Smoking Cessation and Alcohol Advice

Question 1

how much does alcohol misuse cost society?

Answer 1

21.5 billion

Question 2

how much does drug misuse cost society?

Answer 2

10.7billion

Question 3

in 2018-2019, how many hospital admissions were there, due to alcohol misuse?

how many aged 45-64?
how many male?

Answer 3

358 admissions = 2.1%

40% in that age cat
62% male

Question 4

what are the general effects of alcohol misuse?

Answer 4

• stroke
• depression, anxiety and suicide
• heart disease
• high blood pressure
• liver disease
• colorectal cancer
• breast cancer
• harmful to unborn babies

Question 5

what are the oral impacts of alcohol misuse?

Answer 5

• increase risk of oral cancer - 30% from alcohol
• irrigation of gum, tongue and tissue
• poor healing
• poor dental habits
• more decay
• poor compliance
• increase risk of periodontal disease

Question 6

what are the general effects of smoking?

Answer 6

• increase risk of cancer

Question 7

what are the oral impacts of smoking?

Answer 7

• 3x more risk increase risk of periodontitis, bone loss
• decreased wound healing
• increase risk of oral cancer - 60% from smoking

Question 8

how does smoking and alcohol affect the cancer risk?

Answer 8

synergistic effect
- the combined effects is greater than individuals put together

Question 9

why do oral changes occur from smoking?

Answer 9

irritants, toxins and carcinogens from burned tobacco
high intramural temperature
pH changes
- the homeostatic environment of oral cavity is changed

Question 10

what current policies, guidance, resources and toolkits are there to support alcohol reduction? (4)

Answer 10

NICE guidleines
government guidelines
AUDIT-C TOOL - 3 questions
VBA - ask, advise, act
FRAMES

Question 11

describe the AUDIT-C tool

Answer 11

alcohol use disorder identification test
- scores
- 0-4 - low risk, state 14 unit rule
- 5-7 - mid risk, think about consequences = hazardous
8-10 - mid risk = harmful
- 10+ - high risk = dependent - direct to GP or local support, give leaflets

3 questions
1. how often do you have a drink with alcohol
- monthly, 2-4 x a month, 2-3x a week, 4+ a week
2. how many units
- 3-4, 5-6, 7-9, 10+
3. how often do you have 6+ units (female) or 8+ (male) on a single occasion in the last year
- less than monthly, monthly, weekly, daily

Question 12

describe the alcohol consumption of a abstainer and lower risk

Answer 12

abstainer - no alcohol
lower risk - no more than 14 units a week, with 2 alcohol free days

Question 13

what current policies, guidance, resources and toolkits are there to support tobacco cessation?

Answer 13

evidence based toolkit
VBA - ask, advise, act
ask at every opportunity the smoking status

Question 14

describe the 5 steps to The Transtheoretical Model (Stages of Change)

Answer 14

1. pre-contemplation
   - people don’t see that there is an issue
   - may be challenging
2. contemplation
   - thinking about it but not planning to make change
3. action
   - making a change
4. maintenance
5. relapse

Question 15

why can the transtheoretical model be criticised?

Answer 15

assumes everyone has a cyclical mindset and works in the same way

Question 16

what’s important when speaking to patients?

Answer 16

be motivational
give the correct, personalised advice

• write down in the notes what you say

Question 17

describe VBA

Answer 17

simple structured advice, 30 seconds
ASK
ADVISE
ACT

Question 18

describe FRAMES

Answer 18

Feedback - personalised
Responsibility of the patient
Advice - clear and practical
Menu - give variety of options
Empathy - warm, reflective
Self-efficacy - boost confidence

Question 19

what are the ICD-10 codes? what are the codes for lip, oral cavity, tonsil, oropharynx, piriform sinus, hypopharynx, other lip-oral cavity-pharynx?

Answer 19

lip - C00
oral cavity - C00-C06
tonsil - C09
oropharynx - C10
piriform sinus - C12
hypopharynx - C13
other lip-oral cavity-pharynx - C14

Question 20

In 2016-18, how many head and neck cancer cases?

Answer 20

12,400 new cases
females - 13th most common cancer, 3,900 cases
males - 4th most common cancer, 8,600 cases

Question 21

in 2017-2019, how many head and neck cancer deaths?

Answer 21

4,100

Question 22

describe VBA with smokers.

Answer 22

ask - ask smoking status
advise - advise benefits when quitting
act - build confidence, give info, refer, prescribe

Question 23

give 9 types of smokeless tobacco, be aware there are many more

Answer 23

1. mishri
2. qiwam
3. khaini
4. naswar
5. gul
6. gutka
7. zarda
8. mawa
9. paan

Question 24

which groups mainly use smokeless tobacco?

Answer 24

mainly south asians

Question 25

describe e-cigs.

Answer 25

developed in china ‘03
- UK, 1.3 mil users (2013)
- do not contain tobacco but nicotine
- long term safety and effectiveness not established
- deemed less harmful than tobacco cigs

Question 26

how are tobacco products regulated?

Answer 26

• must have health warning label
• child-resistant packaging
• cant contain carcinogenic, energy and vitality related additives
• must give advice on usage
• lie responsibility on the user
• dosage
• cant be advertised
• minimum age of sale
• max nicotine concentration = 20mg/ml