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Interventions in Smoking Cessations

Interventions in Smoking Cessations. Frank Vitale , M.A. School of Pharmacy Director, International Smoking Cessation Program through the University of Pittsburgh Coordinator, UPMC Smoking Cessation Program. Smoking Cessation Skills: The Basics. Program Objectives.

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Interventions in Smoking Cessations

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  1. Interventions in Smoking Cessations Frank Vitale, M.A. School of Pharmacy Director, International Smoking Cessation Programthrough theUniversity of Pittsburgh Coordinator, UPMC Smoking Cessation Program

  2. Smoking Cessation Skills: The Basics

  3. Program Objectives 1. Provide a fundamental understanding of the intricacies of the smoking behavior. 2. Define and examine the stages of the quitting process. 3. Review basic cognitive and behavioral interventions. 4. Briefly detail currently available smoking cessation medications.

  4. Three aspects of smoking Addiction Habit Psychological

  5. Nicotine Addiction

  6. Nicotine- Ganglionic cholinergic-receptor agonist with dose related pharmacologic effects- Basic; liquid alkaloid- Addiction Reinforcer Withdrawal Time to Addiction

  7. Theory of Addiction- Release of neurotransmitters in brain- Pleasure reinforces repeated administration- Acclimation occurs- Abrupt cessation leads to withdrawal

  8. Nicotine Absorption and Metabolism • Readily absorbed from - respiratory tract - buccal membranes - skin - minimal stomach absorption due to acidic environment • Highly metabolized by liver and lungs when inhaled

  9. Predicted Concentration ofSerum Nicotine During the Smoking Day Projected Nicotine Concentration(ng/ml) Cigs I II I II I III II II I II I I I I Hours since waking

  10. Nicotine’s Effects on the Body • CV - dirrect effect: increases BP and HR - indirrect effect: stimulates release of catecholamines from adrenal • Periphery - skeletal muscle relaxant • CNS - causes tremor, increases respirations, facilitates memory, decreases aggression, and decreases weight • GI - increases tone and motor activity

  11. Symptoms of Nicotine Withdrawal • irritability, impatience, anxiety, restlessness, depression, drowsiness, nighttime awakening (lasts approximately 7 days) • decrease in short-term memory (lasts approximately 14 days) • increase in appetite, craving, and difficulty concentrating (can last weeks to months)

  12. Nicotine Replacement Therapy • Contols -cravings, irritability, impatience, anxiety, restlessness, difficulty concentrating, drowsiness, nighttime awakening, decreased short-term memory • Delays/Decreases -appetite, weight gain

  13. Perspiration dizziness headache confusion and weakness differences - withdrawal and toxicity symptoms Abdominal pain hearing and visual disturbance nausea/vomiting/diarrhea Determination of Nicotine Toxicity

  14. HABIT

  15. “Automatic” Smoking • Repeatedly pairing smoking with other behaviors • Paired behaviors create unconscious urges to smoke

  16. How Habits Develop • Pavlov: Conditioned/Response

  17. Morning Routine Coffee After Meals In the car On the phone Alcohol Stress Anger Anxiety Boredom Celebration Situations That May Trigger Smoking

  18. PSYCHOLOGICAL

  19. Smokers’ Misconceptions • The belief that cigarettes are doing something positive for the smoker • The belief that this is something the smoker cannot do on his or her own

  20. Perceived Benefits of Smoking • Stress Management • Weight Management • Mood Regulator • Others

  21. Cigarette as “Friend” What’s in a Cigarette! The price of smoking

  22. Saying Goodbye I can live without cigarette!

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