Smoking cessation

Question 1

Understand which groups are more likely to smoke

Answer 1

• Prisoners
• People with mental illnesses
• Homeless people
• Drug treatment groups

Question 2

List the reasons as to why people smoke and explain why it is important to know this information

Answer 2

• Addiction: satisfy cravings
• Emotions: stressed, upset, bored or happy
• Pleasure: to enjoy self reward
• Social pressure: be a part of the crowd
• Habits: linked to something

Understanding these triggers can help people to recognize them and plan to cope with quitting.

Question 3

Understand how smoking affects general health

Answer 3

• Increases risk of infections
• Higher need for medical care services than non smokers
• Increases risk of complications after surgery (slower wound healing, respiratory complications) and a lower survival rate after surgery due to body damage
• Require longer hospitalizations
• Absence from work because of illness

Question 4

Describe the effects of smoking on pregnant women

Answer 4

• Greater risk of ectopic pregnancy
• Greater risk of miscarriage
• Greater risk of having a premature and/or low birth weight baby

Question 5

Describe the effects of smoking on children

Answer 5

• The risk of Sudden Infant Death Syndrome is increased in babies of mothers who smoke during pregnancy or after birth

Passive smoking or environmental tobacco smoke can effect the health of children:
• Suffer from asthma and other respiratory infections
• Have more middle ear infections
• Have an increased risk of meningococcal disease

Question 6

Describe the effects of smoking on adolescents

Answer 6

• Adolescents become addicted more quickly due to brain development

Question 7

Describe the effects of smoking on adults

Answer 7

Increases the risk of:
• CVD
• Cancer
• Infertility
• Diabetes
• Premature ageing

Question 8

List possible reasons that can help a client stay smoke- free

Answer 8

• There is a stigma related to being a smoker
• You have restricted access to places, activities
• There is a high cost associated with smoking
• It will help you reduce medication
• It will relieve the stress of neuroadaptation to nicotine (addiction cycle)

Question 9

Explain why smoking is damaging to pregnancy

Answer 9

• When a pregnant woman smokes, about 4000 chemicals enter her bloodstream
• The placenta doesn’t filter them out, so they go straight to the baby
• These enter the baby’s bloodstream then brain, heart, kidneys and so on. In effect, the baby is smoking.

Question 10

Understand the statement “how you smoke is as important as how many you smoke”

Answer 10

• Smokers will unconsciously smoke in a way that meets their need for nicotine(titration)
• If cutting down , they will drag harder on next cigarette, taking more carbon monoxide and tar deeper into the lungs
• If wearing a NRT patch, they will drag lighter as they already have some nicotine in bloodstream

Question 11

Compare the dangers of waterpipe smoking to cigarettes

Answer 11

• The waterpipe smoker may inhale as much smoke in one session as a cig smoker would inhale smoking 50-100 cigs

Question 12

Understand the effects of smoking on oral health

Answer 12

• Smokers are more likely to have periodontal disease than non-smokers
• Increased risk of cancer
• Are less responsive to periodontal treatment than non-smokers
• Have higher incidences of complications after a tooth extraction
• Experience greater tooth loss than non-smokers
• Are more likely to have oral leukoplakia (white patch)
• Have delayed healing and are more vulnerable to infection
• Are not recommended to have implants due to healing vulnerability
• Have stained teeth & restorations
• Have bad breath and impaired taste

Question 13

Describe the following oral effects of smoking:

• Nicotine stomatitis
• Smoker’s melanosis
• Hairy tongue
• Oral candidiasis

Answer 13

Nicotine stomatitis: Palate becomes white with little red spots that project out. Theses red spots mark the opening of the duct of the gland. It is caused by high temperatures in the mouth

• Smoker’s melanosis: brown spots in the mouth
• Hairy tongue: overgrowth of papillae that become stained either green, yellow, black, brown or white. It doesn’t look nice and causes halitosis
• Oral candidiasis: Fungal infection due to weakened immune system

Question 14

Describe the link between periodontal disease and smoking

Answer 14

• The presence of bacterial species is more important in periodontitis pathogenesis than the amount of plaque and debris
• Smokers have higher periodontal pathogens e.g. bacteroides forsythus than non-smokers

Question 15

Describe how smoking affects soft tissue

Answer 15

• Smoking/ nicotine have a vasoconstrictive effect and reduce the blood to gingiva.
• Thus, there is impaired delivery of oxygen and nutrients to gingiva
• Smoking impairs tissue repair ability to junctional epithelium

Question 16

Explain the pathophysiology of smoking

Answer 16

• Nicotine replaces the role of acetylcholine in the brain and causes the release of a lot of dopamine
• It is inhaled and delivered to the blood in seconds, and hits the brain in ten seconds
• There is a short- half life of 20- 40 minutes. Thus, smokers need to constantly “top- up”

Question 17

list the triggers of smoking

Answer 17

stress relief 
drinking 
after meals 
alcohol
driving 
watching TV/ Sport 
running into friends that smoke 
as a reward for doing an activity 
talking on the phone

Question 18

explain the 5 As in helping a person quit smoking

Answer 18

ASK- routine screening

ADVISE- clear personalised advice about quitting smoking from a health profession increases rates

ASSESS- willingness to quite

ASSIST- provide information on why smoking nicotein is addictive have regular sessions and the dental clinic. provide empathy and support and advise the use of pharmacotherapy

ARRANGE FOLLOW UPS- at the dental practice, their GP and a quitline referral

Question 19

identify different types of nicotine replacement therapies NRT available

Answer 19

NRT relieves cravings and withdrawal symptoms while the smoker deals with breaking their habit of smoking

• Nicotine patches
• nicotine gum
• nicotine lozenges
• nicotine inhalers
• mouth spray
• oral strips
• PBS- Champix, patches and Zyban