Tobacco and Nicotine Quiz

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Questions and Answers

What are the two main types of tobacco nicotine types mentioned?

Combustible and smokeless (correct)

Natural and synthetic

Traditional and modern

Organic and non-organic

Which smoking method is mentioned as having a higher risk due to shared use?

Cigarettes

Hookah (correct)

Pipe tobacco

Cigars

What is true about bidis and kreteks compared to conventional U.S. cigarettes?

They are considered safer alternatives.

They are banned in the U.S. due to high content of harmful substances. (correct)

They contain less carbon monoxide.

They have lower concentrations of nicotine.

Which of the following is NOT a type of combustible tobacco mentioned?

Spit tobacco Signup and view all the answers

Which feature is true for all types of combustible tobacco discussed?

They still contain high levels of chemical agents and are not safer than traditional tobacco. Signup and view all the answers

What primary chemical is released when nicotine binds to its nicotinic receptor?

Dopamine Signup and view all the answers

Which of the following describes the effect of nicotine that leads to increased task performance?

Cognitive enhancement Signup and view all the answers

What phenomenon often occurs when a person becomes addicted to nicotine?

Development of tolerance Signup and view all the answers

How does nicotine primarily reinforce the cycle of addiction?

Through the release of feel-good chemicals Signup and view all the answers

What is the most likely outcome when the effects of nicotine decline over time?

Cravings to smoke again Signup and view all the answers

What is the primary neurotransmitter that nicotine mimics in the brain?

Acetylcholine Signup and view all the answers

What is a common effect of nicotine on the brain after prolonged use?

Downregulation of nicotinic receptors Signup and view all the answers

What substance is NOT typically found in cigarette smoke?

Hydrogen peroxide Signup and view all the answers

How quickly does nicotine reach the brain after being absorbed?

8 seconds Signup and view all the answers

What triggers nicotine cravings in an individual trying to quit?

Environmental cues Signup and view all the answers

What role do nicotinic receptors play in the brain?

Controlling muscle movement and mood Signup and view all the answers

Which of the following is true about the chemicals in cigarette smoke?

They total over 7000 chemicals and gases Signup and view all the answers

What physiological aspect does nicotine primarily impact?

Brain chemistry and activity Signup and view all the answers

What is a common effect of using smokeless tobacco products?

Increased production of saliva Signup and view all the answers

Which of the following is a known risk associated with long-term use of smokeless tobacco?

Oral cancer Signup and view all the answers

What is a characteristic of Electronic Nicotine Delivery Systems (ENDS)?

They include both disposable and reusable types. Signup and view all the answers

What is true about nicotine levels in tobacco products?

Nicotine levels can vary between different products. Signup and view all the answers

What are the potential environmental concerns associated with ENDS?

The improper disposal of batteries can harm the environment. Signup and view all the answers

What is the main difference between smokeless tobacco and heat-not-burn tobacco products?

Heat-not-burn products heat tobacco but do not burn it. Signup and view all the answers

Which substance is specifically mentioned as an addictive agent in smokeless tobacco?

Nicotine Signup and view all the answers

What is a potential health consequence of using smokeless tobacco products?

Increased risk of vascular disease Signup and view all the answers

What age group appears to be particularly attracted to smokeless tobacco products?

Younger people Signup and view all the answers

Which component is commonly found in smokeless tobacco products that poses health risks?

Nickel Signup and view all the answers

Which of the following reproductive issues are associated with smoking?

Infertility Signup and view all the answers

What is the primary concern regarding the use of nicotine e-cigarettes among non-smokers?

Nicotine addiction Signup and view all the answers

What is a significant health effect caused by malfunctioning vaping devices?

Lung injury (EVALI) Signup and view all the answers

Which of these conditions is NOT a recognized oral health effect of smokeless tobacco?

Improved dental enamel Signup and view all the answers

What type of smoke includes the chemicals from both the smoker exhaled air and what is released from the burning tobacco?

Mainstream smoke Signup and view all the answers

Which of the following is a characteristic of third-hand smoke?

It clings to surfaces after smoke exposure Signup and view all the answers

What potential risk is increased for surgical patients who use smokeless tobacco?

Increased surgical complications Signup and view all the answers

Which of the following effects is caused by nicotine on developing babies?

