Moitraiyee, Sunayana Manipal, Amit Mahuli, Simpy Mittal, Sathish Kumar.D, Barani.K, Ram Narayanan
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1 Moitrayee et al INTERNATIONAL JOURNAL OF PREVENTIVE DENTISTRY AND ORAL EPIDEMIOLOGY Research Article SMOKING CESSATION ADVICE : KNOWLEDGE, ATTITUDE AND PRACTICE AMONG DENTISTS AND YOUNG ADULTS- A CROSS SECTIONAL STUDY. Moitraiyee, Sunayana Manipal, Amit Mahuli, Simpy Mittal, Sathish Kumar.D, Barani.K, Ram Narayanan Abstract: Aim: To know about the knowledge, attitude, and practice among the dentist in giving smoking cessation advice and to know about the knowledge and practice of smoking among young adults. Materials and Methods: A self administered questionnaire was prepared and distributed among the dentist and young adults of Chennai, India. The survey was done among 100 dentists and 100 adults.results: The survey was done among a total of 200 subjects out of which 100 dentists and 100 adolescents of Chennai, India. It was found that around 44% of young adults started to smoke at the age of years.51% of the dentists failed to give smoking cessation advice because of lack of time in the clinics were as 49% dint feel they had lack of time.45% of the dentists prefer to give pamphlets on smoking cessation advice and 55% of the dentist preferred to talk directly to the patients. Conclusion: There is still a lack of practice and knowledge in all the components of smoking cessation advice.4a model of cessation advice (ask, advice, assist and arrange for follow up) should be introduced to the dentists in their curriculum. Keywords : Smoking cessation advice, smoking attitude, curriculum Introduction: The effect of smoking varies from person to person as it will depend on the person's vulnerability to the chemical in cigarette or tobacco smoke 1. There are approximately 120 million smokers in India, about 37 percent of all men and 5 percent of all women between the ages of 30 and 69 2 are found to be smoking. Smoking kills 900,000 people every year in India, and unless corrective action is taken soon that number will increase to 1 million smoking-related deaths annually by More than 50 percent of the tobacco-related deaths in India occur among illiterate men or women. 2 they have a higher risk of developing diseases like: bronchitis), heart attack and other coronary diseases. 4 Most people, who smoke would have, begin smoking before they are 25 years old. Nearly 10 million cigarettes are sold every minute, that s around 15 billion daily. 5 As more than 50% of smokers see a dentist 6-7 in one year it becomes the duty of the dentist to be able to give a proper smoking cessation advice for a better living and better future of mankind. Materials and Methods: Because they experience these different side effects, A cross sectional study was done on a total population of [INTERNATIONAL JOURNAL OF PREVENTIVE DENTISTRY AND ORAL EPIDEMIOLOGY1:1 [2012] : 1-7]Page 1
2 200 subjects out of which 100 were adults and 100 were dentists of Chennai to know about their knowledge and attitude towards smoking and smoking cessation advice. Adults having smoking habits were included in the study. Ethical clearance was obtained prior to the conduct of survey from the department of public health department and oral epidemiology. The study was conducted among the students and dentists of SRM dental college and Ramachandra Dental College of Chennai, India. A pretesting was done among 10 dentists and 10 adults before the study was conducted. The result of this was not included in the main study. Two self administered questionnaire written in English was prepared for this study. It contained a set of fifteen questions and was hand distributed personally to male and female dentists in Chennai in the month of March 2011 and April It contained question regarding the difficulty faced in giving smoking cessation advice and their knowledge and attitude in giving smoking cessation advice. Another self administered questionnaire survey was done among the young adults of Chennai basically college going students to know about their knowledge attitude and practice of smoking habits which contained a set of fourteen question. Each question had two or three options and they had to choose from them. Data collected were entered into spreadsheets. Data was analyzed using SPSS software version Results: Table1 shows that 55% of the people are aware of the ill effects of smoking yet they smoke and 45%of the people were not aware of ill effects.53% of the people smoke more when they are