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This redesigned introductory course about the Prevention and Treatment of Tobacco Use provides a foundation regarding the effects of tobacco on human health, offers effective approaches to preventing and treating tobacco use, and gives opportunities to practice intervention techniques for smoking cessation. All parts of this training are free, including registration, learning, testing, and a certificate of completion. This course is intended for medical and other clinical and public health trainees and practitioners. This course was redesigned in 2024.
The Prevention and Treatment of Tobacco Use course is co-sponsored by the University of the Incarnate Word. Like all NextGenU.org courses, this course is competency-based, using the competencies in Tobacco Control Competencies for US Medical Students and the Core Competencies for evidence-based treatment of tobacco use and dependence. In addition, the course uses resources from world-class organizations such as the Government of Canada, the U.S. National Library of Medicine, U.S. Centers for Disease Control and Prevention, NU.S. National Institutes of Health, and the World Health Organization. The course developers are Florian Stigler MD; Kentya Ford DrPH; Salma Marani MS; Alexander V. Prokhorov MD, PhD; Valeria Reynolds MD, MPH; Hugo Rojas MD, MSc; Madison Cox MSN, RN; Juan Bravo MD; and Pablo Baldiviezo MD.
For publications on NextGenU.org’s courses’ efficacy, see “A Novel Integration of Online and Flipped Classroom Instructional Models in Public Health Higher Education,” (2014), BMC Medical Education, “Building Public Health Capacity through Online Global Learning,” (2018), Open Praxis, or here on NextGenU.org’s publication page. Subscribe to our newsletter to be notified of future updates, new courses, and to be part of our community.
There are 9 modules to complete, providing:
- Introduction to Tobacco Consumption as a Public Health Problem
- Health, Social, Economic, and Environmental Impact of Tobacco Use and Exposure
- Understanding the Neurobiology and Pathophysiology of Nicotine Addiction & Withdrawal
- Tobacco Cessation as a Process
- Clinical Approach to Smoking Cessation and Tobacco Dependence Treatment
- Behavioral Interventions for Tobacco Dependence Treatment
- Pharmacological Interventions for Tobacco Dependence Treatment
- Complementary and Alternative Therapies for Smoking Cessation
- Relapse: Prevention and Management
To obtain credit, the course requires completion of all case studies and peer activities. Module seven is a practicum where you will engage in seven peer activities that will require your interaction with practice patients to complete them. At the end of each lesson, there is a practice quiz. At the end of the course, after you’ve completed each lesson, quiz, and activity, you’ll have access to a final exam, and a chance to evaluate this course. Once you’ve passed that last test, you will be able to download a certificate of completion from NextGenU.org and our course’s co-sponsoring organizations (listed above). We keep all of your personal information confidential, never sell any of your information, and only use anonymized data for research purposes, and we are also happy to report your testing information and share your work with anyone (your school, employer, etc.) at your request.Engaging with this Course:
You may browse this course for free to learn for your personal enrichment; there are no requirements. To register in this course for credit, it is required that learners have obtained a bachelor's degree, or be enrolled in a health sciences training program at the bachelor's level or higher.
To obtain a certificate a learner must successfully complete
- all the reading requirements,
- all quizzes and pass with a 70% with unlimited attempts,
- all case studies,
- all activities,
- the final exam with a minimum of 70% and a maximum of 3 attempts, and
- the self and course evaluation forms.
- complete all requirements listed above for the certificate, and
- your learning institution or workplace should approve the partner-university-sponsored NextGenU.org course for educational credit, as they would for their learner taking a course anywhere.
NextGenU.org is happy to provide your institution with
- a link to and description of the course training, so they can see all its components, including the cosponsoring universities and other professional organization cosponsors;
- your grade on the final exam;
- your work products (e.g. case study activities), and any other required or optional shared materials that you produce and authorize to share with them;
- your evaluations -- course, and self-assessments;
- a copy of your certificate of completion, with the co-sponsoring universities and other organizations listed.
