Knowledge - Students should be able to
describe and define:
- Pharmacological effects of nicotine, nicotine withdrawal symptoms, and symptoms
of nicotine dependence.
- Intervention strategies that physicians can use for patients.
- Common barriers preventing patients from undertaking smoking cessation.
- Principles of at least one theory of behavior modification.
- Common medical diseases associated with chronic smoking.
Skills - Students should be able to:
- History: obtain, document and present an age-appropriate medical history in order
to:
- determine if a patient is nicotine dependent;
- assess a patient's motivation for stopping;
- assess the patient's past experience with smoking cessation;
- review and determine patient's barriers to stopping.
- Physical exam: perform a physical exam to establish diagnosis related to smoking,
especially:
- lesions with malignant potential in the lips and in the oral cavity;
- chest findings consistent with COPD;
- evidence of atherosclerotic vascular disease.
- Communication:
- demonstrate a commitment to administering non-judgmental "stop smoking"
message to every patient who smokes;
- respond positively and non-judgmentally to patients excuses or concerns about
cessation;
- counsel professional smoking cessation;
- get the patient to commit to a specific action plan that can lead to complete
cessation.
- Management:
- design an intervention that matches the stage of behavior change demonstrated by
the patient;
- explain how to use the nicotine patch therapy and nicotine gum therapy;
- negotiate a follow-up plan with the patient.
Attitudes and Professional Behaviors -
Students should be able to:
- Demonstrate a commitment to administering a non-judgmental "stop
smoking" message to every patient who smokes.
Recommended References:
- Hughes, John R et al. "Recent Advances in the Pharmacotherapy of
Smoking" JAMA 281(1):72-76, January 6, 1999.
- Lee, Emmet W., D'Alonzo, Gilbert E. Cigarette Smoking, Nicotine Addiction, and
Its Pharmacologic Treatment. Arch Intern Med 1993; 153, 34-48.
- "The Agency for Health Care Policy .and Research Smoking Cessation Clinical
Practice Guideline" JAMA 275(16);1270-1280
- Epps, Roselyn P., Manley, Marc W., Glynn, Thomas J. Tobacco Use Among
Adolescents. Strategies for Prevention. Pediatric Clinics of North America 1995; 42,
389-402.