Do the Right Thing

I think it is safe to say that every practicing dental health professional, whether he or she is a dental assistant, dental hygienist, or dentist, has worked on a patient who uses tobacco or nicotine-containing products. Moreover, I believe that every dental health professional would welcome the opportunity to help these patients quit their dangerous habits and prevent others from ever starting to use any of these products in the first place.

Throughout the 40 years that I have been practicing periodontics, I have seen many patients who have had their health and well-being terribly compromised by tobacco. I have seen a patient lose half of her tongue and jaw due to oral cancer, leaving her in major pain for the remaining 2 years of her life. I watched her husband continue to smoke after her death because he was just unable to quit his addiction. I have also had to advise teenagers that their tobacco chewing habits had caused significant enough changes in their mouths to warrant a biopsy of the involved areas, causing great stress to them and their families.

In March 2012, the US Centers for Disease Control and Prevention (CDC) launched the first ever paid national tobacco education campaign-Tips From Former Smokers. This campaign profiles real people and shares their experiences about living with the long-term health effects of smoking and secondhand smoke exposure. The program continues to graphically demonstrate the personal struggles of former smokers and the toll that their conditions have taken on them.

On July 31, 2018, the American Dental Association and the CDC collaborated on an excellent webinar to discuss smoking cessation and the resources that are available for dental professionals. In addition, they encouraged participants to make their patients aware of the Tips From Former Smokers campaign.

According to information on CDC's website, the agency estimates that, from 2012 to 2015, more than 9 million smokers attempted to quit as a result of the Tips From Former Smokers campaign and conservatively, more than half a million successfully quit for good. Given the success of the program, I would encourage dental offices to learn about the campaign at: https://www.cdc.gov/tobacco/campaign/tips/partners/index.html. In addition, the CDC encourages dentists to refer patients who are interested in quitting smoking to its "How to Quit Smoking" section at https://www.cdc.gov/tobacco/campaign/tips/quitsmoking/. Finally, the US Department of Health and Human Services offers another helpful site with information about the effects of e-cigarettes at: https://therealcost.betobaccofree.hhs.gov/?g=t.

According to the results of the US Food and Drug Administration (FDA) and CDC's National Youth Tobacco Survey, in 2018, we saw a 78% increase in the use of e-cigarettes among high school students (20.8% are users), and a 48% increase among middle school students (4.9% are users). At present, 3.6 million middle and high school students are now using e-cigarettes, which represents an increase of 1.5 million kids during 1 year. In September of 2018, a new form of e-cigarette called JUUL had a 72% market share of the e-cigarette market. The viral nature of JUUL use among children has finally gotten FDA's attention, and now, it has them so concerned that the agency is investigating JUUL Labs for gearing their advertising toward kids.

The bottom line is that we cannot allow another generation to become addicted to nicotine, be it by cigarettes, cigars, hookahs, e-cigarettes, or any other product the tobacco industry creates, nor can we passively sit by and watch as their parents and grandparents die avoidable deaths from these products. I challenge dental professionals to help patients quit their nicotine addictions, as well as prevent children and adolescents from ever using these products. This endeavor is well worth the effort and will provide an incredible feeling of accomplishment.

Nevin Zablotsky, DMD, is a senior consultant and lecturer on tobacco issues at the Nova Southeastern University School of Dental Medicine, Fort Lauderdale, Florida.