Cognitive-Behavioral Therapy for Smoking 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. All of the following cause damaging effects from smoking except:

a) nitrogen oxide
b) arsenic
c) lead
d) nicotine

2. Smoking prevalence is increasing in developing countries especially China.

a) True
b) False

3. Smoking more than ___________ the risk for a heart attack and related heart disease.

a) quadruples
b) triples
c) doubles

4. Dependence:
  1. is a chronic condition
  2. develops over a fairly long exposure to smoking
  3. recedes slowly after abstinence
  4. should be viewed like hypertension, diabetes, or a serious psychiatric disorder

a) all the above
b) all but 4
c) 1 only
d) 3 only

5. Tobacco smoking delivers nicotine to the brain in less than 20 seconds.

a) True
b) False

6. Covering the tiny holes in the paper of a cigarette negates the ability of the paper to dilute

a) True
b) False

7. The sight, smell and taste of smoking are often called:

a) reinforcers
b) contexts
c) proximal cues
d) sensory triggers

8. Contexts become readily paired with smoking when they:
  1. are combined with a pleasurable activity
  2. require concentration on a work task
  3. include other smokers who serve as models or cues
  4. help pass the time

a) all the above
b) 4 only
c) 2 and 3
d) 1 only

9. Many smokers report the first cigarette of the day is their favorite one which is related to:

a) acute tolerance
b) chronic tolerance
c) abstinence
d) sensory fatigue

10. Which of the following are physiological effects of smoking:
  1. increases the heart rate and blood pressure
  2. decreases the level of oxygen in the blood
  3. decreases the metabolic rate
  4. reduces the appetite

a) all the above
b) all but 3
c) 1 and 4
d) 2 and 3

11. Teenagers who become dependent on smoking have other characteristics such as poor school performance.

a) True
b) False

12. The __________ __________ of CBT addresses the smokers’ attitudes and beliefs about smoking and quitting.

a) behavioral component
b) cognitive component

13. Of the five A’s, practitioners failed to follow through on which step:

a) advise the smokers to quit
b) assess willingness to quit
c) assist with intervention
d) arrange for follow-up on progress

14. The single most important question one can ask to assess tobacco dependence and predict future quitting success is:

a) “Do you smoke when you are ill?”
b) “Which cigarette would you hate most to give up?”
c) “How soon after waking do you have your first cigarette?”
d) “Do others in the home smoke?”

15. In the precontemplation stage, the smoker:

a) is concerned about weight gain
b) has no intention of quitting
c) believes it is not a good time
d) has tried and failed

16. The most common reason smokers report when wanting to quit is:

a) health concerns
b) cost of cigarettes
c) societal restrictions on smoking
d) wanting to be a positive influence on children

17. Past failures can be discouraging. The average American smoker has smoked for ______ years and has made over ________ quit attempts.

a) 10, 2
b) 25, 10
c) 20, 7
d) 19, 5

18. Current smokers are more likely to prefer smaller rewards that they can have immediately over larger rewards for which they must wait (Bickel and Madden,1999). This is called:

a) negative feedback
b) delay discounting
c) cognitive behavior
d) context

19. One way to assess self-efficacy is to ask a smoker:

a) “I have tried and failed.”
b) “I’ll miss it too much.”
c) “How likely is it you will be a nonsmoker one year from now?”
d) “It’s who I am.”

20. The most common triggers for smoking are:

a) cigarettes, ashtrays, and lighters
b) smelling cigarette smoke
c) sitting in a bar
d) peer pressure

21. A 25-year-old female has decided to quit smoking. All of the following are appropriate times except:

a) a holiday, birthday, or anniversary
b) during the luteal phase of their cycle
c) no more than 2 weeks away when set
d) during the follicular phase of their cycle

22. A cognitive strategy to use when triggers remain is:

a) take a walk or visit nonsmoking friends
b) grip a stress ball or manipulate small objects
c) eat healthy snacks
d) remind oneself of the positive consequences of not smoking

23. In this technique, the smoker is prompted to smoke by the clock:

a) narrowing smoking locations
b) harm reduction
c) scheduled reduction
d) rapid smoking

24. In the interest of time efficiency, _____ minutes of total contact time should be the minimum goal when designing an effective smoking cessation program.

a) 30
b) 60
c) 90
d) 120

25. Nicotine replacement therapy (NRTs) is an example of:

a) relief of withdrawal and craving
b) blunting of pleasurable effects of smoking

26. All of the following are true about nicotine replacement therapy medications except:

a) nicotine is delivered more slowly
b) medication is taken in a controlled fashion
c) NRT can be addictive and harmful
d) adverse health effects do not occur over long time use

27. The transdermal nicotine blood level peaks in _____ ______ and nicotine gum peaks in ______ ______ of regular chewing.

