Smoking Cessation Program of the BMA's Affiliated Dental Clinic Thailand
Last Updated on Friday, 30 October 2009 11:57 Written by Administrator Friday, 30 October 2009 11:30
T. CHAOSAUNGAROEN1, C. POKARATSIRI1, S. SANGKHEAW1, M. TATIYAKAVEE1, U. LEETHOCHOCHAWALIT2, and V. PERUNAVIN3, 1Dental Health Division, Health Department, Bangkok, Thailand, 2Taksin Hospital, Medical Department, Bangkok, Thailand, 3Central Hospital, Medical Department, Bangkok, Thailand
Introduction:
Worldwide smoking remains one of the most important public health problem. The harmful effects of smoking and tobacco use on oral health are well recognized. Oral cancers, pre-cancerous lesions, periodontal diseases and poor wound healing are the most detrimental effects of smoking on oral health. Dentist is one of health personnel that has opportunity to meet smoking patients when they are still healthy. Therefore dental clinics of Health Centers and hospitals in Bangkok Metropolitan Administration (BMA) under support from Thai Dental Council put an effort on creating a model of smoking cessation program in dental clinics.
Objective:
To create a model of smoking cessation program in dental clinics of Health Centers and hospitals in Bangkok Metropolitan Administration (BMA).
Materials and Methods:
1. In its first and second year, Dental Health Division arranged academic meeting and intensive workshop to raise awareness among dentists and other dental professional staffs of their ethical obligations towards this smoking cessation program and the importance and process of guiding patients to quit smoking (3A's and 5A's ).
2. After the workshop, all dental clinics started the implementation at the same time. Dental patients aged 13 and above were identified for their smoking status by short questionnaires in rubber-stamps put on their outpatient dental records. This provided data of smoking status and severity of their tobacco addiction.
3. Dentists assessed patients’ tobacco addiction status and advised patients about disadvantages of tobacco and how to quit smoking. Quit date would be arranged when patients were willing to quit smoking
4. Reports were sent monthly from all dental clinics to monitor the implementation.
Results:
The 9-month report showed 73 of the total 79 clinics (92.4%) had started offering cessation counseling. Seven thousand two hundred and six patients (7,206) joined the program. Five thousand two hundred and eighteen patients (72.4%) and 1,922 patients (26.7 %) wanted and did not want to quit smoking, respectively. The 5th – 9th month reports showed that 5 clinics (6.3%) have completed the 5A's. Of the total 201 patients, 186 patients (92.5%) and 15 patients (7.5%) wanted and did not want to quit smoking, respectively. Twelve patients (6%) have successfully quit smoking at 4-month follow-up.
Table1 Distribution of smokers according to age
| Age | Percent of smokers | Number of smokers |
| <15 yrs | 0.5 | 36 |
| 16-25 yrs | 14.0 | 1009 |
| 26-35 yrs | 24.7 | 1780 |
| 36-59 yrs | 54.2 | 3905 |
| 60-69 yrs | 5.2 | 375 |
| 70-79 yrs | 1.3 | 94 |
| >80 yrs | 0.1 | 7 |
| Total | 100 | 7206 |
Graph1 Smokers who received counseling according to sex and willingness to quit
Smoking Data
O Smoker O Nonsmoker
How many years have you smoked cigarettes? ……...yrs.
Amounts of cigarettes per day ……………... cigarettes
How many hours do you start the first cigarettes after wake-up time?..........hours
O Want to quit smoking O Do not want to quit smoking
Discussion:
Three A’s activities can be achieved at dental clinics in BMA. Dental personnel lack of counseling skill, therefore, intensive workshop should be arranged to increase counseling skill. Report of smoking cessation implementation should be integrated into routine report to make report easier. When there are a lot of smokers visiting dental clinic, group counseling should be performed to reduce counseling time.
Conclusion:
Through intensive workshops, distribution of identifying rubber-stamps, monitoring system by report including support from executive level and Thai Dental Council, the program had successfully developed participating dental clinics into well-trained and equipped tobacco cessation centers. This program will be economical and convenient helpful to adopt the scheme for the other clinics. The evaluation reports also helped to improve its implementation and the positive outcome in the future.
