A Practitioner’s Guide to Nicotine Dependence and Smoking Cessation

Introduction    

• At a Glance: Cigarette Smoking in America    

  • Race/Ethnicity    

  • Age    

  • Education    

  • Household Income    

  • Region    

  • Marital Status    

  • Sexual Orientation    

  • Health Insurance Coverage    

  • Disability Status    

  • Mental Health Symptoms    

Health Effects of Smoking    

• Smoking and Death    

• Smoking and Cardiovascular Disease and Cancer Risk    

• Smoking and Respiratory Diseases    

• Smoking and Cancer    

• Smoking and Other Health Risks    

• Smoking can impact fertility.    

• Smoking adversely the health of bones, teeth, and eyes.    

• Smoking and Diabetes    

• Smoking and Immune Function    

• The Benefits of Quitting    

Smoking as a Public Health Crisis    

The Role of Clinicians    

Understanding Nicotine Dependence    

• What Is Nicotine?    

• The Physiological Effects of Nicotine    

• Diagnosing Tobacco Use Disorder    

  • Tobacco Use Increases    

  • Tolerance to Nicotine    

  • Withdrawal Symptom Upon Cessation    

Additional Specifiers    

The Pattern of Current Use    

Severity of Dependence    

Biological Factors Associated with Smoking    

Social, Demographic, and Psychological Factors Associated with Smoking    

Nicotine Dependence and Psychiatric Disorders    

Why Help Patients Quit Smoking?    

• Health Benefits of Smoking Cessation    

Clinical Interventions to Treat Tobacco Use and Dependence Among Adults    

• Non-Pregnant Patients    

  • Behavioral Counseling    

  • Medications    

• Pregnant Patients    

  • Behavioral Counseling    

  • Medications    

• A Team Approach to Smoking Cessation    

  • Advise    

  • Treatment    

  • Referral    

  • Follow Up    

• The 5 As Approach    

• Brief Strategies for Tobacco Users Willing to Quit—More about the “Assist” Component    

  • Practical Counseling—Problem-Solving and Skills Training    

  • Social Support Within the Treatment Context    

• Brief Strategies for Tobacco Users Less Motivated to Quit    

• Brief Strategies for Preventing Relapse in Former Smokers    

Specialized Assessment and Intervention Strategies    

Assessment Considerations    

• Motivation/Readiness to Quit    

• Nicotine Dependence and Cravings    

• Past Quit Attempts and Smoking History    

• Other Substance Use    

• Smoking Triggers/Cues    

• Emotional Triggers    

• Pattern Triggers    

• Social Triggers    

• Withdrawal Triggers    

• Dealing with Triggers    

• Beliefs and Expectancies    

• Social Environment    

• Psychopathology    

Promoting Behavioral Change    

• Transtheoretical Model of Change    

• Motivational Interviewing    

  • Motivational Interviewing Techniques    

• Decisional Balance Strategy    

• Cognitive Behavioral Strategies    

  • Diagram of CBT Model    

  • Challenging Irrational Beliefs    

  • Cognitive Distortions    

• Behavioral Strategies for Smoking Cessation    

Conclusion    

References    

Post-Test