Chapter 8 – Rejecting Tobacco Use
Multiple Choice
1.The 1999 Master Tobacco Settlement Agreement between the states and the tobacco industry included payment of $246 billion over 25 years to the states for
A)reimbursement of smoking related Medicaid costs.
B)lung cancer and nicotine-free cigarette research.
C)smoke-free public building expenses.
D)anti-smoking education programs.
Answer:A
Page:191
2.Which state has the highest smoking rate in the nation?
A)Utah
B)Kentucky
C)Arkansas
D)California
Answer:B
Pages:189, 190
3.Following the 1964 Surgeon General’s report about smoking, the percentage of people smoking in the United States
A)declined until the early 1970s.
B)declined until the early 1980s.
C)declined until the late 1980s.
D)is still declining.
Answer:D
Page:190
4.As education level increases, the rate of smoking
A)increases.
B)decreases.
C)remains stable.
D)becomes less predictable.
Answer:B
Page:190
5.When segments of a college community are studied, there is a direct relationship between cigarette smoking and
A)level of alcohol use.
B)using drugs.
C)having poor study skills.
D)being considered a loner or outcast.
Answer:A
Page:190
6.Nontobacco sources of nicotine include all of the following EXCEPT
A)Stonewall.
B)e-cigarettes.
C)Eclipse.
D)Ariva.
Answer:C
Pages:207, 216
7.Non-nicotine based medications are those medications which
A)allow a controlled and less harmful relationship with nicotine than that associated with tobacco products.
B)influence the production, diffusion, and reuptake of neurotransmitters with the CNS.
C)prevent nicotine from reaching nicotine receptors in the brain.
D)influence nervous system receptors for nicotine to level out the peaks and valleys associated with smoking.
Answer:B
Page:212
8.You have decided to switch from cigarettes to cigars. Which of the following is TRUE?
A)You will not decrease your lung cancer risk.
B)You will escape the addictive effects of nicotine.
C)Your risk of developing throat cancer stays the same
D)You will end up smoking both; cigars don’t substitute for cigarettes.
Answer:C
Page:206
9.Sam, a nonsmoker, has decided it would be cool to smoke cigars. If he begins a lifetime habit of cigar smoking, which of the following BEST describes the risk to his health?
A)He will run a risk of developing lung cancer similar to the risk faced by cigarette smokers.
B)He will increase his risk of developing respiratory disease, heart disease, and certain cancers.
C)He will run a risk of mouth and throat cancers that is double the risk faced by cigarette smokers.
D)His risk of all cancers will be significantly lower than the risk faced by cigarette smokers, but the social restrictions on his habit will be the same.
Answer:B
Page:206
10.A so-called chipper is a smoker who
A)does not develop a physical dependence on cigarettes.
B)successfully quits smoking on the first attempt.
C)regularly indulges in smoking binges.
D)smokes almost constantly.
Answer:A
Page:194
11.The dependency-producing substance found in cigarettes is
A)tar.
B)nicotine.
C)dopamine.
D)benzopyrene.
Answer:B
Page:193
12.Monica started smoking just to look sophisticated, but within months she found herself smoking every day. She now smokes two packs a day and wants to stop. The force driving her habit is
A)compulsion.
B)habituation.
C)indulgence.
D)addiction.
Answer:D
Pages:193-194
13.One of the major theories about how nicotine produces a pleasant effect in the human body is that it
A)deprives brain cells of oxygen.
B)attaches to receptor sites for glucose.
C)changes to a form of morphine when it hits the bloodstream.
D)stimulates the release of natural painkillers from the endocrine system.
Answer:D
Page:195
14.The main concept of the bolus theory of nicotine addiction is that
A)people smoke to keep the brain stimulated with batches of nicotine.
B)nicotine blocks pain receptors in the central nervous system.
C)nicotine stimulates the release of beta endorphins.
D)nicotine raises dopamine levels in the blood.
Answer:A
Page:195
15.According to the self-medication theory, which mood-enhancing substance is released during smoking?
A)adrenaline
B)dopamine
C)ACTH
D)norepinephrine
Answer:B
Pages:195-196
16.Which of the following BEST describes the effect of nicotine on the central nervous system? It
A)kills dendritic tissues.
B)slightly improves the transmission of nerve impulses.
C)stimulates the central nervous system in low levels and depresses it in higher levels.
D)suppresses natural substances that facilitate the replacement of myelin on axons.
Answer:C
Page:196
17.Some children become smokers because they see their parents smoking. This is called
A)modeling.
B)manipulation.
C)peer pressure.
D)subliminal advertising.
