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Course # 61782 • Smoking and Secondhand Smoke


This course provides comprehensive clinical education on tobacco smoke in primary care and public health. It addresses core competencies as well as knowledge, assessment, and treatment-based competencies of healthcare providers. It covers the history of tobacco, epidemiology of tobacco use, tobacco smoke metabolism, dependence, treatment and relapse. It also addresses complications associated with direct and indirect exposure to tobacco smoke, effects of prenatal exposure, methods of screening for exposure, and brief intervention training. This course includes a review of available screening tools, predisposing genetic factors, associated risk and protective factors, withdrawal symptoms and treatment, lab testing procedures, diagnostic tools, and age and gender issues.

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Education Category: Community Health

Release Date: 06/01/2016

Expiration Date: 05/31/2019


This advanced course is designed for psychologists who may intervene to stop patients from smoking.


NetCE is approved by the American Psychological Association to sponsor continuing education for psychologists. NetCE maintains responsibility for this program and its content.

Designations of Credit

NetCE designates this continuing education activity for 10 credit(s).

Course Objective

The purpose of this course is to provide psychologists with a formal educational opportunity that will address the impact of tobacco smoking and secondhand exposure in public health and disease as well as interventions to promote smoking cessation among their patients.

Learning Objectives

Upon completion of this course, you should be able to:

  1. Describe the history of tobacco and its impact on society.
  2. Define the prevalence and economic impact of tobacco smoke exposure on public health.
  3. Differentiate between available tobacco products.
  4. Describe the neurophysiological effects and addictive components of tobacco smoke.
  5. Describe the anatomy and physiology of smoke inhalation, and outline key points in learning of behavior.
  6. Define the psychologic and physiologic aspects of smoking dependence.
  7. List the common health complications related to smoke exposure.
  8. Identify the common comorbid conditions of tobacco users.
  9. Describe the developmental complications related to prenatal exposure to smoke.
  10. Define the effects of exposure to secondhand smoke for children and adults.
  11. Identify the methods of detecting and measuring tobacco smoke exposure.
  12. Define thirdhand smoke.
  13. Outline the methods of tobacco cessation interventions, including necessary considerations for non-English-proficient patients.
  14. Define the treatment modalities for tobacco addiction, including pharmacological options.
  15. Identify strategies to reduce exposure to tobacco smoke.


Mark S. Gold, MD, DFASAM, DLFAPA, is a translational researcher, author, and inventor best known for his work on the brain systems underlying the effects of opiate drugs, cocaine, and food. He has published more than 1,000 peer-reviewed scientific articles, texts, and practice guidelines, including citation classics in cocaine neurobiology, opioid addiction neurobiology and treatment, and food and process addictions. He has been called a groundbreaking researcher, father of medication-assisted recovery, the first to translate rat experiments into theory and treatments for human addicts, and mentor of the next generation of addiction researchers and clinicians.

After working on state dependency of memory, amphetamines, and sleep neurobiology, Dr. Gold proposed a novel model for opiate action, dependence, and withdrawal, changing the way opiate action was understood. This locus coeruleus theory of opiate and drug withdrawal is a mainstay of theory and practice today, even though he proposed it in 1978. Dr. Gold is the senior author on the discovery paper and was awarded a patent for the discovery of new uses for clonidine, which remains widely used for opiate withdrawal and pain management. Drs. Gold and Herbert Kleber were the first to suggest the use of clonidine and naloxone in rapid detoxification and sequential use of clonidine and naltrexone.

During the 1980s, Drs. Gold and Dackis developed a new theory for cocaine action, dependence, and withdrawal based on an understanding of the neuroscience of dopamine-rich areas of the brain. While most at the time did not consider cocaine addictive because of the lack of a classic withdrawal syndrome, Dr. Gold proposed a dopamine theory of pathologic attachment, loss of control, and addiction. This work not only helped to reclassify cocaine as addicting but reduced the importance of withdrawal to the nosology of addiction. Dr. Gold had many of the first reports related to cocaine and crack, including pieces on cocaine and panic disorders, cocaine and cardiovascular accidents and symptoms, and cocaine and body temperature, and was the first to describe crack smoking. His work increased interest in dopamine in pleasure and addictions. Dr. Gold completed a five-year State Department study on opium smoking and second- and thirdhand exposure in the children of Afghanistan. His work reduced stigma, served as the basis for many educational and prevention campaigns, and changed the lives of addicts with basic and applied science leading to new evidence-based treatment.

Dr. Gold is a Distinguished Alumnus of Washington University, the University of Florida, and Yale University. He was a Professor, Eminent Scholar, Distinguished Professor, and Distinguished Alumni Professor during his 25 years at the University of Florida and one of the Directors of the McKnight Brain Institute. He has served as a Consultant to the Office of National Drug Control Policy, the National Institute on Drug Abuse, the State Department, and other governmental agencies, professional sports associations, and the National Center on Addiction and Substance Abuse at Columbia University. He gave a keynote at the Community Anti-Drug Coalitions of America Conference in Washington, DC, in 2016.

He is currently an (Adjunct) Professor of Psychiatry at Washington University in St. Louis, MO, and the Chairman of the Scientific Advisory Boards for RiverMend Health, a national provider of addiction, eating disorders, and obesity evaluation and treatment. Dr. Gold has been awarded a number of national awards for his research, including the Foundations Fund Prize (from the American Psychological Association), the McGovern Award for Lifetime Achievement (from the American Society of Addiction Medicine and the American Board of Addiction Medicine), the National Leadership Award (from the National Association of Addiction Treatment Providers), the Silver Anvil (from the Public Relations Society of America), PRIDE and DARE awards for his career in research and prevention, and the PATH Foundation’s Lifetime Achievement Award, presented by White House Drug Czar Michael Botticelli, Yale Chairman of Psychiatry John Krystal, MD, and David Baron, DO, MSEd, vice chair of the Department of Psychiatry at the University of Southern California.

Faculty Disclosure

Contributing faculty, Mark S. Gold, MD, DFASAM, DLFAPA, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Division Planner

James Trent, PhD

Division Planner Disclosure

The division planner has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

About the Sponsor

The purpose of NetCE is to provide challenging curricula to assist healthcare professionals to raise their levels of expertise while fulfilling their continuing education requirements, thereby improving the quality of healthcare.

Our contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication. The publisher disclaims any liability, loss or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into practice.

Disclosure Statement

It is the policy of NetCE not to accept commercial support. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to learners.

Technical Requirements

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