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Helping your patients to stop smoking
EDITORIAL .I Oral Maxillofac Surg 43238.
19x5
Helping Your Patients to Stop Smoking support patients’ efforts not only by checking on tobacco use and reinforcing positive behavior during subsequent appointments but also by providing encouragement by means of periodic telephone calls even after you have finished treating the patient surgically. For those practitioners who have neither the time nor the inclination to become personally involved in a counseling program, it is advisable to refer patients desiring help to a smoking cessation program or clinic. However, even in such cases, the oral and maxillofacial surgeon can be very helpful by continuing to offer positive reinforcement through verbal or written communication with the patient. For those patients who were treated for smokingrelated oral conditions, such support can also be given during periodic follow-up visits. In a recent study, O’Shea and Corah found that dentists’ cigarette smoking habits were related to their effectiveness as role models for their patients as well as to how likely they were to influence patients to stop smoking. For example, those dentists who did not smoke forbid smoking in their waiting rooms much more frequently and talked to their patients more often about the hazards of cigarette smoking. Likewise, whereas 86 per cent of dentists who had never smoked advised their patients to stop smoking, only 65 per cent who smoked did so. While studies have indicated a steady decline in smoking among dentists in the past 15 years, as well as an increase in the belief that they should help their patients to stop smoking, there is still room for improvement in both areas. Since O’Shea and Corah have shown that both those dentists who never smoked and those who smoked and stopped were equally good role models, and had the same positive attitude about patients’ cessation of smoking, it is clearly to the benefit of the patient and the practitioner when the dentist stops smoking. Although it has been said that only 1 or 2 per cent of patients who attempt to stop smoking as a result of encouragement by the dentist will stay away from cigarettes permanently, this is still a significant contribution when one considers the potential number of persons who can be reached and the health benefits that they can derive.
There is little doubt that smoking is a health hazard. Besides staining the teeth and giving a bad odor to the breath, smoking is associated with the more serious problems of increased risks of chronic bronchitis and pulmonary emphysema, a higher death rate from coronary artery disease, a greater incidence of leukoplakia and oral cancer, and cancer of the lung. In 1980, the Surgeon General of the Public Health Service went so far as to call smoking the chief avoidable‘cause of death in our society and the most important health issue of our time. Despite intensive efforts to warn the public about the potential dangers of smoking, there are still over 53 million smokers in the United States today. Since more than 30 million persons visit the dentist’s office each year, a large percentage of smokers must eventually find their way to the oral and maxillofacial surgeon. We are thus in an excellent position to help our patients to stop smoking. As members of the health profession we have the appropriate prestige and authority, as well as the respect of those whom we treat, to make them receptive to such a preventive health message. There are a number of ways we can influence the smoking habits of our patients. We can begin by not permitting smoking in the reception areas of our offices. This effort should be reinforced by having educational material available for the patient to read that explains both why this request has been made and, particularly, the advantages to the patient of complying with the request. As a follow up, when their history is being taken, all patients should be asked if they smoke. For those with a positive history there are two things that should always be done. First, the patients should be informed about the general as well as oral health problems that can occur from the use of tobacco and the benefits to be derived from stopping smoking. Second, the patients should be asked if they would like to stop smoking. For those who choose the latter alternative, there are a variety of ways in which they can be helped. One thing that can always be done to guide patients is to provide literature or audiovisual presentations on how to go about quitting. You may even go one step further and provide personal counseling for the patient. In both instances it is important to
DANIEL M. LASKIN
238
19x5
Helping Your Patients to Stop Smoking support patients’ efforts not only by checking on tobacco use and reinforcing positive behavior during subsequent appointments but also by providing encouragement by means of periodic telephone calls even after you have finished treating the patient surgically. For those practitioners who have neither the time nor the inclination to become personally involved in a counseling program, it is advisable to refer patients desiring help to a smoking cessation program or clinic. However, even in such cases, the oral and maxillofacial surgeon can be very helpful by continuing to offer positive reinforcement through verbal or written communication with the patient. For those patients who were treated for smokingrelated oral conditions, such support can also be given during periodic follow-up visits. In a recent study, O’Shea and Corah found that dentists’ cigarette smoking habits were related to their effectiveness as role models for their patients as well as to how likely they were to influence patients to stop smoking. For example, those dentists who did not smoke forbid smoking in their waiting rooms much more frequently and talked to their patients more often about the hazards of cigarette smoking. Likewise, whereas 86 per cent of dentists who had never smoked advised their patients to stop smoking, only 65 per cent who smoked did so. While studies have indicated a steady decline in smoking among dentists in the past 15 years, as well as an increase in the belief that they should help their patients to stop smoking, there is still room for improvement in both areas. Since O’Shea and Corah have shown that both those dentists who never smoked and those who smoked and stopped were equally good role models, and had the same positive attitude about patients’ cessation of smoking, it is clearly to the benefit of the patient and the practitioner when the dentist stops smoking. Although it has been said that only 1 or 2 per cent of patients who attempt to stop smoking as a result of encouragement by the dentist will stay away from cigarettes permanently, this is still a significant contribution when one considers the potential number of persons who can be reached and the health benefits that they can derive.
There is little doubt that smoking is a health hazard. Besides staining the teeth and giving a bad odor to the breath, smoking is associated with the more serious problems of increased risks of chronic bronchitis and pulmonary emphysema, a higher death rate from coronary artery disease, a greater incidence of leukoplakia and oral cancer, and cancer of the lung. In 1980, the Surgeon General of the Public Health Service went so far as to call smoking the chief avoidable‘cause of death in our society and the most important health issue of our time. Despite intensive efforts to warn the public about the potential dangers of smoking, there are still over 53 million smokers in the United States today. Since more than 30 million persons visit the dentist’s office each year, a large percentage of smokers must eventually find their way to the oral and maxillofacial surgeon. We are thus in an excellent position to help our patients to stop smoking. As members of the health profession we have the appropriate prestige and authority, as well as the respect of those whom we treat, to make them receptive to such a preventive health message. There are a number of ways we can influence the smoking habits of our patients. We can begin by not permitting smoking in the reception areas of our offices. This effort should be reinforced by having educational material available for the patient to read that explains both why this request has been made and, particularly, the advantages to the patient of complying with the request. As a follow up, when their history is being taken, all patients should be asked if they smoke. For those with a positive history there are two things that should always be done. First, the patients should be informed about the general as well as oral health problems that can occur from the use of tobacco and the benefits to be derived from stopping smoking. Second, the patients should be asked if they would like to stop smoking. For those who choose the latter alternative, there are a variety of ways in which they can be helped. One thing that can always be done to guide patients is to provide literature or audiovisual presentations on how to go about quitting. You may even go one step further and provide personal counseling for the patient. In both instances it is important to
DANIEL M. LASKIN
238