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The dentist's role in smoking cessation management – a literature review and recommendations: part 2

From Volume 45, Issue 4, April 2018 | Pages 298-309

Authors

Ross M Keat

BDS, MFDS, PgCert

Birmingham Dental Hospital/School of Dentistry

Articles by Ross M Keat

Jean-Christophe Fricain

DDS, PhD

Université de Bordeaux

Articles by Jean-Christophe Fricain

Sylvain Catros

DDS, PhD

Université de Bordeaux, 33000 Bordeaux Cedex, France

Articles by Sylvain Catros

Luis Monteiro

DDS, MSc, PhD, Dip Oral Med

Instituto Universitário de Ciências da Saúde (IUCS)

Articles by Luis Monteiro

Luis Martins da Silva

DDS, PhD

Instituto Universitário de Ciências da Saúde (IUCS), 4585-116 Gandra PRD, Portugal

Articles by Luis Martins da Silva

Marcio Diniz Freitas

DDS, PhD

School of Medicine and Dentistry, University of Santiago de Compostela

Articles by Marcio Diniz Freitas

Angel Brandariz

DDS, PhD

School of Medicine and Dentistry, University of Santiago de Compostela, Spain

Articles by Angel Brandariz

Giovanni Lodi

DDS, PhD

Dipartimento di Scienze Biomediche Chirurgiche e Odontoiatriche

Articles by Giovanni Lodi

Alberto Pispero

DDS

Dipartimento di Scienze Biomediche Chirurgiche e Odontoiatriche, Milan 20142, Italy

Articles by Alberto Pispero

Saman Warnakulasuriya

OBE, BDS, PhD, FDS RCS, DSc

Department of Oral Medicine and Pathology, Guy's, King's and St Thomas’ School of Dentistry, WHO Collaborating Centre for Oral Cancer and Precancer, King's College London, Denmark Hill Campus, Caldecot Road, London SE5 9RW

Articles by Saman Warnakulasuriya

Zahid Khan

BDS, MFDS

Birmingham Dental Hospital/School of Dentistry

Articles by Zahid Khan

Rui Albuquerque

LMD, MS, DAS, PhD, PGCME, FHEA, FDS RCS(OM)

Birmingham Dental Hospital/School of Dentistry, University of Birmingham, 5 Pebble Mill Road, Birmingham B5 7EG, UK

Articles by Rui Albuquerque

Abstract

Abstract: By utilizing the ‘stages of change’ approach to smoking cessation an individual's willingness to quit smoking can be ascertained, with provision of knowledge on potential interventions empowering patients to make their own decisions on cessation modalities. Nicotine Replacement Therapy (NRT) can reduce physical cravings, pharmacotherapies can reduce the desire to smoke, stop smoking services can provide smokers with interpersonal support and electronic cigarettes are increasing in popularity but cannot be recommended as a completely safe way of delivering nicotine. Interpersonal support in combination with NRT and/or pharmacotherapy is the safest and most successful method of smoking cessation.

The authors are developing an online resource to assist with smoking cessation advice. It is available at http://www.smokingcessationtraining.com/.

CPD/Clinical Relevance: For a patient who is amenable to brief cessation advice, the stages of change model allows the dentist to adapt brief advice to the patient's current circumstances. By improving knowledge of smoking cessation modalities, the dentist can answer any simple questions the patient may have, signposting them towards specialist cessation centres when appropriate.

Article

During the second part of this article the ‘Transtheoretical Model’ of smoking cessation is discussed, which allows an understanding of the ‘stage’ of smoking or cessation patients currently occupy. Dental professionals can then tailor their brief advice to patients' individual needs.

Most tobacco users continue their use because they are addicted to nicotine. By smoking, long-term users modify their brain chemistry, meaning that it can be very difficult for individuals to stop.1 This can be replaced with ‘clean nicotine’ via nicotine replacement therapy (NRT), or the pleasurable effects of nicotine can be removed through utilization of pharmacotherapies.

Although nicotine plays a large part in an individual smoking, the process is undoubtedly multi-factorial. Pharmacology, genetics, learned habits and social/environmental factors all play their part.2 By smoking, users feel they can regulate their mood alongside their mental and physical abilities.3 Stop smoking services attempt to address these barriers during an individual's smoking cessation attempt.

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