Kickit is a 59-year-old woman who presents to the community pharmacy with complaints of a biased administration at her workplace. A smoking ban at her health care facility will begin in 3 weeks. She states that “I need the income but could work part time to pay the bills. I don’t want to quit smoking. What can you suggest to help me get through my shift without going though nicotine withdrawal? Oh, and don’t suggest those nicotine patches. I tried those in the past and they just made me want to smoke more. Mother died at age 78 of natural causes. Father died at age 61 of aheart attack. Patient is the oldest child of four siblings. All siblings havesmoked cigarettes, but in the past 5 years, two of the siblings have quitsmoking. Son and daughter do not smoke. Twenty-nine-year-old sonhas attention deficit hyperactivity disorder (ADHD). Twenty-five-yearold daughter was hospitalized with a collapsed lung 8 years ago.  This pediatric nurse works the night shift (11 PM–7 AM) at a localhospital. She smokes 2 packs of cigarettes daily and has smoked for thepast 45 years. She drinks 15 cups of coffee a day when she is working.She states that she drinks one glass of wine every 3 months. Son lives inthe mother’s home intermittently throughout the year. Son is anonsmoker.  Imitrex 6 mg injection PRN migraine headache, not to exceed two dosesper dayMeloxicam 15 mg po dailyAmitriptyline 75 mg po at bedtimeHydrochlorothiazide 25 mg po dailyAmbien CR 12.5 mg (for insomenia) po at bedtimeEscitalopram 10 mg po daily Patient’s quality of life is compromised by cigarette smoking status andexposure to second-hand smoke (SHS) at work during smoke breaks,increased migraine headache frequency, and anxiety about work policychanges concerning cigarette smoking 1. Is she a suitable candidate for smoking cessation. Yes or noanswer with explanation?2. What feasible pharmacotherapeutic alternatives are available forthe treatment of smoking cessation ?

Kickit is a 59-year-old woman who presents to the community pharmacy with complaints of a biased administration at her workplace. A smoking ban at her health care facility will begin in 3 weeks. She states that “I need the income but could work part time to pay the bills. I don’t want to quit smoking. What can you suggest to help me get through my shift without going though nicotine withdrawal? Oh, and don’t suggest those nicotine patches. I tried those in the past and they just made me want to smoke more.

Mother died at age 78 of natural causes. Father died at age 61 of a
heart attack. Patient is the oldest child of four siblings. All siblings have
smoked cigarettes, but in the past 5 years, two of the siblings have quit
smoking. Son and daughter do not smoke. Twenty-nine-year-old son
has attention deficit hyperactivity disorder (ADHD). Twenty-five-yearold daughter was hospitalized with a collapsed lung 8 years ago. 

This pediatric nurse works the night shift (11 PM–7 AM) at a local
hospital. She smokes 2 packs of cigarettes daily and has smoked for the
past 45 years. She drinks 15 cups of coffee a day when she is working.
She states that she drinks one glass of wine every 3 months. Son lives in
the mother’s home intermittently throughout the year. Son is a
nonsmoker. 

Imitrex 6 mg injection PRN migraine headache, not to exceed two doses
per day
Meloxicam 15 mg po daily
Amitriptyline 75 mg po at bedtime
Hydrochlorothiazide 25 mg po daily
Ambien CR 12.5 mg (for insomenia) po at bedtime
Escitalopram 10 mg po daily

Patient’s quality of life is compromised by cigarette smoking status and
exposure to second-hand smoke (SHS) at work during smoke breaks,
increased migraine headache frequency, and anxiety about work policy
changes concerning cigarette smoking

1. Is she a suitable candidate for smoking cessation. Yes or no
answer with explanation?
2. What feasible pharmacotherapeutic alternatives are available for
the treatment of smoking cessation ?