Knowledge - Students should be able to describe and define:

  1. Pharmacological effects of nicotine, nicotine withdrawal symptoms, and symptoms of nicotine dependence.
  2. Intervention strategies that physicians can use for patients.
  3. Common barriers preventing patients from undertaking smoking cessation.
  4. Principles of at least one theory of behavior modification.
  5. Common medical diseases associated with chronic smoking.  













Skills - Students should be able to:

  1. History: obtain, document and present an age-appropriate medical history in order to:
    1. determine if a patient is nicotine dependent;
    2. assess a patient's motivation for stopping;
    3. assess the patient's past experience with smoking cessation;
    4. review and determine patient's barriers to stopping.
  2. Physical exam: perform a physical exam to establish diagnosis related to smoking, especially:
    1. lesions with malignant potential in the lips and in the oral cavity;
    2. chest findings consistent with COPD;
    3. evidence of atherosclerotic vascular disease.
  3. Communication:
    1. demonstrate a commitment to administering non-judgmental "stop smoking" message to every patient who smokes;
    2. respond positively and non-judgmentally to patients excuses or concerns about cessation;
    3. counsel professional smoking cessation;
    4. get the patient to commit to a specific action plan that can lead to complete cessation.
  4. Management:
    1. design an intervention that matches the stage of behavior change demonstrated by the patient;
    2. explain how to use the nicotine patch therapy and nicotine gum therapy;
    3. negotiate a follow-up plan with the patient.  















Attitudes and Professional Behaviors - Students should be able to:
















Recommended References:

  1. Hughes, John R et al. "Recent Advances in the Pharmacotherapy of Smoking" JAMA 281(1):72-76, January 6, 1999.
  2. Lee, Emmet W., D'Alonzo, Gilbert E. Cigarette Smoking, Nicotine Addiction, and Its Pharmacologic Treatment. Arch Intern Med 1993; 153, 34-48.
  3. "The Agency for Health Care Policy .and Research Smoking Cessation Clinical Practice Guideline" JAMA 275(16);1270-1280
  4. Epps, Roselyn P., Manley, Marc W., Glynn, Thomas J. Tobacco Use Among Adolescents. Strategies for Prevention. Pediatric Clinics of North America 1995; 42, 389-402.