Home' Australian Pharmacist : March 2011 Contents Vol. 30 -- March #03
Continuing Professional Development
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1. After completely quitting
smoking, the risk of heart
attack will become similar to
that of non-smokers after:
a) 1 year.
b) 5 years.
c) 10 years.
d) 15 years .
2. Among NRT dosage forms,
which one is the least preferable
option to use during a
pregnancy that isn't associated
with nausea or vomiting?
3. A successful attempt at
smoking cessation is more
likely if the individual:
a) is older.
b) has not previously tried to quit
smoking in the past.
c) continues with the same routine
and does not tell friends or family
that they are trying to quit.
d) is equipped with strategies and
life skills to help them move from
their current stage of behaviour
to the next.
A score of 4 out of 5 attracts 1 CPD credit.
4. Which of the following is not
an adverse effect of NRT?
c) Weight gain.
5. Approximately what
percentage of smokers who try
to give up smoking for the first
time, fail to do so?
• Cancer Council Australia at:
• Quit Victoria at: www.quit.org.au.
• NSW Department of Health at:
• Tobacco treatment specialist
clinics within local tertiary
Jane sits down with John in a private
corner of the pharmacy. To encourage
him to follow through and to try to
• Praises John's decision to quit, by
explaining the wide range of harmful
health-related effects associated
with continuing smoking and by
highlighting the significant benefits
accrued by stopping.
• Explains the mechanism of action
of NRTs and their corresponding
success rates. Jane also suggests
a possible regimen consisting of
one patch daily and intermittent
gum throughout the periods
of strong cravings. To obtain a
PBS prescription for the patch,
Jane suggests that John should
see his GP.
• Jane counsels John on how to use
these products, and mentions some
of the adverse effects that may be
incurred upon usage.
• Discusses some lifestyle
modifications to be initiated
along with therapy, in order
to improve John's chances of
• Raises the possibility of sending
John to a local smoking cessation
• Mentions some helplines and
useful websites where John could
get more information on smoking
• Arranges a follow-up visit and
emphasises the fact that it may
take more than one quit attempt to
successfully give up smoking.
Take home message
• It is never too late to quit smoking,
as the benefits of quitting
outweigh the harms associated
with continuing to smoke.
• Nicotine replacement therapy is
one of the most commonly used
treatments for smoking cessation.
It slowly delivers nicotine in lower
doses than a cigarette, therefore
reducing cravings and withdrawal
symptoms. It is associated with
significantly successful quit rates.
• Besides initiating therapy, the
success rate for any quit attempt
can be increased by incorporating
lifestyle modifications with
counselling and support from
healthcare professionals, such
as pharmacists and clinicians in
'quit smoking' organisations.
1. McEwen A, Hajek P, McRobbie H, West R. Manual of
Smoking Cessation: Blackwell Publishing; 2006.
2. Chandler MA, Rennard SI. Smoking cessation. Chest.
3. Eriksen M, Mackay J, Ross H, Shafey O. The Tobacco
Atlas: American Cancer Society and World Lung
Foundation; 2009. Available from: www.cancer.org.
4. Doll R, Peto R, Boreham J, Sutherland I. Mortality in
relation to smoking: 50 years' observations on male
British doctors. BMJ 2004; 328:1519.
5. Kotz D, Wesseling G, Huibers MJ, Schayck OCv.
Efficacy of confrontational counselling for smoking
cessation in smokers with previously undiagnosed
mild to moderate airflow limitation: study protocol of a
randomized controlled trial. BMC Public Health. 2007.
6. Scollo M, Winstanley M. Tobacco in Australia| Facts
and Issues| A comprehensive online resource: Cancer
Council of Victoria; 2008. Available from:
7. Nicorette Gum, Inhaler, Patch and Microtab Package
Inserts. Johnson & Johnson Pacific, Australia.
8. Nicabate Patch and Lozenge Package Inserts.
9. Diefenbach LJ, Smith PO. What is the most effective
nicotine replacement therapy? Journal of Family
10. Government subsidises nicotine patches, giving
smokers support they need to quit. Cancer Council
Victoria; December, 2010; Available from:
11. Lancaster T, Hajek P, Stead L, West R, Jarvis M.
Prevention of relapse after quitting smoking: a
systematic review of trials. Archives of Internal
12. New research shows positive effect of Government's
cigarette tax on health of Australia's smokers. Media
Release Pfizer Australia; September, 2010.
13. Smoking Cessation Clinic Guidelines: National
Smoking Control Programme Health Promotion Board,
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