Smoking Cessation Overview and Practice Questions

Smoking Cessation: Overview and Practice Questions

by | Updated: Jan 28, 2023

Smoking is the leading cause of preventable death in the United States. That is why it’s important for respiratory therapists to be knowledgeable about smoking cessation to help their patients quit.

In this guide, we will discuss what smoking is, the risks associated with smoking, and ways to help patients quit. We provided helpful practice questions on this topic as well.

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What is Smoking Cessation?

Smoking cessation is the process of quitting smoking. This can be done through various methods, including nicotine replacement therapy, medications, and behavioral counseling.

The risks associated with smoking are well-known and include the following:

  • Lung cancer
  • Heart disease
  • Stroke
  • Other respiratory illnesses

In addition to the health risks, smoking is also costly. The average smoker spends over $1,000 per year on cigarettes. Respiratory therapists can play a vital role in helping patients quit smoking to improve their overall health.

Nicotine Replacement Therapy

Nicotine replacement therapy is a type of smoking cessation therapy that helps reduce withdrawal symptoms and cravings associated with quitting smoking.

It has been shown to increase the chance of quitting smoking by 50-70%.


There are various types of nicotine replacement therapy, including the following:

  • Nicorette gum
  • Nicotrol inhaler
  • Nicotine transdermal patches
  • Nicotine nasal spray
  • Prescription medications

Each type of nicotine replacement therapy has its own benefits and risks. Respiratory therapists should be familiar with the different types to best help their patients quit smoking.

Types of Nicotine Replacement Therapy


There are also various prescription medications that can be used to help people quit smoking, including:

  • Bupropion (Zyban)
  • Varenicline (Chantix)

Both medications have been shown to be effective in smoking cessation by reducing the patient’s cravings and withdrawal symptoms.

Behavioral Counseling

In addition to medication, behavioral counseling is an important part of smoking cessation. This type of counseling can help people change their behaviors and thoughts about smoking.

Counseling can also help people develop coping skills to deal with withdrawal symptoms. Respiratory therapists are often involved in this process.

What is a Respiratory Therapist’s Role in Smoking Cessation?

Respiratory therapists can play a vital role in helping their patients quit smoking by providing information about the following:

  • Risks
  • Types of quitting methods
  • Counseling services

In addition, respiratory therapists can provide support to patients who are trying to quit smoking. This includes providing emotional support to help the patient cope with withdrawal symptoms and cravings.

How to Calculate Pack-Years for Smokers?

Pack-years is a way to measure how much a person has smoked over their lifetime. It is calculated by multiplying the number of packs of cigarettes smoked per day by the number of years the person has smoked.

For example, if a person smoked two packs of cigarettes per day for 10 years, their pack-years would be 20.

2 packs x 10 years = 20 pack-years

Pack-years is a helpful way to measure the amount of smoking a person has done over their lifetime. It is a risk factor for developing smoking-related diseases.

Smoking Cessation Practice Questions:

1. In a smoking cessation program, what are the two types of support that can be given by the respiratory therapist?
Physical and emotional support

2. In a smoking cessation program, how can the respiratory therapist physically assist a patient?
They can ask the patient about their smoking history, educate the patient about the benefits of quitting smoking, assess their willingness to attempt to quit, discuss helpful medications, and arrange a follow-up meeting to begin the quitting process.

3. What are the four treatment types for smoking cessation?
(1) Nicotine inhaler, (2) Nicotine gum, (3) Nicotine patch (Transdermal), and (4) Nicotine nasal spray

4. What does a nicotine MDI (inhaler) do?
It works just like a regular MDI. It is very portable and has titratable dosing.

5. How does oral nicotine gum work?
It is chewing gum that supplements a patient’s nicotine intake, so they do not need to obtain it by smoking tobacco.

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6. How does a nicotine transdermal patch work?
It’s a patch that is applied directly to the skin and delivers a steady dose of nicotine over a 24-hour period. Over time, the dose is gradually reduced until the patient no longer has nicotine cravings.

7. How does the nicotine nasal spray work?
It’s a medication that includes a nicotine solution, which is sprayed into the nose through the nose and is absorbed into the bloodstream. It has very fast delivery and is portable to use on the go.

8. After a person quits smoking, when can they expect shortness of breath and coughing to decrease?
Usually within 1 to 9 months after quitting

9. What are bupropion and varenicline?
They are medications for the brands Zyban and Chantix.

10. How long does it take for carbon monoxide levels to return to normal after a person quits smoking?
Usually within 12 hours

11. One of the most immediate benefits of smoking cessation is that the heart rate drops in approximately how many minutes?
20 minutes

12. What are two helpful things to know about cigarette smoke?
(1) It has over 1,000 toxic agents that damage tissue, and (2) It causes short and long-term health problems

13. The 1964 Surgeon General’s Report of the advisory committee of smoking and health concluded that smoking can cause what four illnesses?
(1) Lung cancer, (2) Laryngeal cancer, (3) Emphysema, and (4) Cardiovascular disease

14. What did Mark Twain say that can be applied to smoking?
“Giving up smoking is the easiest thing in the world. I know because I’ve done it thousands of times.”

15. Who is involved in smoking cessation?
Medical professionals that may be involved in helping a patient quit smoking include the patient’s therapist, doctor, nurses, and respiratory therapist.

16. What percentage of adults smoke in the united states?
According to the CDC, 12.5% of adults smoke in the United States.

17. What percentage of smokers have called a quit line in an attempt to stop smoking?
Only 2.3%

18. What percentage of all cancer deaths are related to smoking?
Approximately 25%

19. What are the five A’s of Smoking Intervention?
(1) Ask if the patient smokes, (2) Advise them to quit smoking, (3)Assess their willingness to quit at this time, (4) Assist the patient by discussing helpful medications and possibly counseling, and (5) Arrange a follow-up meeting

20. What are the 5 R’s to help patients quit smoking?
(1) Relevance, (2) Risks, (3) Rewards, (4) Roadblocks, and (5) Repeat

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21. What medications are used to help patients stop smoking?
Chantix and Zyban

22. What are the possible side effects of Chantix?
Nausea is the most common side effect and may persist for several months. Other side effects include stomach pain, indigestion, constipation, gas, weakness, fatigue, dry mouth, headache, insomnia, and unusual dreams.

23. What are the smoking risks for pregnant women?
Smoking during pregnancy can cause a baby to be born prematurely and with low birth weight. This increases the odds that the baby will be sick and have to stay in the hospital for a longer period after birth. It can even cause death, as smoking during and after pregnancy is a major risk factor for sudden infant death syndrome (SIDS).

24. What are two examples of nicotine patches?
Nicotrol and Nicoderm

25. What is an alternative drug type that is effective in smoking cessation?
Anti-depressant drug therapy has been shown to be effective in helping patients quit smoking.

Final Thoughts

Smoking is a leading cause of preventable death around the world. Smoking cessation is the process of quitting smoking and can be done through various methods, including:

  • Nicotine replacement therapy
  • Medications
  • Behavioral counseling

Respiratory therapists can play a vital role in helping their patients quit smoking in order to improve the health of their lungs and body systems.

We have similar guides on asthma and COPD that I think you’ll find helpful. Thanks for reading and, as always, breathe easy, my friend.

Written by:

John Landry, BS, RRT

John Landry is a registered respiratory therapist from Memphis, TN, and has a bachelor's degree in kinesiology. He enjoys using evidence-based research to help others breathe easier and live a healthier life.


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