Prevention and Treatment of Tobacco Use

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,
• ll case studies,
• all peer activities,
• the final exam with a minimum of 70% and a maximum of 3 attempts, and
• the self and course evaluation forms.

To obtain credit

• 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.

To obtain a degree, NextGenU.org co-sponsors degree programs with institutional partners. To obtain a full degree co-sponsored with NextGenU.org, registrants must be enrolled in a degree program as a student of a NextGenU.org institutional partner. If you think that your institution might be interested in offering a degree with NextGenU.org contact us.

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.

Competency covered in this module: 

• Students should value physicians' role in tobacco smoking prevention, assessment, screening, and treatment.
  
• Summarise and be able to apply valid and reliable diagnostic criteria for tobacco dependence.
  
• Describe the existing objective measures of tobacco use such as CO monitoring, and cotinine level assessments.
  
• Understand that a high “standard of care” depends on a team approach.
  
• Students should value physicians’ and health professionals’ role in public health advocacy and participation.
• Students should value medical practice “team approach” for tobacco smoking prevention, assessment, screening, and treatment.
  
• Students should believe that tobacco cessation advice/patient-centered counseling is a learned skill and can be a highly effective skill.
  

Learning objectives:

• Identify the role of health professionals in tobacco prevention throughout history.
  
• Explain the value of the physician's role in tobacco smoking prevention, assessment, screening, and treatment.
• Identify valid and reliable diagnostic criteria for tobacco dependence.
  
• Recognize objective measures of tobacco use such as CO monitoring, and cotinine level assessments.

Click here to start this lesson

Learning objectives:

• Argue why tobacco cessation advice/patient-centered counseling is a learned and highly effective skill.

Click here to start this lesson

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.
  
• Be able to 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.

Learning Objectives:

• Describe predisposing factors and relapse patterns of tobacco dependence.
• Understand how relapse patterns and predisposing factors related to tobacco dependence relapse.
• Outline the pathophysiology of tobacco use
  
• Describe the pathophysiology of tobacco addiction.

Click here to start this lesson

Learning Objectives:

• Summarize the pathophysiology mechanisms of Nicotine withdrawal.
  
• Identify behavioral manifestations of nicotine withdrawal.
  
• Explain the effects of tobacco use, its addictive properties, and the physiological effects of withdrawal on patients.
  

Click here to start this lesson

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.
  
• Be able to explain the risks of tobacco use, including its effect on cancer, oral disease, and the cardiovascular, cerebrovascular, respiratory, endocrine, and reproductive systems.
  
• Be able to explain the risks of environmental tobacco smoke for people other than the smoker with a special emphasis on people living in a smoker’s household.
• Understand the prevalence of tobacco use among adults, particularly among high-risk, low–socioeconomic status groups.
• Describe the prevalence and patterns of tobacco use, dependence, and cessation in the country and region in which the treatment is provided, and how rates vary across demographic, economic, and cultural subgroups.
  
• Be aware of the beneficial effects of quitting at all ages in terms of overall health, reduced risk of disease, and personal/social issues.
  
• Be able to explain the benefits of quitting smoking for each major age group.
  
• Understand the basic principles of patient-centered counseling.
• Know the meaning of each effective objective and associated questions in the 5 A’s for tobacco treatment (ask, advise, assess, assist, arrange follow-up).
• Be able to demonstrate the application of systems-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.
  
• Understand the transtheoretical model and its component stages of change, including readiness to quit.
  
• Be able to discuss alternative therapies such as harm reduction, hypnosis, and acupuncture.
  
• Provide information about alternative therapies based upon recognized reviews of effectiveness such as the Cochrane reviews and the USPHS Guidelines.
  
• Describe the use of models of behavior change including motivational interviewing, cognitive therapy, and supportive counseling.
  
• Be aware of an effective office visit management system that would allow time for patient-centered tobacco cessation counseling.
  
• Describe and demonstrate the use of an evidence-based method for brief interventions for treating tobacco use and dependence, as identified in current guidelines.
  
• Describe how to make referrals to additional resources to reduce the risk of relapse.
  
• Know at least 3 sources for patient referral.
• Demonstrate the process to make referrals to other practitioners or to recommend additional care.
• Describe when to consult with primary medical care providers and make appropriate referrals before treatment planning is implemented. 
• Identify community resources for referral for medical, psychiatric, or psychosocial problems. 
• Describe resources (web-based, community, quitlines) available for continued support for tobacco abstinence for clients. 
• Describe how to make referrals to additional resources to reduce the risk of relapse.
  
