Diagnosis
Epidemiology
Pharmacotherapy
Special Pops
VAPING
Nuts & Bolts
100
At least two criteria within 12 months
What is the minimum number of criteria required to diagnose a Tobacco Use Disorder?
100
about 17%
What is the percentage of people aged 12 or older who used a tobacco product in the past year according to the 2024 National Survey on Drug Use and Health?
100
Over‑the‑counter nicotine replacement
What are patch, gum, and lozenge?
100
vaping
What is the most commonly used tobacco nicotine product used by adolescents?
100
propylene glycol (PG)
What is the liquid heated to create the inhaled aerosol?
Vegetable glycerin is the other commonly used liquid.
100
Ask, Advise, Assess, Assist, and Arrange
What are the the 5As? The 5As constitute an evidence-based, 5-step framework for healthcare providers to deliver brief, effective interventions to help patients quit tobacco.
200
Persistent desire or unsuccessful efforts to cut down
What is loss of control?
Loss of control despite harmful effects is the hallmark of addiction.
200
age 12-17
What age group is most likely to vape nicotine alone? (SAMSHA NSDUH 2025)?
Among people who used any nicotine product in the past month:
- Ages 12–17: 71.5% used only e‑cigarettes (nicotine vaping alone)
- Ages 18–25: 50.3% used only e‑cigarettes
- Ages ≥26: 18.0% used only e‑cigarettes (most used combustible tobacco, alone or with vaping)
200
Partial α4β2 nicotinic receptor agonist
What is varenicline?
200
Behavioral Counseling
What is the first‑line intervention for all youth using tobacco products?
- Pharmacotherapy may be considered for moderate–severe dependence when adolescents are motivated to quit.
- Combine behavioral + pharmacologic strategies for best outcomes
200
Vitamin E acetate
What is Vaping Use-Associated Lung Injury (EVALI), a serious, sometimes fatal, acute respiratory illness linked to vaping, particularly products containing Vitamin E acetate?
.
200
0.5 mg once daily x 3 then, 0.5 mg twice daily x 4, then 1 mg twice daily
What is the titration schedule for varenicline?
300
Craving, tolerance, and withdrawal
What are core substance use disorder features?
300
cigarettes
What is the most common form of tobacco used?
300
Doubles quit rates and limits weight gain
What is bupropion SR?
300
preterm delivery
What is the leading preventable cause of preterm delivery?
Increased risk of placenta previa, placental abruption, and preterm premature rupture of membranes
Higher risk of miscarriage and stillbirth
300
aged 18 - 25 years of age
What is the age group with the highest prevalence of nicotine vaping?
Across surveys, ages 18–25 consistently outpace adolescents and older adults in vaping prevalence.
300
150 mg QDAY for 3 days followed by 150 mg BID for 7 to 12 weeks
What is the typical dosing of bupropion SR for smoking cessation? The drug inhibits the reuptake of dopamine and norepinephrine, disrupting the reward pathways linked to nicotine addiction. Additionally, bupropion may act on nicotinic cholinergic receptors, improving its effectiveness in smoking cessation.
Clark A, Tate B, Urban B, Schroeder R, Gennuso S, Ahmadzadeh S, McGregor D, Girma B, Shekoohi S, Kaye AD. Bupropion Mediated Effects on Depression, Attention Deficit Hyperactivity Disorder, and Smoking Cessation. Health Psychol Res. 2023;11:81043.
400
Tobacco withdrawal can only occur with this severity
What is moderate to severe tobacco use disorder?
400
About 28,000,000 in past month
400
Most effective single agent
What is varenicline?
400
These products are not recommended for smoking cessation during pregnancy.
What is nicotine replacement products?
Have not been shown to be effective and expose the fetus to nicotine. -Nicotine rapidly crosses the placental barrier and reaches fetal circulation. Fetal nicotine levels can equal or exceed maternal levels due to slower fetal metabolism and accumulation in amniotic fluid. Nicotine acts as a neuroteratogen, binding to nicotinic acetylcholine receptors (nAChRs) that are critical for brain development. These receptors regulate neuronal proliferation, migration, synapse formation, and network connectivity.
400
flavors, nicotine salts, concealability
What product characteristics of modern disposable vapes most strongly contribute to youth initiation and dependence?
400
nausea
What is the most common side effect of varenicline?
- Occurs in ~25–30% of patients at the standard maintenance dose (1 mg twice daily)
- Usually mild to moderate
- Often dose‑dependent and most prominent during the first few weeks of therapy
- A leading reason for dose reduction or discontinuation in clinical trial
500
craving
What is the symptom permitted during both early and sustained remission?
500
American Indian/Alaska Native adults
Which racial/ethnic group has the highest prevalence?
500
nicotine inhaler and nasal spray
What are the two forms of NRT that require a prescription?
500
schizophrenia
What is the psychiatric disorder with the highest smoking rate?
- Schizophrenia: 65–85% (highest)
- Bipolar disorder: ~50–70%
- Substance use disorders: ~65–85% (high, but often categorized separately)
- Major depressive disorder: ~30–50%
- Anxiety disorders / PTSD: Elevated vs general population
The general U.S. adult population (~12–14%)
500
cardiovascular disease
What is the leading cause of excess mortality in people with serious mental illness related to smoking and vaping?
500
seizure or eating disorder
What are the contraindications for bupropion?