وصف
More than five million people die prematurely each year due to tobacco use, which is a significant preventable cause of disease and premature death. Both oral and overall health can be badly harmed by smoking or chewing tobacco. Professionals in oral health are crucial in encouraging tobacco-free living. They should advise their patients to quit smoking, reiterate the anti-tobacco message, and direct them to resources for doing so.
ملخص
- Tobacco use is a disease, and users are patients according to international classifications, yet this isn't consistently reflected in hospital coding practices, hindering the ability to accurately assess the burden of tobacco-related illnesses.
- Tobacco is a pandemic, causing far more deaths annually than COVID-19, including deaths from passive smoking, and deserves the recognition and more intense interventions associated with that designation.
- Quitting tobacco at any age provides health benefits, including reducing the severity of tobacco-related illnesses, and making treatment easier, with early cessation preventing the onset of these illnesses altogether.
- The "EMPOWER" approach, promoted by WHO, is a holistic strategy for tobacco control, offering ways to help users quit and emphasizing the responsibility of healthcare providers to deliver cessation advice at every clinical encounter.
- Nicotine is an addictive substance in tobacco that leads to chronic relapse. People start with exploration, then move to experimentation, then to habits and finally to addiction. Key to quitting success is eliminating triggers: people, places, and times associated with tobacco use.
- Nicotine affects the brain by releasing substances like dopamine, leading to physiological alterations and behaviors associated with addiction, including tolerance, dependence, withdrawal symptoms, and stress-induced relapses.
- A quick assessment of nicotine addiction involves checking if tobacco is used over 10 times in 24 hours or within 30-60 minutes of waking. Addiction is also indicated by withdrawal symptoms and continued use despite tobacco-related illnesses.
- The transtheoretical model of change categorizes users into pre-contemplation, contemplation, preparation, action, and maintenance stages, allowing for tailored counseling approaches.
- "5 A's" (Ask, Advise, Assess, Assist, Arrange) is a strategy to help people quit tobacco, while "5 R's" (Relevance, Risks, Rewards, Roadblocks, Repetition) are used for those not ready to quit, emphasizing keeping the door open for future attempts. In the absence of time, practice 2 A's and R.
- A systems approach to tobacco cessation involves screening for tobacco use, treating users with counseling and pharmacotherapy, and providing post-treatment follow-up.
- Counseling can range from minimal intervention to intensive motivational interviewing, focusing on changing behaviors and eliminating triggers, while pharmacotherapy helps manage withdrawal symptoms.
- Available pharmacotherapies include nicotine replacement therapy (NRT) in the form of gums, lozenges, and patches, as well as bupropion, with choice and combination guided by patient needs and contraindications.
- A supportive environment, along with "7 Ds" (Drink Water, Deep Breathing, Delay, Distract, Discuss, Diet, Determined), are important skills for quitting, as are other diversions (listening to music, dancing, gardening, walking).
- Determinants of successful quitting include being in the preparation phase, access to quit portals, not changing the quit date, implementing skills to stay quit, living in a tobacco-free environment, using pharmacotherapy optimally, following up regularly, and having social support.
- A tobacco cessation clinic is a cost-effective, win-win model requiring management support, qualified consultants, a systems approach, data management, and a commitment to help people quit.
- Tobacco cessation is a readily achievable and high-impact intervention, and healthcare professionals should actively address this risk factor to reduce the burden of tobacco-related diseases.
نموذج شهادة
حول المتحدثين
الدكتور راكيش جوبتا
رئيس مؤسسة راجاستان للسرطان، جايبور
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