Tobacco Module 4

Examining the reach of Smoking Cessation Treatment for Hospital Patients

Smokeless Tobacco

Dental Health Intervention

Electronic Cigarettes

KAMUKansas Association for the Medically UnderservedTobaccoModule 4

1Module 1: Why is it Hard to Quit?Module 2: Ask, Advise, Assist, ReferModule 3: Quit Smoking MedicationsModule 4: Smokeless Tobacco, Dental Health Intervention and E-cigarettesModule 5: Office Systems and Creating a Quit Plan

2Goals: Tobacco Cessation TrainingCommunity Health Clinics

Babalola Faseru, MD, MPHDepartment of Preventive Medicine and Public HealthUniversity of Kansas Medical Center

2Types of Smokeless TobaccoPrevalence, Health Effects, and How to TreatAsk, Advise, Refer Model for Dental PracticeE-cigarettesWhat we knowWhat we dont knowWhat do you tell your patients

3

Objectives

34Smokeless Tobacco

Harmful & Highly Addictive

Babalola Faseru, MD, MPHDepartment of Preventive Medicine and Public HealthUniversity of Kansas Medical Center

4Snus (snoose)Scandinavian moist powder tobacco product (place under upper lipless need to spit)SnusAmericansimilar to Scandinavian but no regulationDipping tobaccomoist snuff (lower lip and gums) causes excess saliva, could require spittingNasal SnuffFinely ground dry form of tobacco snuffed through the noseChewing tobaccolong strands placed between cheeks, gum, or teeth (plugs, wads, chew)Dissolvablesstrips, sticks, orbs and compressed tobacco lozenges

5Types of smokeless tobacco

56HEALTH EFFECTS OF Smokeless tobaccoCancer RiskSmokeless tobacco contains 28 carcinogens Increases the risk of developing several cancers Oral Health DangersIncreases the risk of developing precancerous mouth lesions Strongly associated with recession of the gums.Heart Disease and StrokeStrongly associated with heart disease and strokeAddictionUse leads to nicotine addiction and dependence

http://www.ctri.wisc.edu/HC.Providers/spit/Spit_tobacco_treatment.pdf

Leukoplakia

6Twomain types of smokeless tobacco in the U.S. Chewing Tobacco Snuff

7

NICOTINE & Smokeless

Holding an average-size dip in your mouth for 30 minutes gives you as much nicotine as smoking three cigarettes.

A 2-can-a-week snuff dipper gets as much nicotine as a 1-1/2 pack-a-day smoker does.

http://www.nidcr.nih.gov/OralHealth/Topics/SmokelessTobacco/SmokelessTobaccoAGuideforQuitting.htm

Snus by Andreas Hagerman

7Gender differencesAdult:Males:Dual use: 13.3% Exclusively: 5.3% Females: 30 minutes after awakening or patient is using 3 cans or pouches of tobacco per week: Prescribe 4 mg Nicotine gum (1-2 pieces) every 1-2 hours as needed

If the first dip of the day is > 30 minutes after awakening or patient is using