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

2. Of the following states, which has the highest smoking rate in the nation?

3. Following the 1964 Surgeon General’s report about smoking, the percentage of people smoking
in the United States

4. As education level increases, the rate of smoking

5. When segments of a college community are studied, there is a direct relationship between
cigarette smoking and

6. Nontobacco sources of nicotine include all of the following EXCEPT

7. Non-nicotine based medications are those medications which

8. You have decided to switch from cigarettes to cigars. Which of the following is TRUE?

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?

10. A so-called chipper is a smoker who

11. The dependency-producing substance found in cigarettes is

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

13. One of the major theories about how nicotine produces a pleasant effect in the human body is that
it

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.
Page: 1 91 -l 92
15. According to the self-medication theory, which mood-enhancing substance is released during
smoking?
A) adrenaline
B) dopamine
C) ACTH
D) norepinephrine
Pages: 1 92
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.
Page: 1 92-1 93
17. Some children become smokers because they see their parents smoking. This is called
A) modeling.
B) manipulation.
C) peer pressure.
D) subliminal advertising.
Page: 193
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.
Page: 193
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.
Page: 1 94
20. Which of the following is NOT true in regards to individuals who smoke?
A) Many smokers are rejected by the nonsmoking majority.
B) 26 percent of the current US population are smokers.
C) Smokers may experience subtle forms of discrimination when they search for
employment.
D) Smokers often receive lower trade-ins on their vehicles.
Pages: 207
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.
Page: 203
22. The most effective time to begin influencing a child NOT to smoke is I
A) at preschool age.
B) at kindergarten age.
C) during grades one to three.
D) during grades four to six.
Page: 1 94
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.
Page: 1 95
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.
Pages: 195-196
25. Of the following, which component of a cigarette contains most of the carcinogenic compounds?
A) nicotine.
B) tar.
C) carbon monoxide.
D) nitrogen oxide.
Page: 196
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.
Page: 1 96
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.
Page: 1 96
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.
Page: 1 96
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.
Page: 1 97
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.
Page: 1 97
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.
Pages: 199-200
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.
Page: 1 99
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.
Pages: 196, 197
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.
Page: 200
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 j ob.
C) his smoking has resulted in constant respiratory infections.
D) his body is attempting to remove excess mucus from his lungs.
Page: 1 99
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.
Page: 1 99-200
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.
Page: 200
3 8. 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 condition in which the walls of the bronchi become inflamed and infected.
Page: 200
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.
Page: 200
40. Which of the following is TRUE regarding 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.
Page: 201
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.
Page: 200-201
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.

14. The main concept of the bolus theory of nicotine addiction is that

15. According to the self-medication theory, which mood-enhancing substance is released during
smoking?

16. Which of the following BEST describes the effect of nicotine on the central nervous system? It

17. Some children become smokers because they see their parents smoking. This is called

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

19. A psychosocial incentive to smoke is the comfort smokers get from handling a cigarette, pipe, or
cigar. This is called

20. Which of the following is NOT true in regards to individuals who smoke?

21. Which of the following is FALSE regarding use of a hookah?

22. The most effective time to begin influencing a child NOT to smoke is I

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?

24. The cancer-causing substances in tobacco smoke are carried into the body by

25. Of the following, which component of a cigarette contains most of the carcinogenic compounds?