We hope that you will find this a rewarding learning experience, and we count on your assessment and feedback to help us improve this training for future students.Here are the next steps to take the course for credit.
- Complete the registration form.
- Take the pre-test.
- Begin the course with Module 1: Introduction to Prevention and Treatment of Tobacco Use. In each lesson, read the description, complete all required readings and any required activity, and take the corresponding quizzes.
This course meets nationally approved standards of education developed for the addiction/substance use disorders counseling profession. This course's participants are assured that the continuing education (CE) credits provided will be accepted toward national credentialing by the NAADAC Certification Commission for Addiction Professionals (NCC AP), as well as by many of the individual state licensing/certification bodies in the addiction and other helping professions.
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Module 1: Introduction to Tobacco Consumption as a Public Health Problem
Competency covered in this module:
- Value physician’s role in tobacco smoking prevention, assessment, screening, and treatment.
- Understand that a high “standard of care” depends on a team approach.
- Value physicians’ and health professionals’ role in public health advocacy and participation.
- Value medical practice “team approach” for tobacco smoking prevention, assessment, screening, and treatment.
- Understand that tobacco cessation advice/patient-centered counseling is a learned skill and can be a highly effective skill.
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Module 1: Lesson 1: Tobacco and Tobacco Products
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:
- Recall a brief history of tobacco cultivation and cigarette manufacturing.
- Understand the social and cultural history of smoking.
- Identify different tobacco products.
- Understand the composition of a cigarette and cigarette smoke.
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Module 1: Lesson 2: Epidemiology of Tobacco Use
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:- Explain epidemiology in relation to tobacco use.
- Discuss the global and regional prevalence of tobacco use.
- Discuss various factors that promote tobacco use and dependence.
- Discuss various factors that prevent tobacco use and dependence.
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Module 1: Lesson 3: Patterns, Variations, and Subgroups in Tobacco Consumption
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:- Understand why some groups are at high risk for tobacco consumption.
- Explain why some groups are at low risk for tobacco consumption.
- Describe the common patterns of tobacco use and cessation.
- Discuss factors that influence these patterns.
- Discuss how demographic, economic, and cultural factors influence patterns of tobacco use, dependence, and cessation.
- Analyze and interpret data demonstrating these variations.
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Module 2: Health, Social, Economic, and Environmental Impact of Tobacco Use and Exposure
Competency covered in this module: - Describe the chronic-relapsing nature of tobacco dependence, including typical relapse patterns, and predisposing factors.
- Understand the pathophysiology (tissues, systems) of tobacco use and the mechanisms of addiction.
- Explain the health consequences of tobacco use and benefits of quitting, and the basic mechanisms of the more common tobacco induced disorders.
- Understand the pathophysiology, mechanisms, and behavioral manifestations of nicotine withdrawal.
- Know how to intervene to help patients decrease withdrawal symptoms.
- Describe how tobacco dependence develops and be able to explain the biological, psychological, and social causes of tobacco dependence.
- Explain the effects of tobacco use, its addictive properties, and the physiological effects of withdrawal to patients.
- Communicate the symptoms, duration, incidence, and magnitude of nicotine withdrawal.
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Module 2: Lesson 1 Health Implications of Tobacco Use and Exposure
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:- Explain the direct and indirect effects of smoking on general health.
- Outline the specific impacts of smoking on respiratory health.
- Explain the exposure pathways and health effects of second and third-hand smoke.
- Discuss the specific risks and implications for vulnerable populations such as pregnant women and children.
- Discuss the correlation between tobacco use and various diseases.
- Explain the biopsychosocial implications of these associations.
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Module 2: Lesson 2: Socio-economic Impact of Tobacco Use
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:- Discuss the global trends and data related to tobacco use.
- Explain the economic costs associated with smoking at a global level.
- Assess the burden of smoking on public health, considering morbidity, mortality, and quality of life.
- Explain the economic drain from smoking, considering healthcare costs, productivity losses, and other factors.
