smoking cessation Flashcards
what is the prevalence of smoking in adults
- uk = 14.1%
- Scotland 19%
- quite even between males and females
how is smoking influenced by deprivation
- SIMD1 = 27%
SIMD5 = 9%
what is the prevalence of smoking in young peopl
- very low for 13-15 in Scotland
- 2% 13 y/o and 7% 15 y/o
- 17% of children under 16 report exposure to smoke in the home
what is the age of purchase
- rose from 16 to 18
what effects can smoking have on dental health
- oral cancer, periodontal disease
what are the different advice on quitting
- very brief advice (VBA) = 1minute
- brief advice = 3-10 minutes and can include 5 A’s
- detailed advice = up to 30 mins
what advice do dentists give
- usually don’t have much time
- usually give either VBA or brief
what are the 3 A’s of public health England
- very brief
- Ask = establish and record smoking status
- Advise = on personal benefits or quitting
- Act = offer help and sign post to local stop smoking services
what are the 5 A’s
- brief
- Ask
- Advise
- Assess
- Assist
- Arrange follow ups
what are some things to ask patient
- about smoking status
- no. of cigs smoked a day, no. of years a smoker
- age started
- what products used
- quitting history
what is Pack Years
- 1 pack (20) a day = 1 pack year
- 10 cigarettes a day for 10 years = 5 pack years
how many cigarettes in a pack
- 20
how can you act
- depends on what is available locally
- specialist services /pharmacy services
- up to the patient
are specialist services good for advice
- tend to have better outcomes as they are more trained
- get greater success
are pharmacy services good for advice
- have greater reach, accessibility
- lots of people go there
- glasgow has quite a bit pharmacy service
how do you refer patient electronically
- TrakCare
- new request
- other
- smoking cessation services
what are the oral side effects of tobacco
- cause oral cancer, potentially malignant lesions
- periodontal disease
- increase dental treatment risks and problems
- have significantly higher medical risks, compromised health and more days of illness
how much more likely are smokers than non-smokers to get oral cancer
- 2-4 times
how much more likely are smokes than non-smokers to get periodontal disease
- 2-6 times
what is the prevalence of oral cancer
- more men than women, but ratio is decreasing
- links with deprivation
- risk depends on age, genetics and exposure to risk factors
what is the aetiology of oral cancer
- tobacco and alcohol are main determinants
- a diet in ACE vitamins thought to be protective
- sunlight
- pre-existing mucosal abnormalities
- HPV, younger age groups
what is leukoplakia
- a white patch that cannot be rubbed off
what are the chances of smokers getting leukoplakia
- can occur 6 times more in smokers
why are smokers more likely to get leukoplakia
- when you smoke, what’s in the tobacco pools at the floor of the mouth
- makes that area more subject to the toxins
what is the malignant transformation rate of leukoplakia
- varies
- 0.6-30%
what is erythroplakia
- patient has a long history of chronic white and red lesions of soft palate more likely for malignant transformation than white patches
how is smoking and periodontal disease associated
- smoking is associated with increased rates of alveolar bone loss, attachment loss and pocket formation
- 40% of chronic periodontitis
- has a masking effect on gingival symptoms of inflammation = bleed less on probing
how does smoking affect implants
- failure rate of implants in smokers is at least 2 times that of non-smokers
- implants are more likely to fail in the maxilla
how else can tobacco affect the oral cavity
- staining of teeth, dentures etc.
- nicotinic stomatitis = smokers palate
- smokers melanosis = pigmentation
- blak hairy tongue
- aphthae tend to be less common
- extractions take longer to heal
how is the black hairy tongue caused
- by nicotine staining papilla on the tongue
why do people smoke
- enjoyment
- keep weight down
- help concentrate
- relieve boredom
- socialise
- cope with stress
how does smoking keep weight down
- nicotine is an appetite suppressant
what are some withdrawal symptoms
- cravings
- sweating
- nausea/abdominal cramps
- headaches
- coughing
- sore throat
- insomnia
- difficulty concentrating
- anxiety
- irritability
- depression
- weight gain
- tingling in hands/feet
- nicotine dependance
what is nicotine dependance
- a chronic relapsing disease defined as a compulsive craving to use the drug despite harmful consequences
how does a smoker exhibit tolerance
- the more you smoke, the more you need to get the ‘hit’ from the cigarette
is nicotine harmful to health
- no
- it is the addictive element but it is not harmful to health
how many smokeless tobacco products are there
- roughly 30 now
what are the health risks of smokeless tobacco
- will vary
- can have 100 times the tobacco specific nitrosamines (TSNA) than a cigarettes
- higher TSNA is worse
what is Snus
- illegal to buy in UK
- moist powder tobacco
- placed under upper lip, can cause recession
- recession around upper incisors
- less lethal than tobacco
- Sweden
what are Skoal Bandits
- illegal to buy in UK
- american
- dipping tobacco, moist
- less lethal than tobacco
what is Shisha/Hookah
- hookah operated by a water filtration and direct heat
- scented tobacco is crumbled into the bowl
how much more CO and nicotine do you get from a hookah than a cigarette
- from a single 45 minute session, double CO and triples nicotine exposure
- equivalent to 10 cigarettes
what are the health risks of hookah
- TB airborne transmission
- hepatitis A
- helicobacter pylori
- pulmonary aspergillosis = pipe sharing
- not a safe alternative to cigarettes
what are the different types of nicotine replacement therapy
- patches, gum, inhalers, nasal spray, lozenges, microtabs, oral strips, varenicline (Champix), bupropion (zyban), e-cigs
what is NRT used for
- to deal with withdrawal symptoms
- increases success of quitting
how much more effective is quitting with NRT
- increases success by 50-70%
what are some side effects of NRT
- skin irritation
- oral irritation
how does Champix increase chance of quitting
- 2-3 times increase chances of quitting compared to willpower alone
what is the most reported side effects of Champix
- nausea
- people on champion need to be monitored
which produces better quit rates, champix or zybsn
- Champix
who should use e-cigarettes
- ex smokers or current smokers
- non-smokers should not
are e-cigs safer than cigarettes
- yes
- but the long term affects of them are unknown as they are so new
what is vaping
- the act of inhaling and exhaling the water vapour produced by an electronic device
- e-liquid in gaseous form
what is in the liquid of e-cigs
- propylene glycol
- vegetable glycerine
- natural artificial flavourings
- nicotine level
what is propylene glycol
- thinner more flavour, throat hit
- in asthma inhalers
what is vegetable glycerine
- thicker, big clouds, smooth
- cough medicine
what are the different levels of nicotine
- 0%
- 1.5/0.15%
- 3 mg/ml
- 6 mg/ml
- 12 mg/ml
- 18 mg/ml
what is second hand smoke
- term for smoke that non-smokers are exposed to
what is mainstream smoke
- what smokers inhale then exhale
what is side stream smoke
- wafts off the end of a lit cigarette
- 88% of smoke
- contains more carcinogens
what is third-hand smoke
- carcinogen laden residue that builds up on surfaces