Answer:A
Page:197
18.Your fourteen-year-old son has been taught to avoid tobacco and its dangers. He then makes friends with a group of boys who all smoke. You can expect that
A)your son will try smoking.
B)some of the other boys will quit smoking.
C)your son will soon leave that group of friends.
D)your son will bring other nonsmokers into the circle of friends.
Answer:A
Page:197
19.A psychosocial incentive to smoke is the comfort smokers get from handling a cigarette, pipe, or cigar. This is called
A)modeling.
B)identification.
C)manipulation.
D)responsiveness.
Answer:C
Page:197
20.How do we know that a feeling of uncertainty, or dissonance, exists for most adults who smoke?
A)States are beginning to sue tobacco companies for wrongful deaths.
B)About 80 percent of smokers have tried to quit.
C)Smoking is now prohibited in most public places.
D)Most smokers began the habit as teenagers.
Answer:B
Pages:214-215
21.Which of the following is FALSE regarding use of a hookah?
A)Prolonged periods of tobacco-based exposure generate nicotine levels 2.5 times higher than those associated with cigarette use.
B)Infectious agents are transmitted through shared use of mouthpieces.
C)The chemical composition of hookah-generated smoke is unlike cigarette smoke.
D)Tobacco leaves are combined with shisha and set atop lit charcoal.
Answer:C
Page:206
22.The most effective time to begin influencing a child NOT to smoke is
A)at preschool age.
B)at kindergarten age.
C)during grades one to three.
D)during grades four to six.
Answer:A
Page:198
23.As a parent of a fifth grader, which of the following recommendations should you attempt when trying to help your son or daughter deal with pressures to use tobacco?
A)Continue to point out the harmful substances in tobacco.
B)Reinforce the point that smoking is unacceptable behavior for him or her.
C)Allow your son or daughter to make his or her own decisions.
D)Continue to help your son or daughter learn how to say no.
Answer:D
Page:198
24.The cancer-causing substances in tobacco smoke are carried into the body by
A)the gases.
B)the particles.
C)the combustion process.
D)both the gases and the particles.
Answer:D
Pages:199-200
25.Most of the carcinogenic compounds in cigarettes are found in
A)nicotine.
B)tar.
C)carbon monoxide.
D)nitrogen oxide.
Answer:B
Page:199
26.Of all the gases released by tobacco smoke, the most harmful to smokers is
A)hydrogen cyanide.
B)carbon monoxide.
C)ammonia.
D)acetone.
Answer:B
Page:199
27.Carbon monoxide reduces the red blood cell’s ability to transport oxygen by
A)thinning the blood.
B)displacing fluid in cells.
C)destroying oxygen molecules.
D)attaching itself to hemoglobin.
Answer:D
Page:200
28.If you are a heavy smoker, why is carbon monoxide a particular risk to your brain and heart?
A)It slows the activity of the lungs, on which the brain and heart are dependent.
B)It diverts blood from there to the lungs and lower abdominal organs.
C)Normal oxygen supply is especially critical to those organs.
D)It increases blood pressure during the inhalation phase.
Answer:C
Page:200
29.A lifetime, two-pack-a-day, smoking habit will shorten one’s life by
A)two to three years.
B)seven to eight years.
C)ten to twelve years.
D)twelve to fifteen years.
Answer:B
Page:200
30.Nicotine promotes the development of cardiovascular disease primarily by
A)irritating the lining of blood vessels and increasing heart rate.
B)reducing the oxygen supply in blood and increasing blood pressure.
C)stimulating LDL cholesterol production and promoting clots.
D)increasing heart rate, increasing blood pressure, and promoting clots.
Answer:D
Page:200
31.Which of the following BEST describes the connection between cigarette smoking and cancer? Cigarette smoking
A)is the second-leading cause of all respiratory tract cancers.
B)is the second-leading cause of lung cancer.
C)causes most cancers in the United States.
D)is a significant risk factor in virtually all forms of cancer.
Answer:D
Pages:202-203
32.The average cigarette smoker will develop cancer in 20 pack-years, which is a standard that represents
A)one pack a day for 20 years.
B)two packs a day for 20 years.
C)20 packs smoked in 20 years.
D)20 packs per year for a lifetime.
Answer:A
Page:202
33.Which of the following is FALSE regarding carbon monoxide? It
A)interferes with the oxygen transport within the circulatory system.
B)weakens the red blood cells.
C)has a relatively small impact on the cardiovascular system.
D)can cause hypoxia in fetuses.
Answer:C
Pages:199, 200, 202, 208
34.Lung cancer is usually fatal because
A)lung tissues are more vulnerable to cancer than any other body tissues.
