IT Quiz Answer – Jan, 2 2025
Here is the answer to our weekly Intelligent Thursday quiz!
Pop Quiz: January 2, 2025
You have a patient admitted to the hospital who smokes 20 cigarettes per day and is currently using a 21 mg nicotine patch. What evidence based options are appropriate for discussing quitting with this patient upon discharge? (Select all that apply)
A. Continue the 21 mg nicotine patch and add varenicline, titrating to 1 mg twice daily over one week.
B. Encourage him to quit abruptly using the “cold turkey” method to avoid any potential medication side effects.
C. Warn him about the risks of smoking while using a nicotine patch and advise him to delay applying the patch if he intends to smoke.
D. Continue the 21 mg nicotine patch and add bupropion, titrating to 150 mg twice daily over 3 days.
Check your answer!
The correct answers are A and D.
Explanation:
Both varenicline and bupropion are evidence-based pharmacotherapies for smoking cessation and can be added to nicotine replacement therapy.
Varenicline is started at 0.5 mg daily on day one, titrating up to 1 mg twice daily over a week; while bupropion is started at 150 mg daily for 3 days, followed by 150 mg twice daily thereafter.
The “cold turkey” approach is common but only leads to sustained abstinence in 3–6% of patients.
Lastly, it is important to clarify that smoking one or two cigarettes while wearing a patch is not dangerous. This misconception often deters patients from starting the patch right away.