• Demonstrate the ability to collaborate with other healthcare providers to coordinate the appropriate use of medications, especially in the presence of medical or psychiatric co-morbidities.

Learning Objectives:

• Analyze the factors that promote and inhibit tobacco dependence.
• Summarize the personal and family risks of tobacco use.
  
• Explain risks of tobacco use, including its effect on cancer, oral disease, and the cardiovascular, cerebrovascular, respiratory, endocrine, and reproductive systems.
  
• Explain the risks of environmental tobacco smoke for people other than the smoker with a special emphasis on people living in a smoker’s household.
  
• Describe the prevalence of tobacco use among adults, particularly among high-risk, low–socioeconomic status groups.
  
• Evaluate the prevalence and patterns of tobacco use, dependence, and cessation.
  
• Analyze rates variations across demographic, economic, and cultural subgroups in connection with patterns of tobacco use, dependence, and cessation.

Click here to start this lesson

Learning Objectives:

• Recognize the health benefits of quitting tobacco use at all ages.
• Describe the benefits of quitting smoking for each major age group.

Click here to start this lesson

Learning Objectives:

• Discuss the basic principles of patient-centered counseling.
• Describe the meaning of the 5 A's for tobacco treatment.
  
• Recognize the 2000 Public Health Service guidelines recommendations for treating tobacco use and dependence.
  
• Discuss the transtheoretical model and its component stages of change, including readiness to quit.
  
• Understand alternative therapies for tobacco cessation such as harm reduction, hypnosis and acupuncture.
  
• Analyze alternative therapies for tobacco cessation treatment based upon recognized reviews of effectiveness such as the Cochrane reviews and the USPHS Guidelines.
  
• Understand how motivational interviewing, cognitive therapy, and supportive counseling is used to pursue behavior changes in tobacco consumers.
  
• Identify an effective office visit management system.
  
• Remember evidence-based methods for brief interviews for treating tobacco dependence.

Click here to start this lesson

Learning Objective:

• Understand how to make an appropriate referral.
• Describe at least three sources for patient referral.
  
• Create activities to collaborate with other healthcare providers and coordinate the appropriate use of medications.

Click here to start this lesson

Competencies 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.
  
• Be able to identify developmental issues and age-appropriate interventions for tobacco treatment and provide age-appropriate anticipatory guidance through patient-centered counseling.
  
• Be able to demonstrate the application of systems-based practice/practice-based learning that follows the 2000 Public Health Service guidelines.
  
• Know the medical literature regarding vulnerability to tobacco use and the quick onset of addiction properties with early tobacco use.
  
• Describe strategies and coping skills that can reduce relapse risk.
  
• Know resistance skills to early onset of smoking with children and adolescents.
  
• Know at least three sources for pediatric smoking cessation referral, including Internet resources.
  
• Know at least three signs of nicotine dependence.
  
• Be able to assess nicotine dependence with at least three pediatric patients.
  
• Know that every child and adolescent should be asked about tobacco use.
  
• Understand pediatric tobacco prevention and patient-centered tobacco counseling.
  
• Be able to provide a tailored smoking prevention message based on age-appropriate concerns (e.g., the “truth” campaign).
  
• Be aware of different settings of care outside the medical practice/care environment that may affect a patient’s health in a positive way and be able to tap into these external care resources for adolescents (e.g., YMCA sports activities).
• Be aware of the need for pediatricians and other medical professionals treating a child or an adolescent smoker to encourage the patient to set a quit date.
  
• Know how to counsel children and adolescents on smoking cessation and be knowledgeable about setting goals to quit with children and adolescents.
  
• Be aware of the parent’s role in providing health information to their children.
  
• Be able to provide tips to parents regarding smoking prevention and cessation counseling for their children.
  
• Understand the role of parent modeling in shaping children’s behavior.
  
• Understand the potential for adult patient-centered tobacco counseling in the pediatric arena.
  
• Be able to perform the 5A’s for patient-centered tobacco cessation counseling with at least three parents.
  

Learning Objective:

• Describe the major risks of environmental tobacco smoke exposure to children in the household.
• Describe the prevalence of smoking in the pediatric population.
  
• Describe the developmental issues caused by tobacco consumption in children and adolescents.
  
• Describe age-appropriate interventions for tobacco treatment.
  
• Recognize the 2000 Public Health Service guidelines recommendations for treating tobacco use and dependence.

Click here to start this lesson

Learning Objective:

• Discuss medical literature regarding vulnerability to tobacco use and the quick onset of addiction properties with early tobacco use.
• Analyze strategies and coping skills used to reduce tobacco relapse risk.
  
