How ongoing conversations will support a patient’s journey to being smoke-freeNews
Posted by: The Probe 9th January 2021
Oral health practitioners have always been ideally placed to support smokers who want to quit. We can opportunistically offer simple, straightforward and practical advice. Often, just the action of asking about smoking status is enough to start a conversation that encourages them to find the confidence to stop.
Research published last summer by Ash (Action on Smoking and Health) declared that “over a million people in the UK” had stopped smoking since pandemic began.[i] We had been seeing a year-on-year decrease in the number of smokers for a while now, but this is an impressive figure. Since early 2020, there have been plenty of headlines that linked smoking with the likelihood of becoming infected with Coronavirus, also more severe symptoms and hospitalisation. Are they the reason why so many smokers stopped?
As healthcare professionals, we look behind the headlines to deliver evidence-based advice. Smoking is generally associated with a greater risk of contracting a viral respiratory infection (as well as developing a host of other life-limiting diseases), but with specific reference to Coronavirus, the data is still emerging. The UK government’s position is that, for people who smoke, Coronavirus symptoms “may be more severe”; the WHO states that more “population-based studies are needed”.[ii],[iii]
Smoking less… or more?
But around the same time as the Ash survey, there was also a suggestion that smokers were smoking more.[iv] Lockdown boredom, working from home with their own rules, rather than office rules, more disposable cash if they weren’t commuting; smokers certainly had plenty of reasons to light up. As the months rolled on, would-be quitters might have developed a “life’s too short” stance too. Context is so important when analysing behavioural data, and these last 18 months have presented an ever-changing context.
Nevertheless, a ‘Quit for Covid’ public health campaign was launched last summer.[v] The resources for healthcare professionals included information relating to smoking and mental health. With smoking rates for people with mental health problems being “at least 50% higher than in the wider population,” targeted advice is essential to ensure these individuals can get the help they need.
If any of your patients used the pandemic as the incentive to quit, this is a fantastic achievement, and they will enjoy ongoing benefits to their oral, general physical and mental health. For ex-smokers, staying tobacco-free is a journey and that’s why going “cold turkey” often fails. Of course, some of your patients may have been lucky enough to have just stopped and stay stopped, but most would have had to put the work in, and will need to keep on working hard, reminding themselves why they no longer choose to smoke.
Staying stopped when times get tougher
When the Coronavirus crisis began, many of us wanted to start taking better care of ourselves, but this enthusiasm may have waned as the months rolled on. The impressive figures from Ash were released last summer; as we moved into autumn and winter, life got a lot tougher for millions of people across the UK. Job losses, local lockdowns, a second national lockdown, no end in sight… no wonder we have seen a surge in poor mental health.
Perhaps a smoker doesn’t feel ready to quit now, because they are too stressed, or maybe a recent quitter can’t fight the urge for a cigarette any longer. We must listen to our patients, engage with empathy and without judgement, to gain their trust. Losing the crutch of a cigarette might seem terrifying, particularly with so much to be anxious about, but the sense of pride if they do stop will be wonderful and might help them cope a bit better.
If an ex-smoker says they are struggling with stress, remind them how staying off the cigarettes won’t make them feel worse. They could use something else to relax, distract or treat themselves instead, which might be something delicious to eat. Relate to your patients by telling them that quitting smoking and staying stopped is the single best thing anyone can do for their health. Not smoking means healthier teeth and gums too. Teach them how to brush properly – they could try TANDEX brushes, which are easy to handle and will remove optimal debris. Maintaining a fresh mouth is another incentive to not put a cigarette into it.
As oral health practitioners, we should be talking about smoking cessation. We must empathise with patients who might be finding it difficult to quit, or to stay stopped – or are simply finding life too hard to contemplate giving up the pleasure they find in a cigarette. Ensure your advice is tailored, practical and non-judgemental. With your help, they can achieve a smoke-free lifestyle and enjoy all the wonderful things this will bring them now and when this crisis finally passes.
Author: Kimberley Lloyd- Rees on behalf of Tandex
Kimberley graduated from the University of Sheffield in 2010, where she now works as a clinical tutor in Dental Hygiene and Therapy as well as working in practice. She has spent her career working across a variety of specialist private and mixed dental practices, for the MOD and volunteering her time to a dental charity in Nepal.
[i] Ash. A million people have stopped smoking since the COVID pandemic hit Britain. Press release, 15 July 2020. Link: https://ash.org.uk/media-and-news/press-releases-media-and-news/pandemicmillion/ (accessed October 2020).
[ii] Gov.uk. COVID-19: advice for smokers and vapers. Published 29 May 2020. Link: https://www.gov.uk/government/publications/covid-19-advice-for-smokers-and-vapers#:~:text=People%20who%20smoke%20generally%20have,more%20severe%20for%20smokers. (accessed October 2020).
[iii] WHO. Smoking and COVID-19. Briefing published 29 June. Link: https://www.who.int/news-room/commentaries/detail/smoking-and-covid-19 (accessed October 2020).
[iv] Millions in UK smoking more amid coronavirus crisis, study suggests. Guardian, 20 May 2020. Link: https://www.theguardian.com/society/2020/may/20/millions-uk-smoking-more-amid-coronavirus-crisis-study-suggests (accessed 2020).
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