6 months

A. precontemplation

B. contemplation

C. preparation

D. Action

E. maintenance

A. precontemplation

Transtheoretical Theory of Change:

- considering change within the next 6 months

A. precontemplation

B. contemplation

C. preparation

D. Action

E. maintenance

B. contemplation

Transtheoretical Theory of Change:

- intend to change within the next 30 days

A. precontemplation

B. contemplation

C. preparation

D. Action

E. maintenance

C. preparation

Transtheoretical Theory of Change:

- making the change <6 months

A. precontemplation

B. contemplation

C. preparation

D. Action

E. maintenance

D. Action

Transtheoretical Theory of Change:

- sustain change for >6 months

A. precontemplation

B. contemplation

C. preparation

D. Action

E. maintenance

E. maintenance

What NRT is available OTC or Rx (select all)

A. patch

B. gum

C. lozenge

D. inhaler

E. spray

A. patch

B. gum

C. lozenge

What NRT is available Rx only (select all)

A. patch

B. gum

C. lozenge

D. inhaler

E. spray

D. inhaler

E. spray

What NRT does the starting dose depend on cigarettes/day?

A. patch

B. gum

C. lozenge

D. inhaler

E. spray

A. patch

What is the starting dose for the patch if you smoke >10 cigarettes/day

21 mg

What is the starting dose for the patch if you smoke <=10 cigarettes/day

14 mg

These are the side effects of what NRT?

- skin irritation

- difficulty sleeping

- vivid dreams

A. patch

B. gum

C. lozenge

D. inhaler

E. spray

A. patch

Know Patch treatment options

Counseling, Considerations:

- apply new one every 24 hours to clean, dry, hairless area

- rotate sites and/or apply OTC cream for irritation

- remove prior to bedtime for vivid dreams

- To dispose: fold sticky sides together, wash hands after

- do not cut

A. patch

B. gum

C. lozenge

D. inhaler

E. spray

A. patch

What NRT does the starting dose depend on time to first cigarette upon waking? (select all)

A. patch

B. gum

C. lozenge

D. inhaler

E. spray

B. gum

C. lozenge

For the gum and lozenge, if your first cigarette is <=30 min of waking, what is the dose?

4 mg

For the gum and lozenge, if your first cigarette is >30 min of waking, what is the dose?

2 mg

What is the max number of gum that you can have per day?

A. 18

B. 20

C. 22

D. 24

D. 24

What is the max number of lozenges that you can have per day?

A. 18

B. 20

C. 22

D. 24

B. 20

Side effects:

- mouth irritation

- jaw soreness

- GI disturbances

A. patch

B. gum

C. lozenge

D. inhaler

E. spray

B. gum

Counseling, Considerations:

- "Chew and park"

- discard after 30 min

- do not swallow

- no food/drink 15 mins prior and during use

A. patch

B. gum

C. lozenge

D. inhaler

E. spray

B. gum

Side effects:

- mouth irritation

- GI disturbances

A. patch

B. gum

C. lozenge

D. inhaler

E. spray

C. lozenge

Counseling, Considerations:

- place between cheek and gums

- let it melt slowly over time

- do not chew

- easier to use for those with dental work

- no food/drink 15 mins prior and during use

A. patch

B. gum

C. lozenge

D. inhaler

E. spray

C. lozenge

Which NRT:

- 10 mg/mL

- one spray into each nostril every 1-2 hours (max 80 sprays/day)

A. patch

B. gum

C. lozenge

D. inhaler

E. spray

E. spray

Side effects:

- nasal/throat irritation

- rhinitis

- sneezing

- coughing

- lacrimation

A. patch

B. gum

C. lozenge

D. inhaler

E. spray

E. spray

Counseling, Considerations:

- wait 2-3 min before blowing nose

- best results >=8 doses/day

- discontinue over 4-6 wks

- titration optional

- most rapidly absorbed

- worst side effects profile

A. patch

B. gum

C. lozenge

D. inhaler

E. spray

E. spray

Which NRT:

- 10 mg cartridge (80 puffs)

- one cartridge every 1-2 hours (max 16 cartridges/day)

A. patch

B. gum

C. lozenge

D. inhaler

E. spray

D. inhaler

Side effects:

- mouth/throat irritation

- coughing

A. patch

B. gum

C. lozenge

D. inhaler

E. spray

D. inhaler

Counseling, Considerations:

- best results: 20 minutes continously puffing

- at least 6 cartridges/day for 3-6 weeks

- discontinue over 6-8 weeks

- titration optional

- mimics smoking behavior

- frequent puffing required

A. patch

B. gum

C. lozenge

D. inhaler

E. spray

D. inhaler

Can you use varenicline and buproprion together?

no

Buproprion has a black box warning for ___________

suicidality

If CrCl is <= 60 mL/min what is the max daily dose of buproprion?

150 mg

If CrCl is <15 mL/min what is the max daily dose of buproprion?

alternative agent preferred

These are the side effects of:

- insomnia

- agitation

- dry mouth

- headache

buproprion

These are the side effects of:

- N/V

- vivid dreams

- headache

varenicline

What are the contraindications for buproprion?

- seizures

- eating disorders

- binge drinking

- MAO inhibitors

What should you expect with cessation?

- withdrawal symptoms (irritability, difficulty concentrating, insomnia)

- weight gain

- psychiatric symptoms

- cough and mouth ulcers