1. During what life stage do most smokers begin to use tobacco?
A. Adolescence
B. Young adulthood
C. Middle age
D. Retirement
E. Unsure
2. MJ has been a smoker for 13 years and has decided to make a quit attempt. Before she speaks to her primary care physician, she wants to know more about available treatments and which medications have been proven to be the most helpful. What do you tell her?
A. Nicotine patches and varenicline are the most effective options
B. Bupropion is more effective than varenicline
C. The combination of varenicline and nicotine patches is the most effective option
D. Varenicline or combination nicotine replacement regimens are the most effective options
E. Unsure
3. KC is interested in using varenicline to stop smoking. You notice she has a history of generalized anxiety disorder in her medical record, but she denies current symptoms. What do you suggest?
A. Varenicline is likely to exacerbate neuropsychiatric symptoms, so KC should avoid it
B. Varenicline is an appropriate choice, as long as an antianxiety drug is prescribed during the time KC tries to quit smoking
C. Varenicline is contraindicated in anyone with a history of neuropsychiatric symptoms
D. Varenicline is considered safe in patients with stable neuropsychiatric disorders
E. Unsure
4. HS is not sure he is ready to quit smoking, but he agrees that he will try to cut down the number of cigarettes he smokes per day. What does HS need to understand?
A. Smoking reduction undermines eventual quit attempts
B. Smoking reduction prior to quitting results in more successful abstinence
C. Cutting down to 5 cigarettes per day decreases the risk of heart disease from smoking to less than 10%
D. A reduction in cigarette consumption is not considered an appropriate end goal
E. Unsure
5. Which of the following statements about vaping is true?
A. There is no risk for those exposed to secondhand vapors
B. According to the American Heart Association, vaping is a preferred method for smoking cessation
C. Fruit-flavored e-juice is safest because food-grade flavorings are used
D. Data demonstrate that daily vaping doubles the risk of myocardial infarction
E. Unsure
6. BW is a 15-year-old non-tobacco user who has just taken up vaping. According to research, which of the following is true?
A. BW is not at risk of becoming a cigarette smoker as long as he chooses nicotine-free e-juice
B. BW will be exposed to the same serum level of nicotine as a smoker if he uses “high-concentration” nicotine e-juice
C. BW is more likely to become a cigarette smoker if he vapes with nicotine-containing e-juice
D. BW is likely to stop vaping in young adulthood since this is a phenomenon associated primarily with adolescence
E. Unsure
7. What are the 5 A's of smoking cessation?
A. Ask, advise, assess, assist, arrange
B. Ask, admonish, advise, assist, arrange
C. Ask, advise, assess, assist, abstain
D. Ask, assess, advise, accept, assist
E. Unsure
8. LT is a 62-year-old woman interested in quitting her cigarette habit. She wants to know if adding counseling to her nicotine replacement will increase the likelihood she will be successful; she states that she is a busy person and does not have time to attend group classes. What information can you offer her?
A. The combination of pharmacologic therapy and counseling is not more effective than either intervention alone
B. Counseling has been found to be more beneficial for younger persons since they are less likely to understand the risks associated with smoking
C. For counseling to influence a quit attempt, a smoker must commit to at least 90 minutes of contact
D. Even brief counseling can be effective in helping people quit smoking
E. Unsure
9. Many patients express fear of gaining weight if they quit smoking. Which of the following is true regarding post-abstinence weight gain?
A. Medications may delay weight gain, but they do not prevent it
B. Weight gain after quitting is uncommon
C. Bupropion SR has been shown to prevent weight gain
D. Oral nicotine replacement products (gum, lozenges) have been shown to prevent weight gain
E. Unsure
10. TN previously managed a period of abstinence from cigarette smoking for 15 weeks using varenicline. He discontinued the medication after 12 weeks, and he relapsed 3 weeks later. He said the medication worked well to control his cravings and he would like to try it again. What do you suggest to help him remain abstinent?
A. Use varenicline with a nicotine patch for 12 weeks
B. Take the varenicline an additional 12 weeks for a total of 24 weeks
C. Increase the dose to 1 mg 3 times daily for the last 3 weeks of therapy
D. Try a different therapy since varenicline therapy already failed
E. Unsure
Evaluation Questions
11. How confident are you in your decision about treatment for TN in the question above?
A. Not at all confident
B. Somewhat confident
C. Confident
D. Highly confident
