Supporting dental patients to quit smoking: Stoptober 2018

Oral (oral cavity and oropharyngeal) cancers are some of the most preventable types of cancer, and over 90% of all oral cancer cases could be avoided.

We know that dentists and their teams play a vital role in ensuring oral cancers are detected early, and can help to save people's lives.

And yet, oral cancers continue to rise across the four UK countries:

  • We know that head and neck cancers in England are more common in people living in the most deprived areas.
  • Around 200 people in Northern Ireland are diagnosed with mouth cancer each year, often at a late stage, with about a third of those diagnosed dying from the disease. Shockingly, the incidence of oral cancers look set to double by 2035.
  • In Scotland, there has been a 40% drop in GP prescriptions for smoking cessation products between 2005/6 and 2016/17and we know that head and neck incidence rates in Scotland are significantly higher than the UK average.
  • In Wales, the numbers of new diagnoses of mouth cancer continues to rise, with over 500 new cases between 2012 and 2014.This is an increase of around one third since the turn of the millennium. The spend on cancer accounts for nearly seven per cent of all NHS expenditure in Wales and in 2014-15 this amounted to £409 million – the fourth biggest spending area for NHS Wales.
Public Health England's Stoptober campaigns aims to support people to quit smoking, and dentists can take part by encouraging their patients to do so.

Free resources are available from the campaign's website, including posters that can be ordered online.

Quitting smoking: Starting the conversation

The NICE guideline on stop smoking interventions and services was updated in March 2018.

Some of the new recommendations for healthcare workers include:

  • At every opportunity ask people if they smoke, and advise them to stop smoking in a way that best suits their preferences
  • Refer people who want to stop smoking to the local Stop Smoking Services
  • Offer advice on using nicotine-containing products on general sale, including NRT and nicotine-containing e-cigarettes.
  • Explain that a combination of varenicline and behavioural support or a combination of short-acting and long-acting NRT are likely to be most effective.
NICE also recommends that all healthcare professions should be trained to offer Very Brief Advice (VBA) – there's a free short training module available from the National Centre for Smoking Cessation and Training. Public Health England's Smokefree and Smilingguidance provides advice tailored specifically to dentists.

What about e-cigarettes: are they recommended?

The RCP and NICE now also recommend that e-cigarettes should be discussed as an option for smoking cessation when appropriate.

Stop Smoking Services are the most effective way for smokers to quit, but as access to these services varies and they may not be suitable for everyone, they are suggesting that e-cigarettes might be an appropriate option to try.

As e-cigarettes are a new technology, there is not yet enough evidence to prove their long-term safety, and the BDA's Health and Science Committee has a watching brief on this. We will keep you updated with any new evidence.

More tools for dentists and their teams on smoking cessation

Cancer Research UK also has a free e-newsletter, Cancer Insight, which you can sign up to, with best practice advice on important cancer-related topics, as well as evidence, training materials, tools and patient resources.

Don't forget to use our free oral cancer toolkit for dentists and their teams, developed in conjunction with CRUK. It will help you to identify, diagnose and refer, in accordance with the current NICE guidance.

Arianne Matlin, Head of Health and Science Policy
BDA

Campaigning for better oral health

We campaign on a range of issues to get better working lives for dentists and we work to improve the oral health of the nation.
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