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Module 2: Lesson 3: Environmental Impact of Tobacco Use
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:- Describe the environmental footprint of tobacco from cultivation to disposal.
- Explain the impacts of tobacco on various environmental sectors (e.g., soil, water, air, biodiversity).
- Identify the environmental determinants of non-communicable diseases linked to tobacco use.
- Explain potential environmental interventions to reduce tobacco-related harms.
4 URLs, 1 Quiz -
Module 3: Understanding the Neurobiology and Pathophysiology of Nicotine Addiction & Withdrawal
Competency covered in this module:
- Explain the societal and environmental factors that promote and inhibit the spread of tobacco use and dependence.
- Understand personal and family health risks associated with tobacco use.
- Explain the risks of tobacco use, including its effect on cancer, oral disease, and the cardiovascular, cerebrovascular, respiratory, endocrine, and reproductive systems.
- Be aware of the beneficial effects of quitting at all ages in terms of overall health, reduced risk of disease, and personal/social issues.
- Explain the benefits of quitting smoking for each major age group.
- Understand the basic principles of patient-centered counseling.
- Define each affective objective and associated questions in the 5 A’s for tobacco treatment (ask, advise, assess, assist, arrange follow-up).
- Demonstrate the application of system-based practice/practice-based learning that follows the 2000 Public Health Service guidelines.
- Identify evidence-based treatment strategies and the pros and cons of each strategy.
- Describe the benefits of combining pharmacotherapy and counseling.
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Module 3: Lesson 1: Mechanisms Tobacco Use Disorder
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:- Define and discuss the concept of nicotine addiction.
- Explain the process of how tobacco use disorder develops over time.
- Describe the neurophysiological changes associated with tobacco use disorder.
- Analyze the implications of these changes for the onset and progression of tobacco use disorder.
- Explain how nicotine interacts with the nervous system on a molecular level.
- Discuss the role of genetics in nicotine addiction.
Click here to start this lesson5 URLs -
Module 3: Lesson 2: Nicotine Withdrawal: Pathophysiology and Clinical Manifestations
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:- Describe the physiological changes that occur during nicotine withdrawal.
- Explain how these changes contribute to the symptoms and challenges of nicotine withdrawal.
- Describe the primary clinical manifestations of nicotine withdrawal.
- Explain the typical course and evolution of nicotine withdrawal.
4 URLs, 1 Forum, 1 Quiz -
Module 4: Tobacco Cessation as a Process
Competency covered in this module:
- Understand the major risks of environmental tobacco smoke exposure to children in the household.
- Understand the prevalence of smoking in the pediatric population.
- Identify developmental issues and age-appropriate interventions for tobacco treatment and provide age-appropriate anticipatory guidance through patient-centered counseling.
- Know the medical literature regarding vulnerability to tobacco use and quick onset of addiction properties with early tobacco use.
- Describe strategies and coping skills that can reduce relapse risk.
- Know resistance skills for early onset of smoking with children and adolescents.
- Understand the major risks of environmental tobacco smoke exposure to children in the household.
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Module 4: Lesson 1: Understanding the Cessation Process & Models of Change
Upon completion of this lesson, you will be able to:
Student Learning Outcomes:- Distinguish between the processes and goals of cessation vs dependence treatment.
- Discuss appropriate strategies and approaches for each.
- Describe the stages of change and how they apply to tobacco cessation.
- Analyze a patient's readiness for change based on this model.
- Compare and contrast the 'cold turkey' and gradual quitting methods.
- Evaluate the effectiveness of each approach and align them with the needs of different patients.
Click here to start this lesson5 URLs -
Module 4: Lesson 2: Barriers to Quitting & Patient Perspectives
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:- List common challenges individuals face when attempting to quit smoking.
- Discuss strategies to address these barriers.
- Describe the experience of living with a tobacco addiction from a patient's viewpoint.
- Understand the implications of this perspective for treatment and support.
3 URLs, 1 Forum, 1 Quiz -
Module 5: Clinical Approach to Smoking Cessation and Tobacco Dependence Treatment
Competency covered in this module:
- Understand patient instructions for effective use of pharmacological forms of tobacco cessation.
