ANNALS OF IBADAN POSTGRADUATE MEDICINE
A.A. Dedeke1 , O.A. Popoola2 , A.O. Adebiyi2 and M.C. Asuzu2
Introduction: Oral health problems arising from tobacco use have been reported and some of these conditions can be prevented through Tobacco Cessation (TC). Dentists are well positioned to provide tobacco cessation services to patients. In Nigeria, little is documented on the provision of cessation services among dentists and the challenges. This study was conducted to assess the cessation practices of dentists and their related challenges in Southwest Nigeria.
Methods: A cross sectional study was carried out in all the tertiary healthcare facilities within the six states of the Southwest geopolitical zone. A total population survey involving dentists below the cadre of Consultant/Chief Dental Officers undergoing postgraduate training and/or providing services in the tertiary hospitals was conducted using a pretested semi structured selfadministered questionnaire. This included questions on challenges experienced in the provision of TC services in their respective facilities.
Results: A total of 224 eligible dentists were approached to participate in this study with a response rate of 91.5%. Mean age and completed years of working experience were 33.8±5.2 and 6.1±4.4 respectively. In reporting challenges to implementing tobacco cessation services, 60% of respondents reported ‘lack of perceived efficacy and training’ as the major barriers
Conclusion: From this study, incorporation of tobacco cessation into the dental curriculum will increase the knowledge and competence of dentists. Provision of systems support to dentists willing to help patients quit smoking may be important in ensuring the health system is responsive to the tobacco control needs of patients in Southwest Nigeria.
Keywords: Tobacco cessation, Dentists, Challenges, Nigeria
Dr. A.A. Dedeke
Dept. of Preventive Dentistry,
College of Medicine,
University of Lagos
The use of tobacco is a common global event with over one billion smokers, though its prevalence varies from continent to continent as well as from country to country. Its use is reported to kill 6 million people on a yearly basis and this includes approximately six hundred thousand non-smokers.1 Tobacco smoking in its various forms (cigars, cigarettes, pipes) is an important risk factor in many non-communicable diseases (NCDs) which include but are not limited to cardiovascular disease, lung disease, low birth weight and premature birth. Tobacco smoking with its attendant thermo-cycling effects is also associated with dental conditions such as, teeth abrasion and staining, implant failure, halitosis and oral cancer.2,3
Tobacco control effects have gained grounds in recent decades and as part of the solution to the problem in May 2003, the World Health Organization (WHO) World Health Assembly unanimously adopted the WHO Framework Convention on Tobacco Control.4 In 2008, WHO also introduced the MPOWER package of six evidence-based tobacco control measures that are proven to reduce tobacco use and save lives.5 M – Monitor tobacco use and prevention policies, P – Protect people from Tobacco smoke, O – Offer help to quit tobacco use, W – Warn about the dangers of tobacco, E – Enforce bans on tobacco advertising, promotion and sponsorship, and R – Raise taxes on tobacco.
A thrust of the O component of MPOWER is dependent on healthcare personnel integrating tobacco cessation into primary health care and other routine medical visits which provides the health-care system with opportunities to remind users that tobacco harms their health and that of others around them.5
This intervention can be particularly effective because it is provided by a well-respected health professional with whom tobacco users may have a good relationship.6 Dentists are strategically placed in tobacco prevention and cessation as they provide preventive services to a basically healthy population and therapeutic services when needed, on a regular basis. By expanding the dental examination, diagnosis, and treatment to include tobacco cessation, a potentially life-saving element of care is added to an established service.
Nigeria has an estimated 4000 licensed dentists to an estimated population of 170 million.7 As oral health professionals, dentists have the unique opportunity as they interface with the main portal of tobacco entry into the body and as part of the natural consequences of their oral health care efforts, can educate patients in a bid to make informed decisions and behavioral changes as regards smoking. Tobacco cessation is a viable method of achieving this. Despite the strength and the tenacity of the tobacco companies, tobacco control bill was recently enacted and it becomes important to carry out studies like this within the health sector which will provide important baseline information on dentists’ perceived competence and preparedness to undertake tobacco cessation.
Furthermore, periodontal disease and the potential for oral cancer mandate the inclusion of tobacco cessation services into dental care. There is a dearth of information on the knowledge, perceived roles of dentists, and the challenges to carrying out these roles as regards tobacco cessation in Nigeria. This study (which is a part of a larger study), therefore was aimed at determining the various challenges faces by Nigerian dentists in implementing tobacco cessation services.