a) 3 hours, 30 minutes
b) 6 hours, 20 minutes
c) 8 hours, 1 hour
d) 10 hours, 2 hours

28. The most rapid form of nicotine replacement therapy is:

a) the nicotine “inhaler”
b) the nicotine lozenge
c) the nicotine patch
d) the nicotine nasal spray

29. Active dosing deals with intermittent spikes in craving and withdrawals during the day.

a) True
b) False

30. Nicotine replacement therapy medications often fail for all of the following reasons except:

a) the NRT product does not match the rapid uptake of nicotine produced by inhaling
b) no pleasure is obtained from smoking
c) pharmacological actions are less helpful for some smokers compared to others
d) quitting smoking is more than just finding an alternative way to get nicotine in the bloodstream

31. All of the following are physiological symptoms of nicotine withdrawal except:

a) fatigue
b) depression
c) sleep disturbances
d) increased cough
e) constipation

32. _________ _________ are the most difficult symptoms of nicotine withdrawal faced by quitting smokers.

a) Depressive episodes
b) Negative effects
c) Mood alterations
d) Intermittent lapses

33. Relapse is defined as returning to regular smoking.

a) True
b) False

34. The first step of relapse prevention training according to Marlott and George is to:

a) ask for help
b) make a recovery plan
c) renew the commitment to quit
d) stop, look and listen

35. Smoking lowers body weight by:
  1. increasing metabolism from nicotine
  2. decreasing the consumption of food
  3. enhancing satiety and decreasing snacking
  4. combining with catecholamines to decrease appetite

a) all the above
b) 1 only
c) 4 only
d) 1, 2, and 3

36. All of the following are true regarding dieting to increase a weight-concerned smoker’s chances of quitting except:

a) a smaller weight gain does not increase chances of successful cessation
b) counseling while dieting increases chances of quitting smoking
c) diet and exercise programs designed to prevent weight gain have not improved the chances of successfully quitting smoking
d) it is too difficult to change two health behaviors, smoking and eating, at the same time

37. Health risks of weight gain pale in comparison to the dangers of continuing to smoke is a feature of which concern:

a) weight gain expectations
b) rationale about weight gain
c) dieting is detrimental
d) addressing cognitive-behavioral strategies about body shape and weight

38. Conscious efforts to control food intake or the expectation of extreme control over one’s eating is the definition of restrained eating.

a) True
b) False

39. Which of the following are true regarding exercise for the smoker:
  1. low intensity exercise is recommended
  2. walking is the ideal exercise
  3. walking prevents weight gain
  4. exercise aids smoking cessation

a) all the above
b) 3 and 4
c) all but 1
d) all but 3

40. The author suggests that smokers have a minimum of ________ of continuous abstinence from cigarettes prior to the initiation of a weight-loss program.

a) 2 months
b) 4 months
c) 6 months
d) 1 year

41. Which of the following is true regarding why women have a more difficult time quitting smoking than men:
  1. women have less success with nicotine replacement therapy
  2. women are 2 times more likely than men to suffer major depression
  3. wo

a) all the above
b) 2 and 3 only
c) all but 4
d) 3 only

42. One approach that may deter a pregnant woman from smoking is:

a) review the negative health effects of smoking on the unborn baby
b) tell her that her offspring will likely be a smoker
c) perform expired air tests
d) give financial incentives

43. Having friends and a parent who smoke increases the likelihood that an adolescent will smoke.

a) True
b) False

44. Long-term quit rate among coronary heart disease patients is generally:

a) above 80 percent
b) above 90 percent
c) below 40 percent
d) below 20 percent

45. Which of the following groups enables the smoker to use sensory gating:

a) patients with depression
b) schizophrenia patients
c) patients with anxiety disorders
d) ADHD smokers

46. When using alcohol and nicotine, a greater dose of alcohol is required to get the same effect in a smoker who has never drunk alcohol, compared to a nonsmoker who has never drunk. This effect is called:

a) cross-sensitization
b) maladaptive patterns
c) clearance sensitivity
d) cross-tolerance

47. The “gold standard” of success is best defined as:

a) staying quit for a year
b) successfully maintaining efforts to cope with urges after several months
c) not relapsing during the first week or two after quitting
d) quitting on their own

48. Two of the main reasons for rapid relapse when smokers try to quit on their own is due to tobacco withdrawal and triggers.

a) True
b) False

49. A patient comes to counseling and an expired-air carbon monoxide sample is performed. The reading is 10 ppm. This indicated the person:

a) inhaled exhaust fumes at the bus stop
b) came from a smoky room
c) was chewing nicotine gum
d) is still smoking

50. One key attitude change that will prevent relapse is for ex-smokers to:

a) know they can never smoke again
b) fully identify themselves as nonsmokers
c) have a plan if they do relapse
d) continue taking medication to improve mood and decrease urges