- Provide appropriate patient education for therapeutic choices and dosing for a wide range of patient situations.
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Module 5: Lesson 1: Diagnosis of Tobacco Use and Dependence
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:- Describe the clinical criteria for diagnosing tobacco use and dependence.
- Apply these criteria in practice scenarios.
- List the main recommendations from the guidelines.
- Discuss the application of these guidelines in a clinical setting.
Click here to start this lesson2 URLs -
Module 5: Lesson 2: Barriers to Tobacco Cessation
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:- Recognize common barriers to smoking cessation.
- Describe how stress and anxiety can become a barrier to smoking cessation.
- Describe how weight gain can be a barrier to smoking cessation.
- Describe how family and social circles can become a barrier to smoking cessation.
- Give examples of non-cigarette forms of tobacco and nicotine use.
- Summarize effectiveness of the treatment available for non-cigarette tobacco users.
10 URLs, 1 Forum, 1 Quiz -
Module 6: Behavioral Interventions for Tobacco Dependence Treatment
Competency covered in this module:
- Demonstrate application of system-based practice/practice-based learning that follows the 2000 Public Health Service guidelines.
- Understand the risks and benefits of smoking in common cultural groups and family structures.
- Describe specific treatment indications for special population groups (i.e., pregnant women, adolescents, young adults, elderly, hospitalized patients, and those with co-morbid psychiatric conditions).
- Understand the range of risks related to smoking during pregnancy
- Understand the high risk of relapse for postpartum women who stopped smoking while pregnant and who have recently delivered their children.
- Demonstrate application of system-based practice/practice-based learning that follows the 2000 Public Health Service guidelines.
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Module 6: Lesson 1: Applying Behavior Change Theories and Models
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:- Explain different behavior change theories and models.
- Discuss how these theories and models apply to smoking cessation.
- Evaluate the strengths and limitations of different theories and models for smoking cessation.
- Propose how to integrate multiple theories or models in a comprehensive cessation intervention.
- Describe the principles of motivational interviewing.
- Discuss the role of motivational interviewing in facilitating behavior change in smoking cessation.
- Demonstrate the use of motivational interviewing techniques through role-plays or case studies.
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Module 6: Lesson 2: Role of Health Care Workers & Patient Preparedness
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:- Describe the role of various healthcare workers in smoking cessation.
- Discuss how a healthcare worker's attitude may influence a patient's smoking cessation journey.
- Differentiate between patients who are prepared and unprepared to quit smoking.
- Adapt intervention strategies based on a patient's level of preparedness.
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Module 7: Pharmacological Interventions for Tobacco Dependence Treatment
Competency covered in this module:
- Be aware of successful anti-tobacco initiatives outside the clinical setting, including legislative, policy, media, and partnership building.
- Understand the influence of the media on tobacco use, behavior, and attitudes toward tobacco.
- Describe the implications and utilize the regulations that apply to the tobacco treatment setting (confidentiality, HIPAA, and work site-specific regulations).
- Know resources (or how to access resources) for current information on new standards, new practices, and learning objectives.
- Demonstrate sources/skills that enable medical professionals to keep current with tobacco information and trends.
- Demonstrate critical appraisal of intervention modalities.
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Module 7: Lesson 1: Smoking Cessation Drugs: Modes of Action and Classifications
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:- Describe the mechanisms of action of various smoking cessation drugs.
- Explain how these mechanisms contribute to smoking cessation.
- Categorize drugs as first-line or second-line drugs.
- Discuss the factors that determine these classifications and their implications for prescribing.
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Module 7: Lesson 2: Correct Use and Side Effects of Smoking Cessation Medications
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:- Describe the correct usage of various smoking cessation medications.
- Discuss the importance of medication adherence and strategies to promote it.
- Identify potential side effects and contraindications of various smoking cessation medications.
- Discuss the importance of monitoring for adverse events during treatment.
