3. TOBACCO CESSATIONYASMIN MOIDIN 2008 BATCH AL AZHAR DENTAL COLLEGE THODUPUZHA
4. INTRODUCTION Prevention of oral cancer mainly focuses on modifying habits associated with the use of tobaccoIndia is the largest consumer of tobacco andthird largest producer of tobacco There are about 250 million tobacco users in IndiaIn India, at least 800,000 deaths every year are related to tobacco use, and 700,000 them due to smokingof
5. There are three well-known approaches Regulatoryapproach 1975: Cigarette Act 1985: National Cancer Control Program 2003:CigarettesProducts Act 2004: WHO-FCTC Serviceapproach screeningandotherTobacco
6. Educational approachRole of the dentist harmfuleffects of tobacco counselpatients tobacco-free tobacco spendlifestyleuse during pregnancymore time with patients reinforcemessages given to patients
7. buildtheirpatient’sinteresttodiscontinue promoteoralhealthandhealthylifestyles speakwith authority in the community effectiveadvocates for tobacco controlin the community
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 visitADVICE of consequence of smoking• In a clear, strong and personalized manner urge every tobacco user to quitASSESS willingness to quit• Is the tobacco user willing to make a quit attempt at this time ?
9. ASSIST with • For the patient willing to make a quit attempt, use counseling cessation and pharmacotherapy to help plant him quit developmentARRANGE for follow-up• Schedule follow-up contact, preferably within the first week after the quit date
10. NICOTINE REPLACEMENT THERAPY Nicotine replacement therapies (NRT) for tobacco use cessation are : Nicotinegum Nicotinepatch Nicotineinhaler Nicotinenasal spray Nicotinelozenges
11. Basic principles for prescribing NRTs Medical Usesupervision is importanta lower dose for less dependenttobacco users Contraindicated,:lactation,diseases, disease, ,incardiovascularperipheral endocrineinflammationthroat,pregnancyoftheoesophagitis,vascular disorders mouthandgastric
12. Nicotine gum useunder medical supervision for apredefined limited period, e.g. 6 weeks, after which the patient has to face withdrawal
13. Nicotine withdrawal symptomsCraving for tobaccoDepressed moodInsomniaIrritabilityFrustrationAnxietyDifficulty in concentrationRestlessnessDecreased heart rateIncreased appetite and weight gain
17. Reflecting feelingsSummarizingAffirmingEliciting self-motivational statementsSetting realistic goalsResponding to tricky questionsTailoring messages to the patients stageof change
18. ACTION IN THE COMMUNITY Public education Media advocacy ACTION AT THE STATE AND NATIONAL LEVELSMaking the profession and dental facilities tobacco-free Advocacy with the state and national governments
19. CONCLUSION A majority of cancer deaths worldwideare due to tobacco. These are easily avoidable since the factors associatedwith the disease have long been identified.
20. REFERENCES EssentialsofPreventiveandCommunity Dentistry – Fourth Edition 2009SOBEN PETERTextbook of Public Health Dentistry – First Edition 2011 C M MARYA
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3. TOBACCO CESSATIONYASMIN MOIDIN 2008 BATCH AL AZHAR DENTAL COLLEGE THODUPUZHA
4. INTRODUCTION Prevention of oral cancer mainly focuses on modifying habits associated with the use of tobaccoIndia is the largest consumer of tobacco andthird largest producer of tobacco There are about 250 million tobacco users in IndiaIn India, at least 800,000 deaths every year are related to tobacco use, and 700,000 them due to smokingof
5. There are three well-known approaches Regulatoryapproach 1975: Cigarette Act 1985: National Cancer Control Program 2003:CigarettesProducts Act 2004: WHO-FCTC Serviceapproach screeningandotherTobacco
6. Educational approachRole of the dentist harmfuleffects of tobacco counselpatients tobacco-free tobacco spendlifestyleuse during pregnancymore time with patients reinforcemessages given to patients
7. buildtheirpatient’sinteresttodiscontinue promoteoralhealthandhealthylifestyles speakwith authority in the community effectiveadvocates for tobacco controlin the community
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 visitADVICE of consequence of smoking• In a clear, strong and personalized manner urge every tobacco user to quitASSESS willingness to quit• Is the tobacco user willing to make a quit attempt at this time ?
9. ASSIST with • For the patient willing to make a quit attempt, use counseling cessation and pharmacotherapy to help plant him quit developmentARRANGE for follow-up• Schedule follow-up contact, preferably within the first week after the quit date
10. NICOTINE REPLACEMENT THERAPY Nicotine replacement therapies (NRT) for tobacco use cessation are : Nicotinegum Nicotinepatch Nicotineinhaler Nicotinenasal spray Nicotinelozenges
11. Basic principles for prescribing NRTs Medical Usesupervision is importanta lower dose for less dependenttobacco users Contraindicated,:lactation,diseases, disease, ,incardiovascularperipheral endocrineinflammationthroat,pregnancyoftheoesophagitis,vascular disorders mouthandgastric
12. Nicotine gum useunder medical supervision for apredefined limited period, e.g. 6 weeks, after which the patient has to face withdrawal
13. Nicotine withdrawal symptomsCraving for tobaccoDepressed moodInsomniaIrritabilityFrustrationAnxietyDifficulty in concentrationRestlessnessDecreased heart rateIncreased appetite and weight gain
17. Reflecting feelingsSummarizingAffirmingEliciting self-motivational statementsSetting realistic goalsResponding to tricky questionsTailoring messages to the patients stageof change
18. ACTION IN THE COMMUNITY Public education Media advocacy ACTION AT THE STATE AND NATIONAL LEVELSMaking the profession and dental facilities tobacco-free Advocacy with the state and national governments
19. CONCLUSION A majority of cancer deaths worldwideare due to tobacco. These are easily avoidable since the factors associatedwith the disease have long been identified.
20. REFERENCES EssentialsofPreventiveandCommunity Dentistry – Fourth Edition 2009SOBEN PETERTextbook of Public Health Dentistry – First Edition 2011 C M MARYA