Term Paper on "Tobacco Cessation Evaluation and Pre-Assessment"

Term Paper 5 pages (1468 words) Sources: 1+

[EXCERPT] . . . .

Tobacco Cessation

Evaluation and Pre-Assessment

As an oral healthcare professional, I have unique insight into telltale signs of tobacco use ranging from stains and odors to receding gums and oral lesions. Therefore, the first and most important step in the evaluation process is pure observation. Gum recession and lesions can be immediately observable and measured, whereas underlying issues like bone loss can only be determined via a battery of tests. We are not yet at the stage that patients have yielded to invasive testing and so, I would use techniques of good communication such as making and maintaining eye contact when asking questions. Using tools like the intra-oral camera and hand mirror, I may be able to bring up the issue of tobacco use.

When the patient returns my observations with questions of their own, I can also incorporate their reaction as part of the initial evaluation plan. Patients may ask, for example, if the gum recession will simply go away or whether their stains might be due to their coffee drinking rather than from tobacco use. Patients at this stage in tobacco cessation are definitively at the precontemplation stage. At this stage, the patient is not thinking about stopping smoking. They may have never thought about cessation or they might be actively antagonistic to stopping.

I would ask the patient at the precontemplation stage how they feel about smoking to clarify their willingness to change. The patient does have a right to self-determination and it is only my role to offer information and encouragement. Understanding the patient's reactions and not judging the patient are crucial at this stage. However, I may interject statements such as "It is my duty as a professional hygienist to advise you of the adverse effects of tobacco use on your overall health and especially your oral health." Here, I can tell the patient about the various specific oral health issues that tobacco use gives rise to such as dental caries and oral cancer. It is important to offer the patient a wide variety of issues to contemplate, because each person will have different prior knowledge and health histories. For example, some patients might react more strongly to the aesthetic repercussions of tobacco use such as staining and bad breath. Others might react more strongly to the fact that tobacco can cause irreversible health problems like oral mucuosal lesions and carcinomas.

If and when the patient indicates some interest in smoking cessation, I can ask questions that encourage their development. For example, I may ask what they view as the various pros and cons of quitting, making sure to reinforce their reasons for wanting to stop. At this stage, as well as at any other stage, it may be helpful to show patients images of aesthetic and health issues related to their oral hygiene to reinforce the decision to stop smoking. At the contemplation stage, when the patient is actively seeking reasons to quit, providing information is crucial.

The patient will soon progress to the preparation stage, at which time I can propose a thorough treatment plan.

Treatment Plan

The treatment plan for the patient will vary depending on age, gender, and ethnicity, but will mostly be related to individual differences. For example, each person will be motivated by different issues. Some patients will be motivated by wanting to prevent their children to be exposed to secondhand smoke, whereas others will be single and want to stop smoking so that they can date non-smokers. Yet others will be motivated by aesthetics. The issues that arise during the treatment plan, including resistance to change, will also depend on individual differences and the person's social, economic, and cultural background.

At this point in the patient's progress, I would make a note on their official chart as to when they decided to stop smoking. As Seidman & Covey (1999) point out, interventions at this stage may not be limited to the oral hygiene sector. Psychological interventions are crucial in the overall treatment plan. Telling the patient things like, "You have made a very important decision," helps to psychologically reinforce the decision to stop smoking and ensures success. The patient may show signs of wavering in their decision at this time. For example, the patient might indicate that they just want to "cut down."

Questions I would ask at this stage include following-up on their decision by inquiring about a specific date of… READ MORE

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