Raya Alghabban

03/15/2025

Reflection on Tobacco Dependence Treatment

1. Since you have been seeing patients at the school, describe some of the resistance you have faced when discussing tobacco cessation counseling with your patients.
2. Describe the most effective communication techniques, giving examples of ways to interact with patients regarding the discussion of their tobacco use. 

3. Based on what you have learned about helping patients stop tobacco use, what could you have done differently in the past to further encourage/motivate your patients to make a quit attempt?
4. Describe why you believe, or do not believe, that addressing tobacco use is an important part of providing comprehensive dental care (in other words, what impact does a patient’s tobacco use have on comprehensive dental care)?
5.    Once you graduate, receive your license, and begin practicing as a registered dental hygienist, how do you plan to address tobacco use with your patients? If you don’t plan to address this, why not?

    Tobacco cessation is a delicate subject that demands specific skills for effective intervention. During my initial counseling sessions, I faced resistance from several patients. Some were in denial about the link between smoking and their oral health, while others feared quitting due to past unsuccessful attempts or anxiety about withdrawal symptoms. Additionally, I have encountered individuals who believe cutting down is sufficient rather than quitting entirely. These challenges highlight the complexity of behavioral change and the necessity for effective communication techniques to support patients in their journey toward tobacco cessation.

   One of my most effective communication techniques is the Motivational Interviewing (MI) approach. This technique encourages patients to explore their own reasons for quitting, fostering internal motivation rather than imposing external pressure. For example, when a patient expressed uncertainty about quitting, I asked, "What concerns do you have about tobacco use and your oral health?" rather than simply listing the negative effects. This open-ended question prompted them to reflect on their own experiences, such as increased gum sensitivity and staining. Another effective approach is active listening and empathy. Instead of just presenting facts, I acknowledge the patient's challenges and validate their emotions. For example, when a patient shared that they use tobacco as a stress-relief approach, I responded, "I understand that quitting can be difficult, especially when smoking has been a coping tool. Let's discuss some strategies to manage stress that don’t involve tobacco." This approach creates a nonjudgmental environment, making patients more receptive to change. Additionally, recognizing that it often takes multiple quit attempts to succeed and recommending appropriate medications to manage withdrawal symptoms could have helped set more realistic expectations and reduced patient resistance.

   Reflecting on past experiences, I recognize that I could have further encouraged and motivated my patients to make a quit attempt by implementing more follow-up and support strategies. While I provided educational materials and cessation resources, I could have incorporated more structured follow-ups, such as asking about their progress at subsequent appointments or suggesting mobile apps and online support groups. Additionally, I could have utilized behavioral contracts, where patients set a quit date and outline small, achievable steps toward their goal. This method would have increased accountability and motivation.

   I firmly believe that addressing tobacco use is a crucial part of comprehensive dental care. Tobacco use negatively impacts oral health, contributing to periodontal disease, delayed wound healing, oral cancer, and staining. Beyond oral health, tobacco use is linked to serious systemic health issues such as cardiovascular disease and respiratory conditions. As dental professionals, we are in a unique position to identify early signs of tobacco-related damage and provide intervention before more severe consequences arise. By integrating tobacco cessation counseling into patient care, we help improve oral health and contribute to our patients' overall well-being.

    I plan to consistently address tobacco use with my patients once I graduate, receive my license and begin practicing as a registered dental hygienist. My approach is to ask patients about tobacco smoking as a part of their medical and social history. Educating patients about the reason behind these questions should be part of my conversation, and offering cessation resources at every visit. Additionally, I will collaborate with dentists and healthcare providers to ensure a comprehensive, team-based approach to tobacco cessation. By integrating these strategies, I aim to create a supportive and encouraging environment that empowers patients to make healthier choices for both their oral and systemic health. The tobacco cessation counseling project was extremely helpful. It broadened my understanding of techniques for addressing patients' concerns, meeting their needs, and offering suggestions and resources to overcome obstacles while demonstrating genuine interest and support to achieve successful cessation. I am dedicated to helping patients attain better oral health through effective communication and ongoing support.