The role of the dental team in tobacco cessation

The dental team can play an effective role in the creation of tobacco‐free communities and individuals through participation in community and political action and in counselling their patients to quit. Maintaining a smoke‐free environment is important. There are well‐tried and cost effective methods for brief interventions in dental clinical settings, and team‐work, to which both clinical and reception/administrative staff must contribute, is fundamental. Quit rates of the order of 10%, sustained over a year or more, can be achieved and this may be increased by prescription of nicotine replacement therapies, or of buproprion, to aid nicotine withdrawal. Prevention of smoking uptake, especially by young people, is much more difficult and has a weaker evidence base. In much of Central and Eastern Europe the situation is very severe because of high smoking rates and associated diseases and where, although governments are now acting with advertising bans and other legislation arising from the Framework Convention on Tobacco Control, the healthcare professions themselves have high smoking prevalences and a comparative lack of involvement in tobacco cessation and prevention practices. In South and South‐East Asia, and in emigrant communities originating from these areas, the use of oral unsmoked tobacco, the chewing of areca nut, and various mixtures of these ingredients in the form of betel quids, is highly addictive and carcinogenic to the mouth, pharynx and oesophagus. Special and specific efforts are needed for cessation and coping strategies in these communities, for which there is a less well‐developed evidence base.