Tobacco Cessation

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. The American Lung Association estimates that the number of Americans who use tobacco is:

a) 54 million
b) 12 million
c) 66 million
d) 80 million

2. The percentage of dental patients who are tobacco users is:

a) 0.25
b) 0.35
c) 0.15
d) 0.2

3. Smokeless tobacco has been linked to:

a) emphysema and lung cancer
b) oropharyngeal cancer and cancer of larynx
c) all of the above
d) none of the above

4. The risk of dying from cigar smoking is:

a) 3-5 times the risk of non-smokers
b) 2-3 times the risk of non-smokers
c) 4-10 times the risk of non-smokers
d) none of the above

5. Nicotine can be absorbed into the blood through:

a) mucosal lining of the mouth
b) esophagus
c) upper gastrointestinal tract
d) all of the above

6. The chances of cigar smokers getting emphysema are:

a) 5 times greater than cigarette smokers
b) 3 times greater than cigarette smokers
c) 10 times greater than cigarette smokers
d) none of the above

7. Reward pathway of the brain is stimulated by nicotine:

a) via the locus ceruleus
b) all of the above
c) none of the above

8. The physiologic effects of tobacco cessation on improved general health begins:

a) 8 hours after cessation
b) 24 hours after cessation
c) 20 minutes after cessation
d) 72 hours after cessation

9. Oral mucosal conditions associated with tobacco use include:

a) oral cancer
b) Leukoplakia
c) all of the above

10. Periodontal conditions associated with tobacco use include:

a) periodontitis and plaque formation
c) gingival recession
d) all of the above

11. Dental conditions associated with tobacco use include:

a) staining of teeth and restorative materials
b) abrasion
c) dental caries
d) all of the above

12. Smoking can compromise the success of implants due to impaired wound healing because:

a) smoking causes vasoconstriction and decreased blood flow
b) increased platelet aggregation
c) increased level of carboxyhemoglobin and decreased O2† transport
d) all of the above

13. Increased caries incidence in tobacco chewers is due to:

a) abrasive action of tobacco product
b) sugar content of chewing tobacco
c) incidence of dry mouth and gingival recession
d) all of the above

14. Major barriers to integrating tobacco cessation in dental practices are:

a) dentists don't believe it is their area of responsibility
b) patients may complain or leave practice
c) it may take too much time and may not be reimbursed
d) all of the above

15. Contraindications for nicotine gum include:

a) under age 18
b) immediately after heart attack period
c) severe angina or active TMJ condition
d) all of the above

16. Zyban should not be used in patients who:

a) have had a stroke
b) have had a brain tumor or brain surgery
c) have had seizures in the past-epilepsy or a familial history
d) all of the above

17. The 2000 PHS Guideline serves as the foundation for treating tobacco use in the dental clinic. The guideline states that:

a) Tobacco dependence is not a chronic disease.
b) Tobacco dependence is a chronic disease.
c) Tobacco use is a "habit" that can be overcome if the patient desires.
d) none of the above

18. Dentists should identify every tobacco user and then provide the following:

a) advice to quit
b) brief motivational counseling
c) pharmacotherapy
d) all of the above

19. The 5A.s intervention should occur in the following order:

a) Assess Ask Assist Advise Arrange
b) Advise Ask Assist Assess Arrange
c) Ask Advise Assess Assist Arrange
d) Ask Advise Arrange Assess Assist

20. One method to identify all tobacco users is to expand the data base of the patientsí †vitals signs to indicate the use of tobacco.† An alternative to this is:

a) have the patients remind you of their tobacco use during their appointment
b) have the dental hygienist keep a list of tobacco users so that he/she may counsel †††them at hygiene appointments
c) indicate tobacco use status using electronic or computer reminder systems
d) to have different colored dental charts for tobacco-using patients

21. The most important things a healthcare provider can do to help a patient quit tobacco †are:

a) set a quit date
b) provide motivational materials
c) pharmacotherapy
d) all of the above

22. FDA-approved pharmaceuticals for treating tobacco dependence

a) should be used for 2-3 months.
b) are more effective when used in combination with behavioral intervention.
c) are for adult smokers (18 and older).
d) all of the above

23. Proper use of the nicotine lozenge includes:

a) stopping use of tobacco
b) drinking only non-acidic drinks while using lozenge
c) chewing lozenge and swallowing to allow for absorption in the stomach
d) using one lozenge every 2-3 hours during the day

24. Proper use of the nicotine nasal spray includes:

a) inhaling deeply while spraying
b) alternating cigarettes with nasal spray to taper off tobacco use
c) 1-2 doses per hour (1 dose + 1 spray in each nostril)
d) use up to 10 times per hour

25. The following medications have been FDA approved for use as adjuncts to tobacco cessation:

a) Nortriptyline
b) Clonidine
c) Zyban
d) Zoloft

26. For patients who are not ready to quit using tobacco the oral health team should:

a) prescribe pharmacotherapy any way so that when the patient is ready it will be available
b) have the patient sign a release that the patient refused to quit so that the doctor †††cannot be held responsible for impending illnesses
c) refuse any type of esthetic dental treatment until the patient quits
d) provide a brief motivational intervention and provide† educational materials

27. Regarding women and smoking:

a) association with smoking is uncertain for breast cancer
b) 90 percent of all lung cancer deaths are attributed to smoking
c) increased risk for cervical cancer
d) all of the above

28. Regarding quitting tobacco and health:

a) within 20 minutes of the last cigarette your blood pres sure drops to normal
b) after 8 hours the carbon monoxide level in the blood returns to normal
c) after 24 hours the chance of heart attack is reduced
d) all of the above

29. After 10 years of quitting tobacco:

a) lung cancer death rate drops by 50 percent
b) precancerous cells of the mouth and lungs are replaced
c) heart disease rate drops by 50 percent
d) there is a higher prevalence of anxiety disorders

30. Snuff dippers lesion:

a) may regress and disappear when tobacco use is discontinued
b) is seen in 5-10% of smokers
c) is also known as hairy tongue
d) is an atrophic lesion located in the central dorsum of tongue