- Explain how to adapt pharmacotherapy to individual patient needs, taking into account potential exclusions.
5 URLs, 1 Quiz -
Module 8: Complementary and Alternative Therapies for Smoking Cessation
Competency covered in this module:
- Empathize with addicted patients.
- Appreciate that smoking cessation is a process; not all smokers are successful on the first attempt.
- Implement treatment strategies for someone who has lapsed or relapsed.
- Provide guidance in modifying the treatment plan to reduce the risk of relapse throughout the course of treatment.
- Respect the importance of keeping current with evidence-based findings in tobacco smoking prevention and control (e.g., epidemiological, behavioral, clinical, and policy science).
- Utilize the findings of national reports, research studies, and guidelines on tobacco treatment.
- Demonstrate the ability to access information on the above topics.
- Name and use peer-reviewed journals, professional societies, websites, and newsletters related to tobacco dependence treatment and/or research.
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Module 8: Lesson 1: Overview of Complementary and Alternative Therapies
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:- Identify different types of complementary and alternative therapies used in smoking cessation.
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Describe the principles and procedures involved in these therapies.
- Evaluate the appropriateness of these therapies for different patient profiles or contexts.
- Discuss the current state of evidence supporting the use of these therapies in smoking cessation.
- Evaluate the quality of a research study investigating the effectiveness of a complementary or alternative therapy.
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Module 8: Lesson 2: Implementing Complementary and Alternative Therapies in Practice
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:- Discuss how to incorporate these therapies into smoking cessation treatment plans.
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Identify potential challenges in incorporating these therapies and propose solutions.
- Develop a comprehensive smoking cessation plan for a hypothetical patient that includes both conventional and alternative therapies.
- Identify situations where referral for these therapies would be beneficial.
- Identify potential referral sources for these therapies within their community or region.
- Demonstrate how to communicate a referral recommendation to a patient in a supportive and informative way.
4 URLs, 1 Forum, 1 Quiz -
Module 9: Relapse: Prevention and Management
Competency covered in this module:
- Understand the factors that influence the probability of relapse to smoking.
- Understand the consequences and implications of relapse for the smoking cessation process.
- Understand strategies and techniques for preventing relapses in smoking cessation.
- Develop and implement a relapse prevention plan.
- Understand how to respond to a relapse in smoking cessation.
- Apply strategies for rebuilding motivation and commitment to cessation following a relapse.
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Module 9: Lesson 1: Understanding Probability & Predictors of Relapse
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:- Describe common predictors of relapse.
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Explain how these predictors influence the probability of relapse.
- Explain the role of individual, interpersonal, and environmental factors in relapse.
- Explain the consequences of relapse for a patient's physical health and motivation to quit.
- Discuss the implications of relapse for the adjustment and continuation of the smoking cessation treatment plan.
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Module 9: Lesson 2: Strategies and Techniques for Preventing Relapses
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:- Identify different strategies and techniques for preventing relapses in smoking cessation.
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Explain how these strategies work to prevent relapses.
- Discuss the circumstances under which each strategy or technique might be most effective.
- Describe the elements of a relapse prevention plan.
- Apply strategies and techniques for preventing relapses to the development of a prevention plan.
- Implement a relapse prevention plan in the context of an ongoing smoking cessation intervention.
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Module 9: Lesson 3: Handling Relapses in Smoking Cessation
Student Learning Outcomes:
Upon completion of this lesson, you will be able to:- Discuss how to respond to a relapse in a supportive and positive manner.
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Explain how to adjust a treatment plan following a relapse.
- Identify different strategies and techniques for rebuilding motivation and commitment to cessation.
- Discuss how to tailor these strategies to meet the needs and circumstances of different patients.
- Demonstrate empathy and supportive communication in a role-play scenario featuring a patient who has experienced a relapse.
2 URLs, 1 Forum, 1 Quiz -
Course and Self Evaluation & Certificate
In this section, you can provide feedback about this course to help us make NextGenU.org better. Once evaluations are completed, you will be able to download your certificate of completion.