• Describe the resistance skills needed on children and adolescents to avoid the early onset of smoking.
  
• Identify sources for pediatric smoking cessation referrals.
  
• Identify at least three signs of nicotine dependence.
  
• Assess nicotine dependence in at least three pediatric patients.
  

Click here to start this lesson

Learning Objective:

• Identify the reasons why every child and adolescent should be asked about tobacco use.
• Describe tobacco prevention techniques.
  
• Summarize patient-centered tobacco cessation counselling strategies in pediatric patients.
  
• Create an age-appropriate smoking prevention message.
  
• Describe the positive effect of care settings outside the medical practice/care environment.
  
• Recognize the 2000 Public Health Service guidelines recommendations for treating tobacco use and dependence.
  
• Identify the need for pediatricians and other medical professionals treating a child or an adolescent smoker to encourage the patient to set a quit date.
  
• Describe counseling strategies for smoking cessation on children and adolescents.
  
• Recognize how to set goals for smoking cessation in children and adolescents.

Click here to start this lesson

Learning Objective:

• Recognize the parent’s role in providing health information to their children.
• Explain to parents how to provide counseling regard smoking prevention and cessation counseling for their children.
  
• Identify the role of parent modeling in shaping children’s behavior.
  
• Identify the role of adult patient-centered tobacco counseling in the pediatric arena.
  
• Carry out patient-centered tobacco cessation counseling performing the 5A’s.

Click here to start this lesson

Learning Objective:

• Describe the pros and cons of evidence-based tobacco use treatment strategies.
• Summarize the pharmacological mechanisms of the full range of pharmacotherapy available for tobacco treatment including the use of nicotine replacement and antidepressants.
  
• Recognize the advantages of pharmacotherapy over other cessation strategies.
  
• Understand the main components of a follow-up plan to address potential issues, including negative outcomes.
  

Click here to start this lesson

Learning Objective:

• Describe patient instructions for the effective use of pharmacological forms of tobacco cessation.
• Explain all relevant information on tobacco dependence medications approved by national regulatory agencies.
  
• Understand the importance of second-line medications to quit smoking and also be able to find information on these as needed.
  
• Recognize the 2000 Public Health Service guidelines recommendations for treating tobacco use and dependence.
  
• Discuss how to tailor pharmacotherapy to the needs of each individual.
  
• Apply your knowledge about pharmacotherapy for tobacco dependence to address possible adverse reactions and complications.
  
• Contribute to knowledge-based ideas regarding temporary side effects of pharmacotherapies.
  
• Analyze how treatment indications differ according to special population groups.
  
• Summarize the basics of insurance reimbursement, coding, and other entitlements for tobacco cessation treatment.
  
• Identify available over the counter medications and their relative costs in your area.

Click here to start this lesson

Competency covered in this module: 

• Be able to demonstrate the application of systems-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, those with co-morbid psychiatric conditions).
• Understand the range of risks related to smoking during pregnancy.
  
• Be able to demonstrate the application of systems-based practice/practice-based learning that follows the 2000 Public Health Service guidelines.
• Understand the high risk of relapse for postpartum women who stopped smoking while pregnant and who have recently delivered their children.
• Describe specific treatment indications for special population groups (i.e. pregnant women, adolescents, young adults, elderly, hospitalized patients, those with co-morbid psychiatric conditions).
• Understand the safety of using NRT and bupropion HCl in pregnant women.
• Understand barriers to smoking cessation, including weight gain, stress, and smokers in family and close social circles.
• Make effective treatment recommendations for non-cigarette tobacco users.

Learning Objective:

• Recognize the 2000 Public Health Service guidelines recommendations for treating tobacco use and dependence.
• Describe the risks and benefits of smoking in common cultural groups and family structures.

Click here to start this lesson

Learning Objective:

• Summarize the risks related to smoking during pregnancy.
• Recognize the 2000 Public Health Service guidelines recommendations for treating tobacco use and dependence.
  
• Describe the risk of relapse on postpartum women who stopped smoking while pregnant.
  
• Discuss the safety of using Nicotine Replacement Treatment and bupropion HCl in pregnant women.
  

Click here to start this lesson

Learning Objective:

• Recognize the 2000 Public Health Service guidelines recommendations for treating tobacco use and dependence.
• Describe common barriers to smoking cessation.
  
• Understand the different forms of presentation of tobacco products to make effective treatment recommendations for non-cigarette tobacco users.
  
• Explain methods for avoiding weight gain, and stress.