tensed and 47 % of the people said they did not smoke more when they are tensed.54% of the people used other tobacco products but 46% did not use other tobacco products.51%of the people had knowledge about passive smoking and 49% of the people did not know about passive smoking.64% tried to give up smoking and 36% have not tried giving up smoking.55% asked help from others to quit smoking and 45% of the people don t want any help. Table 2 shows that 55% of the people were aware of the ill effects of tobacco and 25% of the people used other tobacco products.45% of the people were not aware of the ill effects and 17% of the people did not use other tobacco products. There was no significant association between awareness and tobacco use. Table 3 shows that out of the total population 61% of the dentists always advice their patients to quit smoking and 39%of the dentists won t advice always. 70 % of the dentists were comfortable to ask their patients about their habits. But 30% of the dentists were not comfortable to ask.51% of the dentists didn t ask their patients about their habits due to lack of time in their clinics.49% of the dentists didn t have lack of time. 43% of the dentists prefer to talk straight away in front of child s parents and 57 % didn t like to talk in front of the parents.45% of the dentists prefer giving leaflets to the patients on quitting smoking and 55%of the dentists preferred to talk to them directly. [INTERNATIONAL JOURNAL OF PREVENTIVE DENTISTRY AND ORAL EPIDEMIOLOGY1:1 [2012] : 1-7]Page 2
3 Table 1: Knowledge, attitude and practice of smoking. Sl.no KNOWLEDGE ATTITUDE AND PRACTICE Yes no Total 1 ARE YOU AWARE OF THE ILL EFFECTS OF SMOKING DO YOU SMOKE MORE WHEN YOU ARE TENSED YOU KNOW SMOKING CAUSES STAINING IN TEEETH YOU USE ANNY OTHER TOBACCO PRODUCTS? YOU HAVE BAD BREATH DOES ANYONE IN YOUR FAMILY SMOKES? YOU KNOW ABOUT PASSIVE SMOKING HAVE YOU EVER TRIED GIVING UP SMOKING DO YOU WANT HELP FROM ANYONE IN QUITING SMOKING? [INTERNATIONAL JOURNAL OF PREVENTIVE DENTISTRY AND ORAL EPIDEMIOLOGY1:1 [2012] : 1-7]Page 3
4 Table 2 : Association between awareness of ill effects of tobacco and tobacco usage. ILL EFFECTS AWARENESS USE OF OTHER TOBACCO PRODUCTS Total Yes No Yes No Total Pearson chi square=4.475 Df=2 P=0.107 Table 3: Smoking cessation advice given by dentist Sl no SMOKING CESSATION ADVICE GIVEN BY DENTIST Yes No total 1 ALWAYS ADVICE YOUR PATIENTS TO QUIT SMOKING ARE YOU COMFORTABLE TO ASK YOUR PATIENTS ABOUT THEIR HABITS 3 YOU DON T LIKE TO ASK YOUR PATIENTS ABOUT THEIR HABITS DUE TO LACK OF TIME IN CLINICS AFTER SEEING HIS ORAL CAVITY IF YOU FIND OUT THE CHILD IS INTO ANY BAD HABITS LIKE SMOKING OR DRINKING WILL YOU START TALKING TO HIM IN-FRONT OF HIS/HER PARENTS ITSELF DO YOU PREFER GIVING LEAFLETS OR PAMPLETS TO PATIENTS ON QUITTING SMOKING INSTEAD OF TALKING TO HIM? [INTERNATIONAL JOURNAL OF PREVENTIVE DENTISTRY AND ORAL EPIDEMIOLOGY1:1 [2012] : 1-7]Page 4
5 Discussion : Smoking is one of the most important public health challenge which leads to various drastic diseases and even death. On an average, cigarette smokers die ten years younger than non-smokers. In the last decade, awareness programs have been organized in most of the schools and institutions across America and Europe which proved to be very effective 8. This idea has been spread to the developing countries like ours and it has carved a special interest by everyone. Maternal smoking is associated with an increasing risk of cleft palate and various other congenital heart defects in infants 9. According to an article the reasons due to which people take on smoking is that- 6 out of 10 people are used to it due to their friends and the surroundings, while others do it either for relaxation or just to follow their idols 10. In the above article, for a question on quitting of smoking,8 out of 10 tried to quit and 2 of them tried but had to cut down because they were not serious about it 10. In the article, 6 out of 10 people start smoking due to the affect of smokers around them 10. According to an article on dentist s attitude and practice regarding prevention of smoking says that 31.2% always ask their patients, 31.2% never asks while 37.6% of the dentists asks sometimes to their patients depending on the person they deal with 11. According to another article by experts, the best way to make students aware about the bad effects of smoking is through a friendly approach that younger dentists can develop by giving their patients clear outcomes through intake of tobacco 11. According to an article