Increased risk of cleft lip/palate Signup and view all the answers

What are the two non-nicotine medications approved for smoking cessation?

Bupropion and Varenicline Signup and view all the answers

Which of the following is NOT a first-line therapy for smoking cessation?

Acupuncture Signup and view all the answers

How does tapering compare to quitting cold turkey?

Tapering usually has a higher success rate. Signup and view all the answers

What approach is suggested for patients who are currently using e-cigs to quit smoking?

Support the quit attempt and provide resources for quitting all tobacco use. Signup and view all the answers

What is one key element of practical counseling for smokers?

Providing education on tobacco use Signup and view all the answers

Which of the following is a recommended method for enhancing the success of smoking cessation?

Combining different counseling techniques with medications Signup and view all the answers

What common misconception exists regarding nicotine replacement therapy products?

They can be used without guidance. Signup and view all the answers

Why is it recommended to document tobacco use by patients?

To improve treatment effectiveness and cost-effectiveness. Signup and view all the answers

What is the purpose of motivational approaches in smoking cessation?

To effectively engage those who are resistant to quitting. Signup and view all the answers

Which medication is currently in clinical trials for smoking cessation?

Cytisinicline Signup and view all the answers

Study Notes

Tobacco Types

Two main types: combustible (smoking) and smokeless (spit)
Combustible types include: cigarettes, cigars, pipes, bidis, kreteks, hookah
Cigarettes are the most common smoking tobacco.
Hookah is a water pipe used for smoking tobacco, often thought of as safer but has health risks associated with longer use, and sharing.

Combustible Tobacco

Cigarettes are the most common form.
Cigars also exist.
Pipe tobacco is another option.
Bidis and Kreteks are other forms with higher concentrations of nicotine, tar, and carbon monoxide than conventional US cigarettes. The FDA banned the manufacturing and sale of bidis and kreteks in the U.S.

Smokeless Tobacco

Plugs, wads, twist, loose leaf
Snuff (dry or moist)
Snus (comes in small cylinder cans, heat and clean)
Smokeless tobacco does not produce smoke, but generates saliva, which can be a trigger of health issues

Electronic Nicotine Delivery Systems (ENDS)

E-cigarettes, vape pens, e-cigs
Have evolved significantly in recent years.
Disposable varieties are more commonly used.
Improper disposal of batteries and chemical products is a danger to the environment.
Heat not Burn tobacco types like IQOS and Eclipse exist.

What's Burning?

Cigarette smoke contains over 7000 chemicals and gasses.
Components include tar, carbon monoxide, hydrogen cyanide, heavy metals (lead, arsenic), formaldehyde, acetone, and pesticides.

Nicotine Addiction

Nicotine addiction is a complex process involving psychological and social factors.
The "chain of nicotine reaction" involves 3 factors: Psychological dependence, nicotine addiction, and socioeconomic factors.
The brain absorbs nicotine rapidly, impacting the brain within 8 seconds, and stimulating the release of dopamine.
Nicotine alters the brain by upregulating nicotine receptors, leading to cravings.
Withdrawal symptoms may include anger, anxiety, cravings, depression, difficulty concentrating, fatigue, and nausea.
Nicotine receptors in brain cells of smokers are different from those in nonsmokers.

Oral Nicotine Products

Synthetic nicotine, a non-tobacco product that contains nicotine, is addictive.
The nicotine levels vary in different brands, however most are addictive.
The products contain carcinogens, including ammonia, chromium, formaldehyde, nickel, and nicotine salt.
Long-term use is associated with increased risks of heart disease, vascular disease, and other health problems.

Cardiovascular and Respiratory Effects

Smoking can cause coronary heart disease and stroke, peripheral vascular disease and abdominal aortic aneurysm.
Smoking can lead to lung cancer and respiratory conditions such as emphysema and chronic bronchitis.

Smoking & Cancer

Smoking is linked to numerous types of cancer, affecting different parts of the body.

Endocrine and Gastrointestinal Systems

Smoking is a risk factor for type 2 diabetes mellitus.
Smoking worsens other complications of diabetes including cardiovascular and other diseases.
Smoking can affect thyroid function, pituitary and adrenal gland hormones, and parathyroid hormone.
GI diseases such as ulcers and Crohn's disease are also risk factors.

