Prompt

You are the paediatric registrar in a youth-friendly clinic. The examiner moves from the biology of adolescent dependence, through screening and the 5 A's, pharmacotherapy choices, a suspected EVALI presentation, and the gateway association.

Stem

The examiner will test whether you can defend adolescent nicotine dependence as a biological process and run evidence-based care under pressure, including an emergency presentation. ^[3] ^[8]

References8Show

[1]Jamal A, Park-Lee E, Birdsey J, et al. Tobacco Product Use Among Middle and High School Students - National Youth Tobacco Survey, United States, 2024. MMWR Morbidity and mortality weekly report, 2024.PMID 39418216
[2]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
[3]Yuan M, Cross SJ, Loughlin SE, Leslie FM Nicotine and the adolescent brain. The Journal of physiology, 2015.PMID 26018031
[4]Scragg R, Wellman RJ, Laugesen M, DiFranza JR Diminished autonomy over tobacco can appear with the first cigarettes. Addictive behaviors, 2008.PMID 18207651
[5]Evins AE, Cather C, Reeder HT, et al. Varenicline for Youth Nicotine Vaping Cessation: A Randomized Clinical Trial. JAMA, 2025.PMID 40266580
[6]Rubinstein ML, Benowitz NL, Auerback GM, et al. A randomized trial of nicotine nasal spray in adolescent smokers. Pediatrics, 2008.PMID 18762494
[7]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
[8]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

Stem

The examiner will test whether you can defend adolescent nicotine dependence as a biological process and run evidence-based care under pressure, including an emergency presentation. ^[3] ^[8]

References8Show

[1]Jamal A, Park-Lee E, Birdsey J, et al. Tobacco Product Use Among Middle and High School Students - National Youth Tobacco Survey, United States, 2024. MMWR Morbidity and mortality weekly report, 2024.PMID 39418216
[2]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
[3]Yuan M, Cross SJ, Loughlin SE, Leslie FM Nicotine and the adolescent brain. The Journal of physiology, 2015.PMID 26018031
[4]Scragg R, Wellman RJ, Laugesen M, DiFranza JR Diminished autonomy over tobacco can appear with the first cigarettes. Addictive behaviors, 2008.PMID 18207651
[5]Evins AE, Cather C, Reeder HT, et al. Varenicline for Youth Nicotine Vaping Cessation: A Randomized Clinical Trial. JAMA, 2025.PMID 40266580
[6]Rubinstein ML, Benowitz NL, Auerback GM, et al. A randomized trial of nicotine nasal spray in adolescent smokers. Pediatrics, 2008.PMID 18762494
[7]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
[8]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

Tobacco, vaping and nicotine dependence — branching viva

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Tobacco, vaping and nicotine dependence — branching viva

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