Paeds Cases · adolescent-and-young-adult-medicine
Tobacco, vaping and nicotine dependence OSCE — dependence assessment, brief intervention and the cessation plan
Observed structured encounter testing universal screening of all nicotine products, dependence grading with DSM-5 and the Hooked on Nicotine Checklist, motivational-interviewing brief intervention, and assembly of an evidence-based cessation plan with an EVALI safety override.
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Study tools
Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is a private dependence assessment and brief intervention with a 16-year-old daily pod-device vaper who wants to quit. Station B is an emergency presentation requiring EVALI recognition and immediate escalation.
Station objectives
- Secure time alone and state conditional confidentiality with its limits. [5] [4]
- Screen for and quantify use across all nicotine products, not only cigarettes. [4]
- Grade dependence with DSM-5 criteria and a validated tool (Hooked on Nicotine Checklist). [2]
- Deliver a motivational-interviewing brief intervention matched to readiness. [4]
- Assemble an evidence-based cessation plan and recognise EVALI as a safety override. [3] [1]
References7ShowHide
- [1]Kalininskiy A, Bach CT, Nacca NE, et al. E-cigarette, or vaping, product use associated lung injury (EVALI): case series and diagnostic approach. The Lancet Respiratory medicine, 2019.PMID 31711871
- [2]Scragg R, Wellman RJ, Laugesen M, DiFranza JR Diminished autonomy over tobacco can appear with the first cigarettes. Addictive behaviors, 2008.PMID 18207651
- [3]Rubinstein ML, Benowitz NL, Auerback GM, et al. A randomized trial of nicotine nasal spray in adolescent smokers. Pediatrics, 2008.PMID 18762494
- [4]Kaliamurthy S, Camenga DR Clinical approach to the treatment of e-cigarette use among adolescents. Current problems in pediatric and adolescent health care, 2022.PMID 35534404
- [5]Pbert L, Farber H, Horn K, et al. State-of-the-art office-based interventions to eliminate youth tobacco use: the past decade. Pediatrics, 2015.PMID 25780075
- [6]Yuan M, Cross SJ, Loughlin SE, Leslie FM Nicotine and the adolescent brain. The Journal of physiology, 2015.PMID 26018031
- [7]Graham AL, Cha S, Jacobs MA, et al. A Vaping Cessation Text Message Program for Adolescent E-Cigarette Users: A Randomized Clinical Trial. JAMA, 2024.PMID 39110436