B)a relatively small amount will destroy the respiratory system.
C)it is spread rapidly by the so-called smoker’s cough.
D)it is usually detected at a late stage.
Answer:D
Page:203
35.After years of cigarette smoking, Hartwig has developed a “smoker’s cough.” This means
A)he has lung cancer.
B)the cilia in his lungs are doing their job.
C)his smoking has resulted in constant respiratory infections.
D)his body is attempting to remove excess mucus from his lungs.
Answer:D
Page:202
36.Which of the following BEST summarizes how smoking causes lung cancer to develop?
A)The carbon monoxide from tobacco smoke changes the character of blood cells, causing mutations at the site of oxygen exchange.
B)The smoke first overcomes the natural cleaning action of the lungs exposing the tissues to cancer-causing substances.
C)Tobacco smoke suppresses the immune system, causing harmful substances to invade lung tissues.
D)The smoke changes mucus on the lungs’ surface to a poisonous compound.
Answer:B
Page:202
37.Chronic obstructive lung disease is a combination of
A)chronic bronchitis and pulmonary emphysema.
B)pulmonary emphysema and lung cancer.
C)asthma and chronic bronchitis.
D)pneumonia and lung cancer.
Answer:A
Page:204
38.Chronic bronchitis is
A)a precancerous condition of the alveoli.
B)a viral infection brought on by the smoker’s weakened immune system.
C)any destruction of lung tissue caused by smoking and manifested by a constant coughing.
D)a persistent inflammation and infection of the smaller airways in the lungs.
Answer:D
Page:204
39.A regular smoker in her forties has just been told by her doctor that she has chronic bronchitis. Frightened, she has decided to quit smoking. What are her chances for recovery? She
A)will no longer have frequent lung infections, but the destruction of lung tissue will slowly progress.
B)will recover some function but will never regain full health.
C)could recover completely.
D)will die of the disease.
Answer:C
Page:204
40.Which of the following is TRUEregarding chronic obstructive lung disease?
A)Fewer than five million Americans suffer from it.
B)Patients who have it tend to die an unpleasant, prolonged death.
C)The amount of airflow in and out of the lungs progressively increases.
D)It is made up of three separate but related diseases.
Answer:B
Page:204
41.Emphysema is
A)a permanent narrowing of the airways that limits the victim’s ability to breathe.
B)any generalized infection of lung tissues that causes inflammation.
C)a disease caused by the destruction of alveoli in the lungs.
D)a cancerous condition of the bronchial tubes.
Answer:C
Page:204
42.Smoking affects men’s fertility by
A)causing changes in sperm number, motility, and shape.
B)reducing the oxygen supply to reproductive tissues.
C)causing a thickening of cell walls inside the gonads.
D)depressing the central nervous system activities that bring about sexual arousal.
Answer:A
Page:208
43.When a pregnant woman smokes, the greatest threat to the health of the developing fetus comes from
A)tar.
B)carbon monoxide.
C)non-tar particulates.
D)the increased cancer risk.
Answer:B
Page:208
44.Hypoxia is
A)an irreversible disease in which the bronchi are destroyed.
B)a persistent inflammation of the tissue in the lungs.
C)when tissue does not receive enough oxygen.
D)when estrogen levels are sufficiently reduced as a result smoking.
Answer:C
Page:208
45.Sarah smokes a pack of cigarettes a day and has just given birth. Which of the following is FALSE regarding the health of her newborn? Her baby will
A)generally have a normal birth weight.
B)have an increased risk of sudden infant death syndrome.
C)more likely develop chronic respiratory problems.
D)be hospitalized more often and have poorer overall health.
Answer:A
Page:208
46.Women who smoke and use oral contraceptives have a(n)
A)increased risk of unexpected pregnancies.
B)decreased risk of ovarian cancer.
C)increased risk of cancer of the fallopian tubes.
D)increased risk of experiencing a fatal cardiovascular accident.
Answer:D
Page:202
47.Which of the following is a health risk of smokeless tobacco?
A)lung cancer
B)periodontal disease
C)emphysema
D)chronic bronchitis
Answer:B
Page:207
48.Mainstream smoke is
A)smoke that a smoker inhales.
B)smoke that a smoker does not inhale.
C)smoke that accumulates in a room full of smokers.
D)environmental smoke that does not originate from tobacco use.
Answer:A
Page:209
49.Smoke that comes from the burning end of a cigarette, pipe, or cigar is termed ______smoke.