Click here to start this lesson

Competencies covered in this module

• Be able to use patient-centered counseling with at least 3 patients and include pharmacological therapy.
• Plan-individualised treatments that account for patient assessment factors identified during the intake assessment and history gathering.
• Demonstrate establishing a warm, confidential, and non-judgmental counselling environment.
  
• Summarise and be able to apply valid and reliable diagnostic criteria for tobacco dependence.
  
• Demonstrate the ability to gather basic medical history information and conduct a brief screening for psychiatric and substance abuse issues.
• Identify information relevant to a client’s current and past medical, psychiatric, and smoking history,(including past treatments) that may impact pharmacotherapy decisions.
  
• Be able to practice patient-centered counseling with at least 3 patients.
• Demonstrate competence in at least one of the empirically supported counselling modalities such as individual, group and telephone counseling.
• Provide culturally competent counselling.
  
• When given three different patient scenarios, be able to identify the patient’s stage of change and perform an appropriate patient-centered interview.
• Demonstrate the effective use of clinically sound strategies to enhance motivation and encourage commitment to change.
• Identify personal risk factors and incorporate into the treatment plan.
  
• Be able to provide at least three patients with appropriate referrals.
  
• Be able to employ culturally competent and family-sensitive patient-centered tobacco treatment strategies with at least three patients.
• Provide information that is gender, age, and culturally sensitive and appropriate to learning style and abilities.
• Demonstrate effective counselling skills such as active listening and empathy that facilitate the treatment process.
  
• Be able to demonstrate patient-centered counseling skills taking into account barriers to quitting with at least three patients.
• Demonstrate the ability to conduct an intake assessment interview including:
  i. tobacco use history
  ii. validated measures of motivation to quit
  iii. validated measures for assessing tobacco use and dependence
  iv. current challenges and barriers to attaining permanent abstinence
  v. current strengths to support abstinence.
  vi. prior quit attempts including treatment experiences, successes and barriers
  vii. availability of social support systems
  viii. preferences for treatment.
  ix. cultural factors influencing making a quit attempt
  
• Be able to perform patient-centered counseling with at least three parents regarding the effect of smoking on their children.
  
• Be able to perform the 5A’s for patient-centered tobacco cessation counseling with at least three parents.
• Collaboratively develop a treatment plan that uses evidence-based strategies to assist the client in moving toward a quit attempt, and/or continued abstinence from tobacco.
  
• Be able to provide parents who smoke with information about the most effective quitting strategies
  In collaboration with the client, identify specific and measurable treatment objectives.
  
• Be able to perform tobacco prevention patient-centered counseling with at least three children.
  
• Be able to perform tobacco prevention patient-centered counseling with at least three adolescents.
  
• Be sensitive to issues of child and parent confidentiality.
• Demonstrate an ability to respond to high-risk client situations.
• Describe and use a code of ethics established by your professional discipline for tobacco dependence treatment specialists if available.
  
• Be able to discuss vulnerability to tobacco use and quick onset of addiction with early tobacco use with at least three children and three adolescents.
  
• Be able to assess nicotine dependence with at least three pediatric patients.
  
• Be able to discuss the use of resistance skills when smoking is offered or part of the patient’s environment (e.g., peer pressure, parents smoke) with at least three children and three adolescents.
  
• Be able to provide patient-centered tobacco counseling to pregnant women at least three times.
  
• Be able to provide patient-centered counseling at least three times to women who stopped smoking and who have recently delivered their children.
  

Click here to start this module

Competencies 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, work site-specific regulations).
  
• Be able to demonstrate awareness of key public health strategies and advocacy processes for tobacco prevention.
  
• Be aware of current international policy recommendations for curtailing tobacco use.
  
• Demonstrate an awareness of restructuring of health systems, including reimbursement required to have an effect on optimal cessation practices.
  
• Have the ability to articulate the role of organization, practice, and individual in affecting tobacco policy.
  
• Know resources (or how to access resources) for current information on new standards, new practices, and learning objectives.
  
• Be able to demonstrate sources/skills that enable medical professionals to keep current with tobacco information and trends.
  
• Be able to demonstrate critical appraisal of intervention modalities.
  
• Be able to demonstrate the application of systems-based practice/practice-based learning that follows the 2000 Public Health Service guidelines.
  
• Be aware of the evidence concerning the effectiveness of practice systems (e.g., chart stickers, reminder systems).
  
• Be able to measure clinicians’ actions (i.e., tracking systems) so they are held accountable.
• Develop and implement a protocol for tracking client follow up and progress.
• Maintain accurate records utilizing accepted coding practices that are appropriate to the setting where services are provided.