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Block 2 Therapeutic Interventions

Unit 6 Tobacco Cessation

1. How would you define tobacco dependence?

Tobacco dependence is a cluster of behavioural, cognitive, and physiological phenomena that develop after repeated tobacco use. It typically includes a strong desire to use tobacco, difficulties in controlling its use, persistent tobacco use despite harmful consequences, a higher priority given to tobacco use over other activities, increased tolerance, and sometimes physical withdrawal symptoms.

2. Why do tobacco users need treatment for quitting tobacco use?

Tobacco dependence is a chronic condition that often requires repeated interventions. Effective treatments are available, and it's important to address both the physical and psychological aspects of withdrawal to quit and stay quit. Treatment is both clinically and cost-effective compared to other medical and disease prevention interventions.

3. What is 5 As approach in behavioural counselling for tobacco cessation?

The 5 A’s are a research-based counselling approach for tobacco cessation:

1. Ask: Systematically identify all tobacco users at every visit.
2. Advise: Strongly urge all tobacco users to quit.
3. Assess: Assess willingness to quit and the level of nicotine addiction.
4. Assist: Help the tobacco user make a quit plan and provide practical counselling.
5. Arrange: Schedule follow-up contacts.

4 What strategy would you adopt for a tobacco user who is unwilling to quit tobacco use?

For tobacco users not ready to quit, use the 5 R's approach to promote motivation:

1. Relevance: Encourage them to consider the personal relevance of cessation.
2. Risks: Discuss short-term, long-term, and environmental risks of continued tobacco use.
3. Rewards: Encourage them to identify the benefits of cessation.
4. Roadblocks: Identify barriers they may face in quitting.
5. Repetition: Regularly review this information with them.

5 What would you explain to tobacco users who are willing to quit but are apprehensive of weight gain?

Addressing Apprehension About Weight Gain: Reassure tobacco users that weight gain can be minimised by proper diet and exercise, and the need to quit must be emphasised. You can mention that pharmacotherapy or nicotine gum can delay weight gain. It’s important to offer continuing reassurance and support.

6. Which chemical in tobacco produces dependence/ addiction?

Nicotine

7. How does tobacco produce dependence?

Both smoked as well as smokeless forms of tobacco contain nicotine, a highly addictive chemical, making it difficult for habituated tobacco users to quit. In fact, it is as addictive, or even more, than heroin or cocaine. Over time, users become dependent on nicotine and suddenly stopping produces both physical and psychological withdrawal symptoms

8. How can the tobacco users who are trying to give up their dependence on tobacco be assisted?

Through help in making a QUIT plan.

• By providing practical counselling
• By helping in obtaining intra-treatment and extra-treatment social support
• By recommending pharmacotherapy.

9. Mention any three withdrawal symptoms of tobacco products, and the coping strategies for the same.

• Irritability - Take walk/bath, relax and talk to friends, listen of favourite music, do breathing exercises/yoga.
• Insomnia - Develop habit of reading books, avoid tea, coffee and aerated drinks after 6 p.m.
• Fatigue - Take rest/nap relax, increase intake of fluids.