GOOD
MORNING !
SEMINAR
TOBACCO CESSATION

YASMIN MOIDIN
2008 BATCH
AL AZHAR DENTAL COLLEGE
THODUPUZHA
INTRODUCTION


Prevention of oral cancer mainly focuses on
modifying habits associated with the use of
tobacco



India ...


There are three well-known approaches

 Regulatory

approach

 1975

: Cigarette Act

 1985

: National Cancer Contr...


Educational approach



Role of the dentist

 harmful

effects of tobacco

 counsel

patients

 tobacco-free
 toba...
 build

their

patient’s

interest

to

discontinue
 promote

oral

health

and

healthy

lifestyles
 speak

with autho...
Guide to counseling for tobacco
cessation (5 A’s)

ASK about
patient’s habit

• Identify and document tobacco user
status ...
ASSIST with • For the patient willing to make
a quit attempt, use counseling
cessation
and pharmacotherapy to help
plant
h...
NICOTINE REPLACEMENT
THERAPY


Nicotine replacement therapies (NRT) for
tobacco use cessation are :

 Nicotine

gum

 N...


Basic principles for prescribing NRTs

 Medical
 Use

supervision is important

a lower dose for less dependent

toba...


Nicotine gum

 use

under medical supervision for a

predefined limited period, e.g. 6 weeks

, after which the patien...


Nicotine withdrawal symptoms



Craving for tobacco



Depressed mood



Insomnia



Irritability



Frustration

...


Antidepressants

 Function

as anti-craving medications

 Available

therapies :

 First-line

therapies



Bupropr...


Counseling those unwilling to quit

 Relevance

 Risks

of quitting

of continuing tobacco use

 Rewards

of quittin...


Key counseling concepts



A non judgmental attitude



Caring



Empathy



Listening



Raising awareness



Pr...


Reflecting feelings



Summarizing



Affirming



Eliciting self-motivational statements



Setting realistic goal...
ACTION IN THE COMMUNITY
Public education
 Media advocacy




ACTION AT THE STATE AND NATIONAL
LEVELS

Making the profes...
CONCLUSION
A majority of cancer deaths worldwide

are due to tobacco. These are easily
avoidable since the factors associa...
REFERENCES
Essentials

of

Preventive

and

Community Dentistry – Fourth Edition
2009

SOBEN PETER

Textbook of Public Hea...
THANK
THANK YOU !
YOU !
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TOBACCO CESSATION

  1. 1. GOOD MORNING !
  2. 2. SEMINAR
  3. 3. TOBACCO CESSATION YASMIN MOIDIN 2008 BATCH AL AZHAR DENTAL COLLEGE THODUPUZHA
  4. 4. INTRODUCTION  Prevention of oral cancer mainly focuses on modifying habits associated with the use of tobacco  India is the largest consumer of tobacco and third largest producer of tobacco  There are about 250 million tobacco users in India  In India, at least 800,000 deaths every year are related to tobacco use, and 700,000 them due to smoking of
  5. 5.  There are three well-known approaches  Regulatory approach  1975 : Cigarette Act  1985 : National Cancer Control Program  2003 : Cigarettes Products Act  2004 : WHO-FCTC  Service approach  screening and other Tobacco
  6. 6.  Educational approach  Role of the dentist  harmful effects of tobacco  counsel patients  tobacco-free  tobacco  spend lifestyle use during pregnancy more time with patients  reinforce messages given to patients
  7. 7.  build their patient’s interest to discontinue  promote oral health and healthy lifestyles  speak with authority in the community  effective advocates for tobacco control in the community
  8. 8. Guide to counseling for tobacco cessation (5 A’s) ASK about patient’s habit • Identify and document tobacco user status of every patient at every visit ADVICE of consequence of smoking • In a clear, strong and personalized manner urge every tobacco user to quit ASSESS willingness to quit • Is the tobacco user willing to make a quit attempt at this time ?
  9. 9. ASSIST with • For the patient willing to make a quit attempt, use counseling cessation and pharmacotherapy to help plant him quit development ARRANGE for follow-up • Schedule follow-up contact, preferably within the first week after the quit date
  10. 10. NICOTINE REPLACEMENT THERAPY  Nicotine replacement therapies (NRT) for tobacco use cessation are :  Nicotine gum  Nicotine patch  Nicotine inhaler  Nicotine nasal spray  Nicotine lozenges
  11. 11.  Basic principles for prescribing NRTs  Medical  Use supervision is important a lower dose for less dependent tobacco users  Contraindicated , : lactation, diseases, disease, , in cardiovascular peripheral endocrine inflammation throat, pregnancy of the oesophagitis, vascular disorders mouth and gastric
  12. 12.  Nicotine gum  use under medical supervision for a predefined limited period, e.g. 6 weeks , after which the patient has to face withdrawal
  13. 13.  Nicotine withdrawal symptoms  Craving for tobacco  Depressed mood  Insomnia  Irritability  Frustration  Anxiety  Difficulty in concentration  Restlessness  Decreased heart rate  Increased appetite and weight gain
  14. 14.  Antidepressants  Function as anti-craving medications  Available therapies :  First-line therapies  Buproprion SR  Selegeline  Second-line  Clonidine  nortryptiline therapies
  15. 15.  Counseling those unwilling to quit  Relevance  Risks of quitting of continuing tobacco use  Rewards of quitting  Roadblocks  Repeat to quitting these at each visit
  16. 16.  Key counseling concepts  A non judgmental attitude  Caring  Empathy  Listening  Raising awareness  Prompting self-evaluation  Offering support  Asking open-ended questions  Clarifying
  17. 17.  Reflecting feelings  Summarizing  Affirming  Eliciting self-motivational statements  Setting realistic goals  Responding to tricky questions  Tailoring messages to the patients stage of change
  18. 18. ACTION IN THE COMMUNITY Public education  Media advocacy   ACTION AT THE STATE AND NATIONAL LEVELS Making the profession and dental facilities tobacco-free  Advocacy with the state and national governments 
  19. 19. CONCLUSION A majority of cancer deaths worldwide are due to tobacco. These are easily avoidable since the factors associated with the disease have long been identified.
  20. 20. REFERENCES Essentials of Preventive and Community Dentistry – Fourth Edition 2009 SOBEN PETER Textbook of Public Health Dentistry – First Edition 2011 C M MARYA
  21. 21. THANK THANK YOU ! YOU !
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