Smoking Effects: Skin & Hair

Poor wound healing, premature wrinkling, smoker's face, brittle/dry hair, hair loss, benign skin lesions, and cancerous skin lesions are possible consequences of smoking

Women & Tobacco

Women find quitting more difficult than men.
Postmenopausal women who smoke have lower bone density.
Women smokers have an increased cancer risk compared to men smokers.
Smoking affects fertility (including miscarriage, premature, and low birth weight babies).
Smoking increases the risk of nicotine addiction in children, and risk of cleft lip/palate, and sudden infant death syndrome (SIDS).

Health effects of Vaping

Evidence on vaping devices is limited.
Nicotine in e-cigarettes can cause poisoning and addiction in non-smokers.
Malfunctioning devices can cause oral injury, and lung injury.
Reduced exposure to toxins compared to traditional smoking products may be one positive.
Cellular cytotoxic effects are a potential concern.

Smokeless: Not Harmless

Smoking affects the heart, damage to DNA and key enzymes.
Smoking can lead to damage to oral health.

Adverse Oral Health Effects

Stained teeth, reduced taste/smell, halitosis, hairy tongue, Smoker's Melanosis, Nicotine Stomatitis, Candidiasis, Leukoplakia, Carcinomas, Periodontal disease or dental cares are oral health effects from smoking.
Increased surgical risks, poor wound healing, increased risk of implant failure are potential risks due to smoking

Environmental Tobacco Smoke (ETS)

Secondhand smoke is the smoke exhaled by smokers
Mainstream smoke is what is directly produced by burning tobacco.
Sidestream smoke is what is directly emitted during burning of tobacco products.
Thirdhand smoke refers to the cigarette by-products found on surfaces even after the smoke is gone

Clinical Practice Guideline: Treating Tobacco Use and Dependence

Pharmacotherapy – includes medication for smoking cessation. Many medications can double quitting rates compared to a placebo. Some examples include Bupropin and Varenicline.
Practical counseling – in-person, group, and phone counseling can help patients to quit.
Motivational interviewing (MI) – Effective motivational approaches can be effective in helping support the unwiling to quit.
Medication combined with counseling – Most effective treatment option.

Quitting Success

Help from a clinician practically doubles quit opportunities from 5+ months compared with no clinician support.
Clinicians are obligated to address tobacco use and help in establishing quit plans.
Quitting is a decision for the individual.

Pharmacotherapy

All FDA-approved therapies increase long-term smoking cessation
Nicotine Replacement Therapy (NRT) including patches, gum, lozenges, inhalers, and nasal sprays are first-line therapies

Nicotine Replacement Therapy (NRT)

Products aid in reducing nicotine withdrawal symptoms, including those affected by quitting.

Common Elements of Practical Counseling

Provide basic information on addiction, withdrawal symptoms, relationship of lapse to relapse, and coping mechanisms.
Help clients recognize triggers and develop coping skills to prevent lapses during their quitting journey.
Help clients to anticipate and avoid triggers that may cause a relapse

Guideline Recommendations

Tobacco use is considered a chronic disease.
Clinicians should document tobacco use by patients.
Treatment should be effective and cost-effective, advising all users to QUIT.
Brief intervention, medications (7 first-line drugs), individual, group, and phone counseling are effective.
Combination approaches work even better than individual approaches and/or brief intervention

Tapering (Cut Down to Quit)

Tapering is gradually reducing cigarettes, rather than quitting immediately.
Cold turkey (immediate cessation) vs. tapering.
Ways to taper include reducing the # cigarettes smoked, and lengthening the space/time between cigarettes smoked.

ENDS/Vaping Devices

Recommend evidence-based cessation aids for patients interested in quitting.
Include behavioral counseling and pharmacotherapy.
Support the attempt to quit e-cigs and vaping, while encouraging quitting all traditional tobacco.
Emphasize the lack of evidence for safety and efficacy of e-cigarettes and vaping.
Urge a quit date for vaping

Great American Smoke Out

Public health campaign encouraging people to quit smoking.

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Description

Test your knowledge on tobacco and nicotine types with this engaging quiz. Explore various smoking methods and their associated risks, focusing on differences between combustible tobacco products. Challenge your understanding of nicotine's effects and addiction mechanics.