Christoph A. Ramseier
Saman Warnakulasuriya
Ian G. Needleman
Jennifer E. Gallagher
Aira Lahtinen
Co-authors of the 2 European Workshop’s Position Papers†

Summary of the

Tobacco consumption has been identified as a major risk factor for pathological changes in the oral area, e.g. periodontal disease and cancer. Exiting tobacco offers the possibility of a reduction in cancer precursors, improved long-term success of periodontal treatment and improved periodontal status compared to patients who continue to smoke. Providing help to stop smoking is thus partly the responsibility of dental professionals and the dental profession in general. Tobacco cessation should consist of supporting a change in behaviour. Accompanied by medicinal measures, the probability of success becomes even higher. It is generally accepted that appropriate remuneration for smoking counselling would provide dental professionals with a greater incentive to offer these measures. Therefore, it should be possible for dental professionals to obtain remuneration for smoking counselling and it should be in proportion to other treatments. International and national institutions for dental professionals are urged to promote all efforts to prevent and eliminate smoking among the population, communities and personal contacts, including the integration of these measures into pre-clinical and clinical education. To facilitate acceptance of weaning strategies by dental professionals, we propose a step-by-step care model: 1) basic care: a brief survey of all patients in the practice to assess smoking status, willingness to quit, and permission to ask for it during further visits to the dentist; 2) middle care: (short) surveys on current motivation to drop out, tools to support this behavioural change, including medication, and 3) advanced care: intensive care to develop a detailed drop-out plan, including the use of appropriate medication. To ensure that the effective use of smoking cessation becomes a generally accepted standard, training and refresher courses should be organised and regularly offered to all dental professionals.

key words

* Original article: Consensus Report: 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals. Int Dent J. 2010 Feb; 60(1):3–6

† Die 53 Teilnehmer des 2nd European Workshop on Tobacco Prevention and Cessation for Oral Health Professionals sind (in alphabetischer Reihenfolge): Anja Ainamo, (Finland), Ivan Alajbeg, (Croatia), David Albert, (U. S. A., Correspond.), Nadia Al-Hazmi, (Saudi Arabia), Magda Ecaterina Antohé, (Romania), Johann Beck-Mannagetta, (Austria), Habib Benzian, (France, Correspond.), Jan Bergström, (Sweden), Viv Binnie, (Scotland), Michael Bornstein, (Switzerland), Silvia Büchler, (Switzerland), Alan Carr, (U. S. A.), Antonio Carrassi, (Italy), Elias Casals Peidró, (Spain), Iain Chapple, (United Kingdom, Correspond.), Sharon Compton, (Canada – English), Jon Crail, (France), Karen Crews, (U. S. A., Correspond.), Joan Mary Davis, (U. S. A.), Thomas Dietrich, (United Kingdom), Birgitta Enmark, (Sweden), Jared Fine, (U. S. A., Correspond.), Jennifer Gallagher, (United Kingdom), Tony Jenner, (United Kingdom), Doriana Forna, (Romania), Angela Fundak, (Australia), Monika Gyenes, (Hungary, Correspond.), Marjolijn Hovius, (Netherlands), Annelies Jacobs, (Netherlands), Taru Kinnunen, (U. S. A.), Ron Knevel, (Netherlands), Anne Koerber, (U. S. A.), Roberto Labella, (United Kingdom), Aira Lahtinen, (Finland), Martina Lulic, (Switzerland), Nikos Mattheos, (Sweden), Andy McEwen, (United Kingdom, Correspond.), Ian Needleman, (United Kingdom), Kerstin Öhrn, (Sweden), Argy Polychronopoulou, (Greece), Philip Preshaw, (United Kingdom), Nicki Radley, (United Kingdom), Christoph Ramseier, (Switzerland), Josine Rosseel, (Netherlands), Meta Schoonheim-Klein, (Netherlands), Jean Suvan, (United Kingdom, Correspond.), Sabina Ulbricht, (Germany), Petra Verstappen, (Netherlands), Clemens Walter, (Switzerland), Saman Warnakulasuriya, (United Kingdom), Jan Wennström, (Sweden, Correspond.), Seppo Wickholm, (Sweden), Liana Zoitopoulos, (United Kingdom)

Beck-Managetta Johann, Salzburg Regional Hospitals, Department of Maxillofacial Surgery, Müllner Hauptstr. 48, 5020 Salzburg, Austria

Consensus Report: 2 nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals

summary

Tobacco use has been identified as a major risk factor for oral disorders such as cancer and periodontal disease. Tobacco use cessation (TUC), on the other hand, is associated with the potential for reversal of precancer, enhanced outcomes following periodontal treatment, and better periodontal status compared to patients who continue to smoke. Consequently, helping tobacco users to quit has become a part of both the responsibility of oral health professionals and the general practice of dentistry. TUC should consist of behavioural support, and if accompanied by pharmacotherapy, is more likely to be successful. It is widely accepted that appropriate compensation of TUC counselling would give oral health professionals greater incentives to provide these measures. Therefore, TUC-related compensation should be made accessible to all dental professionals and be in appropriate relation to other therapeutic interventions. International and national associations for oral health professionals are urged to act as advocates to promote population, community and individual initiatives in support of tobacco use prevention and cessation (TUPAC) counselling, including integration in undergraduate and graduate dental curricula. In order to facilitate the adoption of TUPAC strategies by oral health professionals, we propose a level of care model which includes 1) basic care: brief interventions for all patients in the dental practice to identify tobacco users, assess readiness to quit, and request permission to re-address at a subsequent visit, 2) intermediate care: interventions consisting of (brief) motivational interviewing sessions to build on readiness to quit, enlist resources to support change, and to include cessation medications, and 3) advanced care: intensive interventions to develop a detailed quit plan including the use of suitable pharmacotherapy. To ensure that the delivery of effective TUC becomes part of standard care, continuing education courses and updates should be implemented and offered to all oral health professionals on a regular basis.