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Active engagement a key in getting younger smokers to quit

June 16, 2011
Joan M. Davis, RDH, PhD, offers thoughts on how to prevent youth from starting to use tobacco, and if they have already started, how to help them quit.
By Joan M. Davis, RDH, PhD
According to the Centers for Disease Control and Prevention (CDC) approximately 3,450 youth between the ages of 12 and 17 initiate smoking [CDC Youth and Tobacco].(1) In 2009, an average of 17.2% of high school students identified themselves as regular smokers. Though most think they can quit using smoked or smokeless tobacco, many find that quitting is much more difficult than they thought.
Whatever form of tobacco, the neurons in the brain are changed when exposed to nicotine, a highly addictive drug that can readily lead to nicotine dependence, which is a recognized chronic relapsing disease.(2) The level and frequency of exposure, the greater the likelihood nicotine dependence will occur. Though teens may be aware of the dangers of tobacco use through school programs, they are sure nothing will happen to them! As oral health professionals, we have a unique opportunity to see healthy, active youth on a regular basis. We often have a rapport already established with them as they enter tweens and young adulthood. The dental appointment is a perfect time to explore tobacco use. We could ask, “I would like to up-date your health history, could I ask about any tobacco use?” This non-threatening, open-ended question gives the patient an opportunity to respond openly. If the youth indicates no tobacco use, then reinforce a good choice by saying: “That’s great! Great choice!”
Another opportunity to assess tobacco use is during the oral assessment. If any signs of staining or brown hairy tongue are present, we can ask again.(3) Make a note in the chart of any tobacco use and the need to follow-up at the next appointment. They could start at any time.For youth who admit to tobacco use, it is helpful to empathize that it is hard to not smoke around friends who use. Ask the patient if it has been hard to pay for the cigarettes and if they mind the smell on their close or breath. Youth are not concerned about health effects as they are sure that they will never happen to them so an esthetic approach would be more effective. Finally, ask if he/she would like some help with quitting.
Traditional assistance in quitting for adults has not been shown to be that effective for youth such as referral to a quit line. A better approach would be to direct them to a quit web site such as where a teen could create a customized quit plan for themselves. The CDC has an excellent free resource, “Youth Tobacco Cessation: A Guide for Making Informed Decisions,” that contains detailed information on how to help teens quit.(4)The key is to be actively engaged in helping both your young and adult patients quit using tobacco. Become a life-saver! For more information or questions concerning tobacco dependence interventions, contact Dr. Davis at [email protected].References
1. Srivatsan, M., Treece, J. and Shotts, E. E. (2006), Nicotine Alters Nicotinic Receptor Subunit Levels Differently in Developing Mammalian Sympathetic Neurons. Annals of the New York Academy of Sciences, 1074: 505–513. doi: 10.1196/annals.1369.051. 3. 4.
Joan M. Davis, RDH, PhD, is a professor of dental hygiene at Southern Illinois University Carbondale.