Tobacco cessation: isn't it time for dentistry to become more involved?

T he statistics are staggering. Tobacco is by far the greatest risk factor associated with cancer deaths in Canada. 1 Tobacco use causes approximately 30% of all cancer deaths. 2 The Canadian Cancer Society estimates there were 132,100 new cases of cancer and 65,000 deaths from cancer in Canada in 2000. 3 Lung cancer is still the leading cause of cancer death for both men and women. 3 There are about 1.9 million daily smokers in Ontario alone, and it is estimated that about half will die of smoking-related illnesses. 4 According to the literature it is not just lung cancer that smokers should be concerned about. Tobacco users need to become more informed about the relationship between tobacco use and oral cancers and periodontal disease. Who better to address this important health issue with patients than individual dentists and the profession as a whole? Indeed, dentistry has been involved in tobacco-related issues for years. By way of example, the Ontario Dental Association (ODA) developed a policy statement on tobacco in 1987. That policy recognized the potential direct and indirect health effects associated with the use of tobacco and introduced a smoking ban at the ODA that extended to all rooms in which Association meetings are held. It also encouraged a ban on smoking in public places and discouraged the promotion of tobacco products. A good foundation for an organization interested in promoting optimal oral health. However, it took another decade for the ODA to adopt a statement on smoking cessation. The latest policy, approved in November 1998, emphasizes smoking cessation. It goes so far as to encourage members to learn about tobacco cessation so they will be in a better position to aid patients in the cessation process. Based on this policy direction, the ODA has joined with the Ontario Medical Association and the Ontario Pharmacists' Association in an effort to mobilize health care professionals and to encourage them to enhance their smoking cessation skills through a program called Clinical Tobacco Intervention (CTI). This joint partnership in the CTI program builds on the regular encounters patients have with their primary care providers. We are working together to give practitioners the tools they need to help patients quit using tobacco. Tobacco dependence is a chronic condition. Research indicates that a majority of smokers want to quit smoking and that even brief interventions may help them. 5 Why has it taken …