Effectiveness of Dentist's Intervention in Smoking Cessation- Quit Smoking Method

Vi Hoang & Abigail Garret

Rogers, Lori

DHYG 2301 1A1

04/21/2023
 Introduction

Dentists are a critical asset for healthcare organizations because they help deliver

smoking cessation interventions to the affected patient populations. Smoking is a leading cause

of preventable morbidity and mortality in patients and imposes financial burdens based on

healthcare expenditure and the inability of smokers to work. Smoking cessation interventions

should be integrated into dental care to help smokers quit their smoking habits because more

than half the smokers visit dentists annually (Brown et al., 1). Previous research shows that

clinician assistance in smokers' quit attempts increases the chances for success, hence the need to

ensure dentists know the cessation interventions available to support smokers (Brown et al., 2).

Training and educating dentists on smoking cessation intervention is important for the

effectiveness of smoking cessation aids (Vollath et al., 367). Therefore, promoting smoking

cessation is a top priority for health professionals, especially dentists, through integrating

professional tobacco cessation services.

Medication

Pharmacological interventions have been proven effective in promoting patient smoking

cessation (Piplani et al., 131). Medications such as Varenicline are used in promoting smoking

cessation. Patients are required to take the medication orally for a week. Later twice a day for 12

weeks (Holliday et al. 67). Varenicline is recommended because it interferes with nicotine

receptors in the brain to decrease the pleasure derived from smoking. Varenicline has proved to

be more effective than nicotine replacement therapy or bupropion. The efficacy of

pharmacological therapy has also been confirmed by previous research on bupropion (Pilplani et

al., 131). Bupropion works by decreasing the craving for smoking and also eliminates

withdrawal symptoms. Pharmacological therapy also includes nicotine replacement therapy

(NRT), which is effective in helping people quit smoking (Piplani et al., 131). Nicotine

replacement therapy is administered in varied ways, such as gum or e-cigarettes, for 2 or 4 weeks

to decrease nicotine cravings and withdrawal. Dental professionals can deliver nicotine

replacement therapy (NRT) to increase tobacco abstinence in cigarette smokers (Holliday et al.,

17). In most states, patients have comprehensive insurance coverage to ensure that patients can

receive NRT and stop-smoking medications (Brown et al., 5). The delivery of professional

smoking cessation interventions, both pharmacological and nonpharmacological therapies, is

vital for decreasing smoking.

Behavioral Counseling

Along with medication, one other effective way of being able to quit smoking is to go

through behavioral counseling. This technique focuses specifically on altering a person’s

behavior towards smoking. By using this method, the patient is able to change their thoughts and

behaviors while offering a long-lasting and positive result to actively involve change. According

to studies it has been shown that “single or multiple sessions of advice and support may help

people to stop smoking or using tobacco products” (Holliday et al., 17). There are several steps

in their process, first is to provide manual on how to start this regimen. It also services frequent

telephone operations with the use of motivational interviewing techniques. This allows the

patient to engage in active change by provoking motivation. Many of these programs also

involve videos to provide visual techniques to cope with withdrawal symptoms. Most

importantly, the patient is able to set a “quit date.” By doing this they will be able to have a real

time goal set in order to quit smoking. “On average,106 out of 1000 people stopped compared

with 56 out of 1000 people who did not receive behavioral support. Several sessions of

behavioral programs involving dental professionals may help people to stop using tobacco.”
(Holliday et al., 17). These studies are showing that behavioral programs are the most beneficial

with the support and advice from a dental professional. It is important that patients who smoke

understand the harmful effects of smoking tobacco products can do to their overall oral health.

Ultimately if the patient is unable to quit smoking after the use of medication, they need to

understand how important it is to have knowledge and support. With the use of behavioral

programs, especially alongside a dental professional, they will be able to understand the

progression of oral disease, periodontitis, caries, and furthering diseases which can all be cause

by smoking.