by Dentists attitude on prevention of smoking 7.8% of the dentists prefer using leaflets, 77.1% do not prefer these methods and 17.1% sometimes prefer using pamphlets for awareness programs 11. Dental professionals can play an important role in preventing adverse health effects by promoting smoking cessation, as more than 50% of the smokers see a dentist in any one year 6-7. A survey by Scandinavian medical practitioners showed that the shortage of smoking cessation experts to whom patients could be referred was the most common barrier to the practitioners discussing cessation with their smoking patients 12. The dental team has an important role to playing encouraging the patients to quit using tobacco as they are ideally placed to recognize and point out the damage caused by tobacco to oral tissues and highlight the general health benefits of quitting and to refer on to professional cessation if appropriate 13. According to current practice, most of the students who spend less than three minutes, whereas 12% of the students spend an estimating time of three or more than three minutes. While a brief advice given over three minutes is effective 14-15,16. There is a gap in the evidence base for the effectiveness of brief interventions of less than two minutes 17. Moreover, lack of proper knowledge was identified as the key barrier for discussing smoking with adolescent patients 18. Conclusion : The above studies suggests that currently, courses in smoking cessation are not a part of under-graduate or post-graduate curriculum and not even incorporated in the dental programs for qualified practitioners. When considering the increase in number of smokers in and around us reinforcement is mandatory. This might be established through curriculums and continuous and educations. [INTERNATIONAL JOURNAL OF PREVENTIVE DENTISTRY AND ORAL EPIDEMIOLOGY1:1 [2012] : 1-7]Page 5
6 References : 1. Yip J K, Hay J L, Ostroff J S, Stewart R K, Cruz GD. Dental students attitude towards smoking cessation guidelines. J Dent Educ 2000;64: Crisis in India: Smoking Expected to Kill 1 Million People Annually by 2010 WHO aims to prevent cancer deaths by reducing smoking in developing nations By Larry West, About.com Guide Accessed on Aug 5 th AM. 3. New England journal of medicine. Accessed on Aug 12 th AM 4. Effects of smokingsmokingadvice.info Accessed on Jun 23 th AM 5. Smoking facts- enough to scare you Smokingadvice. Accessed on Jun 25 th AM 6. Walsh M M, Ellison J A. treatment of tobacco use and dependence: the role of dental professionals. J dent Educ 2005; 69: Chestnut I G. What should we do about patients who smoke? Dent update 1999; 26: Wang L Y, Corossett L S, Lowry R,Sussman S, Clyde W.Cost effectiveness of a school based tobacco use prevention program. Archives of pediatrics and adolescent medicine 2001; 155(9): Squire C. Introduction: tobacco, human disease and the rate of dental profession dent Assoc 2001;65: You participate, HDC student partnership. University of Cambridge. Faculty of education Accessed on Jul 5 th AM 11. Dentist attitude and practice regarding smoking cessation intervention and prevention Riyadh, Saudi Arabia. Dalal Al- Qahtani BDS, Maha AL- Qahtani, Ohoud Al- Otaibi BDS,Aziza Al- Obeerirk BDS, Msc 12. M, Ellison J A. treatment of tobacco use and dependence: the role of dental professionals. J dent Educ 2005; 69: Helgason A, Lund K. General Practitioner perceived barriers to smoking cessation-result from four Nordic countries. Seand public health 2002:30: Department of health. Smoke free and smiling: helping dental patients to quite tobacco. Publication nodh London: the stationary office, Department of health. Smoking kills: a white paper on tobacco (1998 b). London: the stationary office, Rikard Bell G, Groenlund C, Ward J. Australian dental student s views about smoking cessation and counseling and their skills as councilors. J public health dent 2003;63: The Public Health Intervention advisory committee. NICE public health intervention guidance. Brief interventions and referral for smoking cessation in primary care and other settings. Publication no. PHI 001. London: department of health, Yaha N A, Croucher R E. smoking cessation for adolescent: opinions and experiences of Malaysian government. Dental Practitioners Malaysia Dent J. 2005,26(2): [INTERNATIONAL JOURNAL OF PREVENTIVE DENTISTRY AND ORAL EPIDEMIOLOGY1:1 [2012] : 1-7]Page 6
7 [INTERNATIONAL JOURNAL OF PREVENTIVE DENTISTRY AND ORAL EPIDEMIOLOGY1:1 [2012] : 1-7]Page 7
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