Case history
Case history #1
A 60-year-old man with spirometry demonstrating airflow obstruction is seen for a follow-up appointment. He continues to smoke 1 pack per day, but he recently attempted to stop and stopped smoking for more than 2 days before relapsing. He expresses a strong interest, but little confidence, in trying to stop again. During the recent attempt to stop he tried nicotine gum, but used it only once or twice daily. Additional past history is significant for hypertension under control and a remote history of a seizure disorder.
Case history #2
An 18-year-old woman with increased anxiety regarding college and social stressors is seen for a first visit with a new primary care provider. She reveals that she initially started using nicotine e-cigarettes (vaping) because a number of friends were using them, and because she enjoyed the candy flavours. Since starting college she has switched to combustible cigarette use. She describes how she and a number of peers share cigarettes with one another, and use smoking for stress and anxiety management.
Other presentations
The experience of smoking and smoking cessation may differ between adolescents and adults. For instance, levels of nicotine dependence in adolescents may not be equal to those of adult smokers.
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