Upload
yasminmoidin
View
239
Download
0
Tags:
Embed Size (px)
DESCRIPTION
PUBLIC HEALTH DENTISTRY
Citation preview
GOOD MORNING !
SEMINAR
TOBACCO CESSATION
YASMIN MOIDIN 2008 BATCH
AL AZHAR DENTAL COLLEGETHODUPUZHA
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 of them
due to smoking
There are three well-known
approaches
Regulatory approach
1975 : Cigarette Act
1985 : National Cancer Control Program
2003 : Cigarettes and other Tobacco
Products Act
2004 : WHO-FCTC
Service approach
screening
Educational approach
Role of the dentist
harmful effects of tobacco
counsel patients
tobacco-free lifestyle
tobacco use during pregnancy
spend more time with patients
reinforce messages given to patients
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
•Identify and document tobacco user status of every patient at every visit
ASK about patient’s
habit
•In a clear, strong and personalized manner urge every tobacco user to quit
ADVICE of consequence of smoking
•Is the tobacco user willing to make a quit attempt at this time ?
ASSESS willingness
to quit
Guide to counseling for tobacco cessation (5 A’s)
•For the patient willing to make a quit attempt, use counseling and pharmacotherapy to help him quit
ASSIST with cessation
plant developme
nt
•Schedule follow-up contact, preferably within the first week after the quit date
ARRANGE for
follow-up
NICOTINE REPLACEMENT THERAPY
Nicotine replacement therapies (NRT) for
tobacco use cessation are :
Nicotine gum
Nicotine patch
Nicotine inhaler
Nicotine nasal spray
Nicotine lozenges
Basic principles for prescribing NRTs
Medical supervision is important
Use a lower dose for less dependent
tobacco users
Contraindicated in : pregnancy , lactation,
cardiovascular diseases, peripheral
vascular disease, endocrine disorders ,
inflammation of the mouth and throat,
oesophagitis, gastric ulcers, diabetes
Nicotine gum
use under medical supervision for
a predefined limited period, e.g. 6
weeks , after which the patient
has to face withdrawal
Nicotine withdrawal symptoms
Craving for tobacco
Depressed mood
Insomnia
Irritability
Frustration
Anxiety
Difficulty in concentration
Restlessness
Decreased heart rate
Increased appetite and weight gain
Antidepressants
Function as anti-craving medications
Available therapies :
First-line therapies
Buproprion SR
Selegeline
Second-line therapies
Clonidine
nortryptiline
Counseling those unwilling to quit
Relevance of quitting
Risks of continuing tobacco use
Rewards of quitting
Roadblocks to quitting
Repeat these at each visit
Key counseling concepts
A non judgmental attitude
Caring
Empathy
Listening
Raising awareness
Prompting self-evaluation
Offering support
Asking open-ended questions
Clarifying
Reflecting feelings
Summarizing
Affirming
Eliciting self-motivational statements
Setting realistic goals
Responding to tricky questions
Tailoring messages to the patients
stage of change
ACTION IN THE COMMUNITY
Public educationMedia advocacy
ACTION AT THE STATE AND NATIONAL LEVELS
Making the profession and dental facilities tobacco-free
Advocacy with the state and national governments
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.
REFERENCES
Essentials of Preventive and
Community Dentistry – Fourth
Edition 2009 SOBEN PETER
Textbook of Public Health
Dentistry – First Edition 2011 C M
MARYA
THANK YOU !THANK YOU !