Tobacco Intervention Flashcards
Reasons to Get Involved
- Successful interventions save lives
- RDH have a unique opportunity to reach
smokers - Oral evidence of tobacco use 4. Patient respect for oral health professionals
- RDH focus on prevention services
- Practice building aspects
Oregon Tobacco Quit Line
• Oregon Tobacco Quit Line
• http://public.health.oregon.gov/PreventionWellness/Tob
accoPrevention/GetHelpQuitting/Pages/oregonquitline.
aspx
The Quit Line is open seven days a week, 4:00 AM
to 12:00 AM (Pacific time)
• The Oregon Tobacco Quit Line provides free
counseling to help you quit tobacco.
• Call 1.800.QUIT.NOW (1.800.784.8669) or visit
www.quitnow.net/oregon/ to get started.
Washington County Tobacco Prevention & Education Program
• http://www.co.washington.or.us/H
HS/HealthPromotion/TobaccoPrev
ention/
Smoke Free Oregon
• Information & resources for
healthcare providers
• http://www.smokefreeoregon.com/quit
/quit-resources
STATISTICS
● __% U.S. population use tobacco, 18% of Adults in
Oregon.
● Daily 4,000 U.S. youth smoke their first cigarette.
● Smoking cost in healthcare costs 300 billion each year.
● 156 billion in lost productivity.
● ___% of all smokers desire to quit.
- 20%
- 70%
How does tabacco affect the infant/child during pregnancy
Low birth weight
Preterm birth
increase sudden infant death syndrome SIDS)
Tobacco major cause of heart disease by
- Hardens and narrows arteries
- Causes blood to thicken and clot
- May cause heart attack
- Chemicals in cigarrettes (toxic mix of more than 7,000 chemicals and compounds) damage blood cells
- chemicals in tabacco smoke cause inflammation and cell damage
- the body makes white blood cells to respond to injuries, infections, and cancers
- White blood cell counts tend to stay high while a person continues to smoke, as the body is constantly trying to fight against the damage being caused by smoking
Tobacco Effect
Lungs:
- Lung cancer- __ % in men and women smokers
- Major cause of COPD which is
90 %
Chronic obstructive pulmonary disease
Tobacco effects skin how?
Oxidative stress: Insufficient oxygen is supplied to the skin. Causes:
● Tissue ischaemia-restriction of blood supply to skin
● Blood vessel occlusion- chemicals in cigarettes cause blood
vessel narrowing, blockage.
● Reduces innate and host immune responses.
● Induces metallo-proteinase MMP-1-enzyme that
specifically degrades collagen
● Inhibits inflammation.
● Delays wound healing.
Tabacco effects on the eyes
what is the eye condition/destroys the central vision. Cataracts- blurry vision.
Macular degeneration
Tobacco effects on eyes / how?
___-inflammation of eye’s middle layer.Causes blindness.
Dry eye syndrome-chemical irritant causing increased dryness.
___ -transmit dangerous toxins to the placenta causing fetal/infant eye disorder
Uveitis
Pregnancy
JOINTS? Smokers more likely to get ___ ___(R.A.) R.A. medications don’t work as well for smokers.
rheumatoid arthritis
How does smoking cause rheumatoid arthritis
Researchers suspect smoking somehow ignites faulty immune system functioning. People genetically predisposed to getting rheumatoid arthritis have increased risk. Coping: With the pain of rheumatoid arthritis
Feelings of isolation and lack of support.
How does smoking cause rheumatoid arthritis
Researchers suspect smoking somehow ignites faulty immune system functioning.
People genetically predisposed to getting rheumatoid arthritis have increased risk.
Coping: With the pain of rheumatoid arthritis
Feelings of isolation and lack of support.
Effects on GUMS:
Twice as likely to have __ ___
Bad breath, bleeding gums, __ ___
periodontal disease
painful chewing
Tobacco effects on gums-how?
● Creates plaque and tartar: affects saliva flow causing
bacteria to stick to teeth and gums.
● Blood circulation interference:causing infections and
restricting blood flow.
● Leads to oral cancers:six times more likely.
● Changes teeth and breath:stains teeth, cause bad breath.
what is the oral health concern for smokers
tooth decay- dry mouth, smoking and eating goes hand and hand
- How does tobacco affect the lungs?
a. Cells make more mucus
b. Extra mucus decreases infection
c. Reduction in cilia
d. Both a and c.
e. All of the above
d. Both a and c
What are the RDH’s responsibility with tobacco intervention
- Educating their patients on oral manifestations of tobacco use.
- Updating the health history with tobacco use questions.
- Discovering the patient’s motivation to quit tobacco use.
- Assisting in providing information that may be of help to the
patient in ceasing tobacco dependency.
The Five A’s - Tobacco Cessation
ASK: Do you ever smoke or use any type of tobacco? ADVISE: There have been some tissue changes/periodontal disease is getting worse/advise to stop smoking. (individualize based on pt. needs)
ASSESS: Would you like to try to quit? (yes, no, maybe) ASSIST: Engage in behavior change strategies.
ARRANGE: Followup care/resources/coping.
Utilizing Motivational Interviewing for Tobacco Intervention
● Leads an individual to action.
● Voice arguments for change.
● Open ended questions: What do you like about smoking?
● What roadblocks come to mind about stopping?
● Reinforce and focus on comments about stopping.
● Reflective responses: This is what I heard you say.
● Summarize results of dialogue.
Treatment: Elicit-Provide-Elicit Model
Elicit a Responce: ___
Provide:___
Elicients - ___ deceision
-Ask about reasons for quitting/ask about
past quitting attempts/conclude that trying is not failing.
- Help with choosing a quit date or tobacco free date. - Pharmacotherapy options - Finding support from family and friends
- Client’s decision
Another Option- ADHA Model:
Ask, Advise, Refer
Ask- About tobacco use at every visit
Advice- those that currently use tobacco to quit
Refer- resources to refer to for help
24 hour use, delivers constant
dose of nicotine across the skin.
Transdermal patch
OTC doses: 2 mg(less than 25 cigarettes daily) or
4mg(greater than 25 cigarettes daily).
Week 1-6 one piece every 1-2 hours. Week 7-9 one piece every 2-4 hours. Week 10-12 one piece every 4-8 hours.
Gum
Rx only, rapid absorption through nasal
membranes. 2 sprays of .5 mg. of nicotine in each nostril every 1-2
hours. 8 doses daily for 6-8 weeks.
Nicotine spray
Rx. Sustained release. Antidepressant drug. Initially 150
mg. in the morning for three days, 300 mg. for 7-8 weeks.
Zyban
Rx. Blocks neurochemical effects of nicotine. Initially .5
mg taken for three days then 1 mg. for 7 days. Day 8 to 12 weeks 1
mg. twice daily.
Chantix
The Five A’s approach in order is
Ask, advise, assess, assist, arrange