Combination Therapy

If the patient is willing to try either medication or behavioral counseling, studies have

shown that combining both of the techniques have been successful in helping patients to quit

smoking. By using the medication to help with the symptoms of quitting and the counseling to

provide support the patient will hopefully be able to stop the habit all together. This type of

program is designed in order for patients to get all the help they need in both the Pharmacologic

effect and psychological effect. With the use of both medication and behavioral counseling the

patient will be provided with the most adequate techniques to stop smoking. As a clinician, it is

important to offer both forms of therapy in order for the patient to understand every possible

technique to help with their habit.

Motivational Interviewing

An evidence-based, patient-centered strategy called motivational interviewing (MI) has

shown the potential to aid smoking cessation. This approach tries to support people in exploring

their ambivalence against quitting smoking, identifying their unique motivations for change, and
strengthening their resolve to make that change. The efficacy of motivational interviewing for

quitting smoking was assessed in a thorough study by Lindson, Thompson, Ferrey, Lambert, and

Aveyard (2019), providing insights into this strategy's possible advantages and limitations.

Dentists and other oral healthcare practitioners may use motivational interviewing to help people

stop smoking in dental settings. Dental practitioners may employ MI approaches to support

discussions about quitting smoking since they are well-positioned to witness the detrimental

effects of smoking on oral health (Lindson et al., 2019). This patient-centered approach focuses

on extracting patients' justifications for quitting and increasing their will to change to maximize

the chance of successful cessation.

There are for key ideas in motivational interviewing which include; demonstrating

empathy, creating disagreement, dealing with resistance, and boosting self-efficacy. Dental

practitioners may provide a supportive workplace where patients feel heard and valued by

demonstrating empathy. Developing discrepancy requires stressing the difference between the

patient's present behavior (smoking) and their values or objectives to improve the patient's desire

to change. While promoting self-efficacy boosts the patient's confidence in their capacity to stop

smoking, rolling with resistance involves responding to the patient's objections and worries

without being confrontational (Lindson et al., 2019). Although MI has shown potential as a

smoking cessation technique, it is essential to understand its limits. For instance, Lindson et al.'s

assessment from 2019 stated that the quality of the evidence was moderate and that further study

was required to determine the ideal frequency and length of MI sessions. Additionally, owing to

time restrictions or a lack of resources, all dental practitioners may need more resources to apply

MI efficiently since it needs specific training. In conclusion, the patient-centered approach of MI

focuses on extracting patients' justifications for quitting and bolstering their will to change,

which may raise the chance of effective cessation.

Conclusion

Overall, smokers are more likely to quit their smoking habits when provided with the

necessary support, such as pharmacotherapy and nonpharmacological interventions to support

their quit attempts. Dental care professionals can deliver these interventions to increase quit

rates. Medications such as Bupropion, Varenicline, nicotine replacement therapy and other

behavioral therapies increase abstinence rates.

 References

Brown, E. M., Hayes, K. A., Olson, L. T., Battles, H., & Ortega ‐Peluso, C. (2019). Dentist and

hygienist smoking cessation counselling and awareness of Medicaid benefits. Journal of

Public Health Dentistry, 79(3), 246-252.

Holliday, R., Hong, B., McColl, E., Livingstone-Banks, J., & Preshaw, P. M. (2021).

Interventions for tobacco cessation delivered by dental professionals. Cochrane

Database of Systematic Reviews, (2).

Lindson, N., Thompson, T. P., Ferrey, A., Lambert, J. D., & Aveyard, P. (2019). Motivational

interviewing for smoking cessation. Cochrane Database of Systematic Reviews, 7(7).

https://doi.org/10.1002/14651858.cd006936.pub4

Piplani, A., Manjunath, B. C., Kumar, A., Srivastava, M., Kumar, K., & Kundu, H. (2022).

Effectiveness of smoking cessation interventions in dental settings: A randomized

controlled trial. Journal of Indian Association of Public Health Dentistry, 20(2), 131.

Vollath, S. E., Bobak, A., Jackson, S., Sennhenn‐Kirchner, S., Kanzow, P., Wiegand, A., &

Raupach, T. (2020). Effectiveness of an innovative and interactive smoking cessation

training module for dental students: A prospective study. European Journal of Dental

Education, 24(2), 361-369.