Smoking Cessation is a term that refers to the discontinuance of smoking tobacco. A Respiratory Therapist is a medical professional who plays an important role in this process.

In this article, we’re going to talk about how RT’s are potentially saving lives by assisting their patient in the process of quitting smoking. So if you’re ready, let’s get into it.

How Can a Respiratory Therapist Assist With Smoking Cessation?

As a Respiratory Therapist, you will be required to care for patients with a history of smoking on daily basis. That is why it’s important to have an understanding of how smoking affects the lungs (and entire body) so that you can help them quit smoking.

Initially, an interview may be required in order gain an understanding of the patient’s smoking history. Here are some questions that you may ask:

  • Do you smoke?
  • Have you ever smoked?
  • If yes, how long have you smoked?
  • How many packs of cigarettes a day do you smoke?
  • Does your spouse smoke, or are you frequently around someone who smokes?

Even if the patient is not a smoker, second-hand smoke can be just as bad because it can affect their spouse or children. So, in some cases, you may need to suggest that the patient’s family members quit smoking as well for the well-being of your patient.

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What is Smoking Cessation?

Smoking Cessation is the process of stopping or discontinuing the act of smoking tobacco. A Respiratory Therapist is a skilled medical professional that can assist a patient in quitting.

One of the firsts steps in the process is to assess the patient’s pulmonary health. You can do so by calculating the number of pack-years that they have smoked.

How to Calculate Pack-Years for a Smoker?

A pack-year is a number that can be calculated in order to measure the amount of exposure a person has endured to tobacco smoke.

You can calculate the number of pack-years by multiplying the number of packs smoked per day by the number of years that they smoked.

For example, if a patient has smoked 2 packs per day for 15 years, they would have a 30 pack-year smoking history.

2 packs x 15 years = 30 pack-years

Many patients are often unable to quit smoking due to withdrawal symptoms. In this case, it is likely that they have a nicotine addiction. So for these patients, nicotine replacement therapy may be indicated.

What is Nicotine Replacement Therapy?

Nicotine Replacement Therapy is a means of medications that give a patient small doses of nicotine in order to help minimize the withdrawal symptoms that come with quitting smoking.

It has been shown to increase the chance of quitting by 50-70%.

Although this form of therapy does not work 100% of the time, in most cases, nicotine replacement therapy combined with psychological support is very effective in help a patient quit smoking.

Types of Nicotine Replacement Therapy:

  • Nicorette gum
  • Nicotrol inhaler
  • Nicotine transdermal patches
  • Nicotine nasal spray

By using these types of therapy, over time, the patient will be able to essentially wean themselves away from nicotine cravings and eventually quit smoking.

Another alternative is to use prescription medications that work by altering the brain’s chemistry so that it no longer craves nicotine. Some examples include:

  • Zyban
  • Chantix

Do keep in mind that a prescription is needed from the physician in order to administer these medications, which can be very effective for smoking cessation.

Smoking Cessation Practice Questions:

1. In a smoking cessation program, what are the two types of support that can be given by the Respiratory Therapist?
(1) Physical and (2) emotional support.

2. In a smoking cessation program, how can the Respiratory Therapist physically assist?
Ask the patient about their smoking history. Advise the patient about the benefits of quitting smoking. Assess their willingness to attempt to quit. Assist the patient by discussing helpful medications and counseling. Arrange a follow-up meeting to begin the quitting process.

3. What are the four treatment types in smoking cessation?
(1) Nicotine Inhaler, (2) Nicotine gum, (3) Nicotine Patch (Transdermal), and (4) Nicotine nasal spray.

4. What does the nicotine MDI (inhaler) do?
It works just like a regular MDI. It is very portable and has titratable doing.

5. How does oral nicotine gum work?
It’s basically like chewing gum on a schedule and supplements the patient’s nicotine intake so they do not need to obtain it by smoking tobacco. The major brand is Nicorette. It may not be appropriate for patients with jaw pain or those who are unable to chew properly. Also, it has a very fast delivery.

