Opinions

How To Help Patients Quit Their Tobacco Dependence

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The best thing a person can do to improve their health is to quit tobacco use.

Tobacco dependence is a chronic relapsing disease. It is not only detrimental to oral health, but also a cause of various lung diseases, heart diseases, and several cancers including oral cancer.

For most people, quitting means a total change in lifestyle. It may be difficult, but it is not impossible for anyone. The first and most necessary step is for the person to have a desire to quit.

Dentists are in the position where they can educate and counsel their patients best regarding their dependence and help them quit as judiciously as possible.

Every dental patient should be asked specifically if they use any amount of tobacco in any form. Explicitly state that you’re referring to not only cigarettes, but cigars, pipes, chewing tobacco, hookah, electronic cigarettes and all other types.

Patients must understand that it is a dentist’s obligation to know about their tobacco use, and discuss it. Inform patients precisely how tobacco damages their oral health, particularly during their intra-oral and extra-oral examination. Keep pamphlets about tobacco use in the waiting area for patients to read and take home.

Motivate the patient by explaining how many of the undesirable effects of tobacco use can be reversed by quitting immediately. Here is a helpful chart:

ADVERSE EFFECTS OF TOBACCO USE BENEFIT OF QUITTING
Bad breath Reduced bad breath
Gum/periodontal disease Decreased risk of tooth loss, healthier pink gums
Teeth staining Lesser tartar and buildup on teeth
Sore throat and hoarseness Inflammation in throat and mouth reduced
Oral lesions/ulcers on mouth/lips/tongue Lesions/ulcers will disappear and not return

Remind the patient about the greatly increased risks of oral/throat/lung cancer, which is already hugely prevalent in Pakistan. Inform them of the painful and costly treatments such as radiation and chemotherapy, and the poor prognoses.

Cold turkey attempts (quitting everything abruptly) have the least success rates. It is rather advised to gradually decrease use, then begin some form of nicotine replacement therapy (patches, chewing gum or inhaler), before completely stopping.

Provide follow-up support for continued guidance and encouragement. Set a quitting date for the patient. Contact your patient a week before this date, a week after it, and then a month after the date. Sometimes it takes more than one attempt to give up tobacco use in order to quit for the long term. Encourage the patient to keep trying.

Sometimes, the patient is not interested in quitting even after being counselled about the adverse effects of tobacco use and the benefits of quitting. Don’t give up. Keep trying in the duration of their treatment.

Emphasize the advantages of stopping tobacco use. No matter the age you quit at, it is not too late. Even after several years of tobacco use, quitting will result in healing of the body, and a better quality life and a longer life will ensue.

You will find that helping patients quit is most rewarding, and generally your patients will be extremely thankful to you.

February 21, 2017
Dental is part of the Medical News Group of publications which in 1968 became the pioneer of medical journalism in Pakistan. Medical News is the only periodical in Pakistan which has 3 simultaneous editions from Karachi, Islamabad and online.

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