A)incidental
B)industrial
C)sidestream
D)mainstream
Answer:C
Page:209
50.Skip uses smokeless tobacco. Which of the following is heLEAST likely to develop?
A)mouth cancer
B)bladder cancer
C)stomach cancer
D)lung cancer
Answer:D
Pages:203, 207
51.What is the current scientific opinion regarding involuntary smoke?
A)The dangers tend to be with only those who actively smoke.
B)Smokers and nonsmokers are exposed to the very much the same smoke when tobacco is used within a common space.
C)It may be responsible for only about 5,000 premature deaths per year.
D)It makes up only about 10 percent of our exposure to harmful substances in the air.
Answer:B
Page:209
52.If you are a smoker, you currently stand the BEST chance of being able to quit if
A)your cessation program includes nicotine replacement products.
B)you quit on your own, without professional help.
C)you are trying to quit for the first time.
D)you try to cut back very gradually.
Answer:A
Page:211
True/False
53.Nonsmoking spouses of smokers face a higher risk of heart attacks and lung cancer than spouses of nonsmokers.
Answer:True
Page:209
54.The per-capita consumption of cigarettes has declined since the 1960s.
Answer:True
Page:190
55.There has been an increase in reported smoking among college students.
Answer:True
Page:190
56.In the United States’ population, smoking rates decline as education level increases.
Answer:True
Page:190
57.Cigarette advertising is not intended to entice youngsters to smoke.
Answer:False
Page:191
58.Pipe and cigar smoking have most of the same hazards as cigarette smoking.
Answer:True
Page:206
59.There is evidence to suggest genetics may play a strong role in addiction to nicotine.
Answer:True
Page:193
60.Most cigarette smokers develop a physical dependence on cigarettes.
Answer:True
Pages:193-194
61.Heavy smoking can have a depressive effect on the central nervous system.
Answer:True
Page:196
62.A person who smokes one pack of cigarettes a day will collect ten ounces of tar in his lungs per year.
Answer:False
Page:199
63.Carbon monoxide is the least dangerous component of tobacco smoke.
Answer:False
Page:199
64.Cigarette smoke contains hundreds of cancer-causing chemicals.
Answer:True
Page:199
65.Cigarette smoking can deprive the brain of oxygen.
Answer:True
Page:200
66.Cigarette smoking more than doubles the risk of experiencing a heart attack.
Answer:True
Page:200
67.Smoking has been proven to cause cancer, but not cardiovascular disease.
Answer:False
Page:200
68.A smoker’s body can absorb cancer-causing substances not only from smoke but also through the saliva.
Answer:True
Page:203
69.Smoking has many negative consequences on fertility for both men and women.
Answer:True
Page:208
70.Smoking increases a pregnant woman’s risk of having a miscarriage.
Answer:True
Page:208
71.Nursing children are protected from ingesting nicotine from breast milk.
Answer:False
Page:208
72.A newborn baby’s risk of sudden infant death syndrome increases if the mother is a smoker.
Answer:True
Page:208
73.Smokers can eliminate their nicotine intake by switching to smokeless tobacco.
Answer:False
Page:207
74.Women who smoke and use oral contraceptives are at high risk for stroke.
Answer:True
Page:202
75.Research indicates that the use of smokeless tobacco is safer than smoking cigarettes.
Answer:False
Pages:205
76.The use of smokeless tobacco can damage the teeth and gums.
Answer:True
Page:207
77.Sidestream smoke is more toxic than mainstream smoke.
Answer:True
Page:209
78.Tobacco smoke that stays within a common source of air is known as environmental smoke.
Answer:True
Page:209
Essay
79.Briefly describe the theories of nicotine addiction.
Answer:
1)Bolus theory: nicotine reaches the brain in doses that excite the nervous and endocrine systems.
2)ACTH theory: nicotine stimulates ACTH secretion, which activates the body’s natural painkillers.
3)Self-medication theory: smoking stimulates dopamine secretion--smoking a cigarette resembles administering a dose of natural medication to oneself.
4)Genetic influences: sixty percent of the initiation and maintenance of initial smoking is driven by genetic influences.
Pages:194-196
80.Explain how smoking distributes carbon monoxide in a smoker’s system.
Answer:Carbon monoxide (CO) is not a substance in the tobacco, but rather a byproduct of the burning. When inhaled with the tobacco smoke, CO reaches the bloodstream through the lungs. CO bonds with hemoglobin in red blood cells and makes those cells useless for oxygen transport, thus reducing overall oxygen supply to tissues. Heavy smoking can replenish the CO supply faster than the blood can get rid of it. CO permanently weakens the red blood cells to which it has bonded.