6. How does the nicotine transdermal patch work?
It’s applied directly to the skin and delivers a steady dose of nicotine over a 24-hour period. Over time, the dose is gradually reduced until the patient no longer has nicotine craving. Then they can stop using the medication. The patch requires a once-a-day placement. It has slow delivery and must maintain a certain blood level in order to be effective. You can titrate the doses with different strengths for each patch.

7. How does the nicotine nasal spray work?
It’s a medicine that helps to reduce nicotine craving when a measured dose of nicotine solution is sprayed into the nose through the mucous membrane and is absorbed into the bloodstream. It has a very fast deliver and is portable to use on the go. Also, the patient should be careful when administering the spray because it can irritate the nose and eyes. The patient will need a prescription in order to obtain nicotine nasal spray.

8. After a person quits smoking, shortness of breath gets better and coughing decreases in this time frame?
Usually within 1 to 9 months

9. After a person quits smoking, heart attack risk begins to drop, lung function begins to improve, and ciliary begins to work within this time period?
Usually within 2 weeks to 3 months

10. How long does it take for carbon monoxide levels to return to normal after a person quits smoking?
Usually within 12 hours

11. One of the most immediate benefits of smoking cessation is that the heart rate drops in approximately how many minutes?
20 minutes

12. What are two helpful things to know about cigarette smoke?
(1) It has over 1000 agents that damage tissue and (2) It causes short and long-term health problems.

13. The 1964 Surgeon General’s Report of the advisory committee of smoking and health concluded that smoking can cause these four illnesses:
(1) Lung cancer, (2) Laryngeal cancer, (3) Emphysema, and (4) Cardiovascular disease

14. What did Mark Twain say that can be applied to smoking?
“Giving up smoking is the easiest thing in the world. I know because I’ve done it thousands of times.”

15. What are eight benefits of smoking cessation:
(1) Food tastes better, (2) Improved smell (of clothing, body odor, etc.), (3) You save money by not buying cigarettes, (4) You feel better about yourself, (5) Your personal items will smell better, (6) It sets a good example and decreases the odds that your children will smoke, (7) You will perform better physically, (8) Improved appearance, i.e. wrinkles, etc.

16. What percentage of adults smoke in the united states?
According to the CDC, 17.8% of adults smoke in the United States.

17. What percentage of smokers have called a quitline in an attempt to quit?
2.3%

18. What percentage of all cancer deaths are attributable to smoking?
28.7% (in 2010)

19. What are the five A’s of Smoking Intervention?
(1) Ask if the patient smokes, (2) Advise them to quit smoking, (3)Assess their willingness to quit at this time. (4) Assist the patient by discussing helpful medications and possibly counseling, and (5) Arrange a follow-up meeting.

20. What are the 5 R’s to help patients quit smoking?
(1) Relevance, (2) Risks, (3) Rewards, (4) Roadblocks, and (5) Repeat.

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21. What medications are used to help patients stop smoking?
Prescriptions medications used include (1) Chantix and (2) Zyban.

22. What are the side effects of Chantix?
Nausea is the most common side effect and may persist for several months. Other side effects include: stomach pain, indigestion, constipation, gas, weakness, tired feeling; dry mouth, unpleasant taste in your mouth; headache; insomnia and/or unusual dreams.

23. What are the smoking risks for pregnant women?
Smoking during pregnancy can cause a baby to be born premature and/or to have low birth weight. This increases the odds that the baby will be sick and have to stay in the hospital for a longer period after birth. It can even cause death, as smoking during and after pregnancy is a major risk factor of Sudden Infant Death Syndrome.

24. What are two examples of nicotine patches?
Two examples include Nicotrol and Nicoderm.

25. What is an alternative drug type that is effective in smoking cessation?
Anti-depressant drug therapy has been shown to be effective in helping patients quit smoking.

Final Thoughts

Smoking Cessation is often a forgotten topic but hopefully this article has helped you learn just how important it is — especially for Respiratory Therapists.

Having a solid understanding of the effects of smoking is critical because, again, Respiratory Therapists care for these patients on a daily basis. And if you can help them quit, you can change their life.

We have a full guide on Medical Gas Therapy as well that I think you will enjoy. Thanks for reading and as always, breathe easy my friend.

References

The following are the sources that were used while doing research for this article: