Behavioral Midterm

Front 1

% of high school students that smoke

Back 1

17%

Front 2

# of kids under 18 that become new daily smokers each year

Back 2

2800

Front 3

# kids exposed to secondhand smoke

Back 3

84000 kids

Front 4

# of packs of cigarettes bought or smoked by kids each year

Back 4

5.4 million

Front 5

% adults in Nevada who smoke

Back 5

22%

Front 6

# adults that die each year from their own smoking

Back 6

3300

Front 7

# of kids 18 and under and alive in Nevada who will die prematurely from smoking

Back 7

47000

Front 8

# of adult nonsmokers that die each year from secondhand smoke

Back 8

440

Front 9

Annual healthcare costs in Nevada directly caused by smoking

Back 9

$565 million

Front 10

$ in smoking caused productivity losses in Nevada

Back 10

$903 million

Front 11

NICOTINE:

1) Absorbed through?
2) Reaches peak level in brain when?
3) Where does it go after being absorbed by the lungs?
4) What receptors does it attach to?
5) How does it affect HR and bp?
6) What neurotransmitter does it affect?

Back 11

1) Mucous membranes, mouth, nose, lungs
2) 10 seconds
3) Bloodstream, then circulated through brain
4) Ach
5) Increases HR, raises BP
6) Raises levels of dopamine

Front 12

1) What is the neurotransmitter involved in addictions to other drugs like cocaine and heroin?
2) __% of people with oral cancer use tobacco. The risk is related to _____
3) __ out of ___ people who develop oral cancer drink a lot of alcohol
4) T or F: some types of cancers may result from heredity

Back 12

1) Dopamine
2) 90%, how much or how long they smoked or chewed
3) 7/10
4) T - abnormal genes that pass among family members

Front 13

5 risk factors for oral cancer

Back 13

1) Tobacco
2) Alcohol
3) Tobacco & alcohol
4) Sunlight
5) Diet

Front 14

NEVADA CLEAN INDOOR AIR ACT:

1) When was it passed?
2) What does question 5 permit?
3) Who enforces compliance with this act?
4) How can violations be reported?

Back 14

1) 2006
2) Local governments to adopt regulations more restrictive than state law
3) Washoe County Health District and the Nevada State Health Division are responsible for enforcing compliance to the NCIAA
4) NCIAA complaint form on the health district or health division website

Front 15

1) 5 year survival rate of oral cancer?
2) Diagnosing cancer at an early stage will give you a __% survival rate
3) T or F: oral cancer is a lifestyle disease
4) Non tobacco users should conduct oral cancer screenings every __ months

Back 15

1) 50%
2) 80%
3) T - entirely preventable if risk factors are controlled
4) 6 months

Front 16

1) 9/10 smoking caused deaths are from?
2) Smoking causes __/10 deaths from all cancers
3) Smoking causes __/10 deaths from COPD, such as emphysema
4) Smoking causes __/5 deaths from heart disease

Back 16

1) Lung cancer
2) 3/10
3) 9/10
4) 1/5

Front 17

5 consequences of secondhand smoke?

Back 17

ABLOH

1) asthma
2) bronchitis
3) heart disease
4) lung cancer
5) other cancers

Front 18

1) Secondhand smoke has been classified by the EPA as?
2) Exposure to secondhand smoke has been associated with increased risk of what 3 conditions in children?
3) __% of nonsmokers in the US have biological evidence of secondhand smoke exposure

Back 18

1) Known cause of cancer in humans
2) Asthma, bronchitis, pneumonia
3) 60%

Front 19

1) Tobacco use causes __ deaths per year WORLDWIDE
2) Tobacco use will cause more than __ deaths annually by 2030 WORLDWIDE
3) On average, smokers die ____ years earlier than nonsmokers
4) Top 5 countries for consumption of cigarettes?

Back 19

1) 5 million
2) 8 million
3) 13-14 years earlier
4) CRUJI - China, Russia, US, Japan, Indonesia

Front 20

1) What is the leading preventable cause of death?
2) Cigarette smoking is responsible for ___ deaths annually in the US?
3) Tobacco use kills how many people per year in the US?
4) How many tobacco related deaths are a result of secondhand smoke exposure in the US?

Back 20

1) Cigarette smoking
2) 1/5
3) 443,000
4) 50,000

Front 21

1) What % of U.S. adults are current smokers?
2) What % of high school students are current smokers?
3) Each day, ___ people <18 years become regular smokers
4) Each day, ___ people >18 years older become regular smokers

Back 21

1) 19.5%
2) 15%
3) 1,000
4) 1,800

Front 22

1) What % of adults smoke in Nevada?
2) __% of high school students in Nevada smoke?
3) __ become new smokers in Nevada each year
4) # of cigarettes bought or smoked by kids in Nevada each year

Back 22

1) 22%
2) 17%
3) 2800
4) 5.4 million

Front 23

4 ways to fight tobacco use?

Back 23

1) Higher tobacco taxes (.80/pack, Nevada ranks 34th)
2) Laws requiring smoke free workplaces + public places (NCIAA)
3) Well-funded prevention programs (no state funding)
4) Regulation of manufacturing, marketing, sale of tobacco products

Front 24

1) CDC recommended funding level for fighting tobacco? NV's funding?
2) Nevada ranks __ among states in funding of tobacco prevention programs
3) How much money is generated in tobacco?

Back 24

1) 32.5 million/yr, $0
2) 51st
3) 148 million, but none is spent on prevention

Front 25

1) If earmarked for tobacco control, an increase of __ would get NV to CDC recommended funding levels
2) How much of a return for a $1 investment on tobacco cessation?
3) When was the last cigarette tax increase?

Back 25

1) .31 increase in tobacco tax
2) $1.31 return on investment
3) 7/22/2003

Front 26

HOOKAH:

1) Hookah users are __x more likely to develop lung cancer than non-smokers?
2) Hookah smoking delivers the addictive drug __
3) T or F: Hookah is at least as toxic as cigarette smoke
4) Hookah has high levels of what toxic compounds?

Back 26

1) 8x
2) Nicotine
3) T
4) Carbon monoxide, heavy metals, cancer causing chemicals

Front 27

1) T or F: hookah smoke is not as bad as cigarette smoke
2) Hookah smoke has __ carcinogens
3) T or F: water filters out all the toxins in hookah, and nicotine is not addictive
4) 1 session of hookah is equivalent of?
5) A typical 1 hour session of hookah smoking exposes the user to __x the volume of smoke inhaled from a single cigarette

Back 27

1) F - there is 11x more CO in hookah than in cigarette smoke
2) 69 carcinogens
3) F, and nicotine is still addictive
4) Smoking 1 pack of cigarettes a day
5) 100-200x

Front 28

1) T or F: Hookah is less harmful because the smoke passes through water which acts as a filter.
2) T or F: Only people who smoke hookah regularly can get disease from smoking

Back 28

F - the water cools the smoke which allows the smoker to inhale deeper, exposing the body to harmful chemicals
2) F - sharing of mouthpieces increases risk for colds, herpes, oral bacterial infections, hepatitis, TB

Front 29

1) T or F: low tar and low nicotine cigarettes make smoking safe
2) T or F: light cigs are safer and are a good option to quitting
3) T or F; all natural hand rolled cigs are safer

Back 29

1) F - they often end up smoking more cigs to get to the same nicotine dose as before
2) F - low tar cigs can be just as harmful b/c takes deeper puffs, puffs more often, smokes them to a shorter butt length
3) F - still have many carcinogens + toxins that come from tobacco itself, like tar + CO. Lifelong smokers of hand-roller cigs have increased risks of larynx, esophagus, mouth, pharynx compared to manufactured cigs

Front 30

1) What delivers more nicotine, smokeless tobacco or cigs?
2) Every pinch of dip = how many cigs?
3) What is the most harmful carcinogen?

Back 30

1) Smokeless tobacco
2) 1 pinch of dip = 3 cigs
3) Nitrosamines (100x higher than in foods)

Front 31

4 effects of smokeless tobacco on oral health?

Back 31

1) Leukoplakia
2) Recession of gums
3) Bad breath/teeth
4) Greater likelihood of losing teeth (perio problems)

Front 32

1) __% of high school boys and __% of high school girls use smokeless tobacco?
2) Dipping 8-10 a day can bring as much nicotine into the body as smoking __ cigs
3) T or F: smokeless tobacco is just as addictive as cigs

Back 32

1) 14%, 2%
2) 30-40
3) T

Front 33

1) What are e-cigs?

Back 33

1) Battery powered device, inhaled dose of nicotine by way of vaporized solution - flavor and physical sensation similar to inhaled tobacco smoke

Front 34

1) Smoking during pregnancy puts you at increased risk for?
2) __% of infant deaths would be prevented if pregnant women did not smoke
3) What bad crap from cigs get directly into the bloodstream?

Back 34

1) Miscarriage, premature delivery, infant death, low birthweight, SIDS
2) 5%
3) Nicotine, carbon monoxide

Front 35

1) Definition of heavy smoker
2) Definition of average smoker
3) Definition of light smoker

Back 35

1) Heavy: 20 cigs/day
2) 10-20 cigs/day
3) <10 cigs/day

Front 36

6 stages of change model?

Back 36

PCP AMT

Precontemplation - not ready to quit within next 6 months
Contemplation - intends to quit within next 6 months
Preparation - willing to set quit date within 30 days

Action - quit - has quit for less than 6 months
Maintenance -staying quit (6+ months)
Termination - living quit (no longer using tobacco)

Front 37

1) _% are not ready to quit
2) __% are thinking about quitting
3) __% are ready to quit

Back 37

1) 40%
2) 40%
3) 20%

Front 38

5 A's of intervention

Back 38

1) Ask
2) Advise
3) Assist
4) Assess
5) Arrange

Front 39

Nicotine patch

Back 39

Nicoderm

Front 40

Nicotine gum

Back 40

Nicorette

Front 41

Nicotine lozenge

Back 41

Commit

Front 42

Nicotine nasal spray

Back 42

Nicotrol NS

Front 43

Nicotine inhaler

Back 43

RX

Front 44

Buproprion SR

Back 44

Zyban, Wellbutrin SR

Front 45

Varenicline tartrate?

Back 45

Chantix

Front 46

1) Who can use NRTs and who can't?
2) What factors should be considered when choosing which NRT to use?
3) Can NRTs be used long term
4) Can NRTs be combined?
5) NRT therapy should be monitored by?

Back 46

1) Everyone except med contraindications, <10 cigs/day, pregnant + teen smokers
2) No data to rank
3) Yes, can be effective with smokers who report persistent withdrawal symptoms
4) Yes, patch + gum or spray = long term abstinence rates over single form
5) Medical provider or certified tobacco counselor

Front 47

1) __% of smokers try to quit each year
2) How many attempts before successful?

Back 47

1) 40%
2) 8-10

Front 48

Definition of communication

Back 48

Exchange of understanding between sender and receiver, between dentist and patient. Exchange of thoughts, ideas, feelings, info, opinions, knowledge

Front 49

What helps build trust and loyalty?

Back 49

Effective communication

Front 50

Communicating bad news depends on what 4 things?

Back 50

LOSA - legal liability, organizational openness, seriousness of the problem, adversarial relationships

Front 51

4 objectives in patient relationships?

Back 51

COST:

1) communicate with power
2) overcome obstacles
3) sustaining commitment
4) TRUST in relationships

Front 52

We listen with __% effectiveness. __ and __ are the enemy

Back 52

1) 25%, distraction, preconception

Front 53

__/__ of communication is conveyed by nonverbal parts of communication. __ and __ establish value and commitment

Back 53

2/3rds. Emotion, expression

Front 54

Referent power

Back 54

Pt wants dr to like them

Front 55

Legitimate power

Back 55

Pt believes the dr. has a right to control their behavior

Front 56

Reward

Back 56

Dr. has ability to reward the pt

Front 57

Expert power

Back 57

Pt regards the dr as having knowledge/expertise

Front 58

Persuasion

Back 58

The pt attributes to the doctor the ability to communicate logically and persuasively