Deck 34: Tobacco Cessation

Question 1

Pharmacotherapy for tobacco-use cessation involves which of the following?

A) Use of Zyban
B) Nicotine replacement
C) Some help from adjunctive counseling
D) All of the above

Answer 1

All of the above

Question 2

She decides to use the nicotine patch.Which dose is appropriate for Ms.H to begin with?

A) 21-mg patch
B) 14-mg patch
C) 7-mg patch
D) All of the above

Answer 2

21-mg patch

Question 3

A 22-year-old man has used snuff daily for 4 years.He is in good health and takes no medications.Which of the following statements is true?

A) There is no risk for developing a carcinoma within 10 years.
B) The primary carcinogen in smokeless tobacco consists of nitrosamines.
C) There are no sugars in smokeless tobacco and therefore no risk for caries.
D) There is so little nicotine in smokeless tobacco that habituation and/or addiction are unimportant factors.

Answer 3

The primary carcinogen in smokeless tobacco consists of nitrosamines.

Question 4

Nicotine addiction is a:

A) Chronic relapsing brain disorder
B) Disorder that has physiologic,psychologic,sensory,and behavioral aspects that must be addressed for cessation
C) Challenge that makes it difficult to stop using tobacco
D) All of the above

Question 5

Which of the following is not a nicotine withdrawal symptom?

A) Alertness
B) Insomnia
C) Increased appetite
D) Restlessness
E) Anger

Question 6

Motivational interviewing is which of the following?

A) A patient-centered philosophy to address behavior change
B) Designed to facilitate resolution of ambiguity that inhibits positive behavior change
C) An approach to actively engage the patient in the communication process
D) All of the above

Question 7

CASE STUDY
You have completed your examination of Ms.Choy,a 35-year-old woman who has indicated on her health history form that she smokes cigarettes.During the course of the intraoral examination you note 6- to 8-mm probing depths around maxillary and mandibular molars and bleeding on probing throughout the mouth.
When Ms.Choy verbally informs you that she smokes,what is the very next thing you would do?

A) Try to persuade her to stop.
B) Inform her about how smoking affects her periodontal health and advise her to quit.
C) Assess her willingness to quit.
D) Arrange follow-up.

Question 8

Which statement about the use of smokeless tobacco is correct?

A) It is a safe alternative to smoking.
B) It delivers a rapidly absorbed dose of nicotine.
C) It is not addicting.
D) Long-term use is not associated with an increased risk of oral cancer.

Question 9

Hallmarks for nicotine addiction include which of the following?

A) Compulsive use
B) Use despite harmful effects
C) Recurrent drug cravings
D) All of the above

Question 10

Which of the following smoking-cessation techniques or methods has no validity?

A) Transdermal nicotine patches to increase nicotine blood levels to help break tobacco smoking habituation and addiction
B) Group psychology sessions to help break the smoking habit
C) Hyperbaric oxygen treatments to reduce tobacco-related carbon monoxide blood levels
D) Use of a chewing gum containing nicotine to reduce the urge to smoke

Question 11

With regard to the federal clinical guidelines for Tobacco Cessation Treatment,the Five A's approach stands for:

A) Ask,Alert,Assess,Assist,and Arrange
B) Ask,Advise,Accentuate,Assist,and Arrange
C) Ask,Advise,Assess,Assist and Arrange

Question 12

CASE STUDY
Answer questions 13 to 17 based on the following case study.
Ms.H,a 38-year-old woman who is a long-time client of yours,comes to you and says she is finally ready to quit smoking.She smokes approximately 1 1/2 packs daily and has her first cigarette about 2 hours after she wakes up in the morning.She has never tried to quit smoking before.She wants to use a pharmacologic therapy that is available over the counter.
Which of the following nicotine delivery systems provides the fastest onset of action (i.e. ,is absorbed the fastest)?

A) Nicotine gum
B) Nicotine lozenge
C) Nicotine nasal spray
D) Nicotine inhaler
E) Nicotine patch

Question 13

The spirit of motivational interviewing is:

A) Collaborating
B) Imparting information
C) Persuading
D) All of the above

Question 14

Increased absorption of tobacco nicotine and aromatic hydrocarbons is related to which of the following?

A) Low pH
B) High pH
C) Neutral pH (7)
D) Acidity and alkalinity make little difference.

Question 15

In using motivational interviewing to help individuals quit their tobacco use,it is important to have the client voice the arguments for change known as "change talk." Examples of change talk include which of the following?

A) Reasons for concern about their tobacco use
B) Reasons for continued use
C) The good things to be gained from quitting
D) All of the above
E) A and C only

Question 16

CASE STUDY
Answer questions 13 to 17 based on the following case study.
Ms.H,a 38-year-old woman who is a long-time client of yours,comes to you and says she is finally ready to quit smoking.She smokes approximately 1 1/2 packs daily and has her first cigarette about 2 hours after she wakes up in the morning.She has never tried to quit smoking before.She wants to use a pharmacologic therapy that is available over the counter.
Which of the following smoking-cessation medications is available over the counter?

A) Bupropion
B) Nicotine nasal spray
C) Nicotine oral inhaler
D) Nicotine lozenge

Question 17

Key skills of motivational interviewing include which of the following?

A) Use of open-ended questions to allow patients to express themselves
B) Affirming "change talk"
C) Reflective responding (i.e. ,acknowledging "Here is what I heard you say")
D) Summarizing results of the dialogue
E) All of the above

Question 18

CASE STUDY
You have completed your examination of Ms.Choy,a 35-year-old woman who has indicated on her health history form that she smokes cigarettes.During the course of the intraoral examination you note 6- to 8-mm probing depths around maxillary and mandibular molars and bleeding on probing throughout the mouth.
When you ask Ms.Choy if she would like to try to quit in the next month,she responds that she does not smoke very much and she really does not think it is that big of a problem.She states she will brush and floss more to improve her periodontal health.In which stage of change is Ms.Choy?

A) Preparation
B) Precontemplation
C) Contemplation
D) Action
E) Maintenance