Tobacco cessation introduced in Tobacco cessation introduced in the graduate and postgraduate the graduate and postgraduate

dental curriculumdental curriculum

Katalin Nagy, Katalin Barabás, Katalin Nagy, Katalin Barabás, Márk Antal, András Forster, Zsolt Márk Antal, András Forster, Zsolt

ZalaiZalai

University of SzegedFaculty of DentistryFaculty of Medicine

Smoking among dentists and Smoking among dentists and general practitioners?general practitioners?

Smoking among dentists and general practitioners-reality

37% of the smoking professionals will smoke in presence of their patients

Dental and medical students 20% smoking prevalence

Many of them get addicted during university-studies

Current data on medical and dental Current data on medical and dental student’s smoking attitude (Univ. of student’s smoking attitude (Univ. of

SzegedSzeged, 2011., 2011.))Man Woman Altogethe

r

I.st yr. Med 46 123 169

I.st yr. Dent

18 20 38

V.th yr. Dent

5 13 18

Altogether 69 156 225

Frequency of students smoking behaviour in the last month

26%

17%

10% 9%

17%

21%

Did notsmoke

1-4 day

5-9 day

10-19 day

Almost everyday

Every day

Learning about smoking during medical school: are we still missing opportunities?

Chatkin J et al. Int J Tuberc Lung Dis. (2009)Chatkin J et al. Int J Tuberc Lung Dis. (2009)

Answers from 1353 medical faculties:

Only 11% of the faculties addresses smoking in the curriculum

In Europe, only 8% of the faculties addresses smoking in the curriculum

Is it possible to make changes?

International Tobacco and Health Research International Tobacco and Health Research and Capacity Building Program and Capacity Building Program

(RFA-TW-06-006 )(RFA-TW-06-006 )

1.1. pursue observational, intervention and policy researchpursue observational, intervention and policy research

2.2. build capacity in epidemiological and behavioral build capacity in epidemiological and behavioral research, prevention, treatment, communications, research, prevention, treatment, communications, health services and policy researchhealth services and policy research

3.3. promote international collaborationpromote international collaboration

**Sponsored by Fogarty International Center, National **Sponsored by Fogarty International Center, National Cancer Institute, and National Institute on Drug AbuseCancer Institute, and National Institute on Drug Abuse

HungaryHungary

1. Conduct research that has the potential to significantly reduce tobacco use at the local and national level.

2. Create institutional capacity that will support scientists and advocates engaged in tobacco research and translate research findings into programs and policies to reduce tobacco use.

3. Build individual capacity among Hungarian and U.S. research partners.

Curriculum developmentCurriculum developmentin the Faculty of Dentistry, University of in the Faculty of Dentistry, University of

Szeged, 2009/2010Szeged, 2009/2010

The new course is part of a complex development of European Curriculum

„Health professionals as role model for patients and students”

Message of the courseMessage of the course

45-50% of the smokers would like to quit smoking, but only 4-5 % succeed

17% of smokers are ready to quit in 6 months.

/ Róbert Urbán 2009/

The dentist-patient relationship provides a possibility for a personalized consultancy and guiding; this could increase dramatic chances of cessation

Dental Team

Dentist

Dental Nurse

Dental Hygienist

Why??? Dentist-as „role-model”

Good example for patients, what they should follow Students are following their teachers’ example

Natural way of discussion regarding symptoms in the oral cavity Oral effect of smoking (mucosal) Periodontal diseases Healing process decreased Relative contraindication of dental implant Discoloration of teeth Halitosis

Active intervention in the cessation process Only non-smoker dental professionals can take part

successfully in cessation process Smoking dentist are less interested to ask about this

habit or to give advice on the field

Goal of the courseGoal of the courseAfter completing the course, the dental student:

Will be acquainted with the possible health effects of smoking and its scientific relations tools and methods for prevention supporting tobacco

cessation Will be able to give personalized advice and

support the patient in cessation process By the end of the course, professionals will be

capable of understanding, supporting patients, giving them different alternatives in the cessation process

Outcome of the courseOutcome of the courseThe dentist’s role in healthcare*

Personal development

Attitude, ethical, legal responsibility

Decision making capability

Clinical/practical knowledge, knowledge in behaviour sciences

Patient management*

Patient examination

Practical skills

Communication*

Practical methods

Health promotion, disease prevention*

Studies carried out prior to course-introduction

Survey on tobacco use (completed by)

265 dentists 347 dental students

Results analyzed using the SPSS 10.0 software

Results published in Hungarian (prereviewed) journal

International publication in process

Professionals responsible for Professionals responsible for teaching in the courseteaching in the course

Professor of dental sciences Associate professor (Behavior

sciences) General practitioner (family

doctor/SHO) Assistant lecturer (specialist) Communication professional

Motivation for taking the Motivation for taking the coursecourse

„I would like to touch base with the smokers, find alternatives and be helpful in cessation.”

„Not to say only the average - smoking is bad - sentence”

„To develop my ability to convince and have positive influence on my environment, or at least to help my grandmother to give up smoking.”

„I hope to see and experience things, which will help me to give up smoking””

Educational methods of the Educational methods of the graduate graduate coursecourse

Problem oriented method

Interactive „small” group activity Training in the frame of „Dental

Communication” Guidelines for supporting cessation Cooperation with global/Hungarian

supporting agencies and companies

How to progress?How to progress?

Preparation

Feedback

Execution

Authorization

Next course

Reflexions

Explanations

Modifications

Experiences

Interpretation

Feedback from students

Role of the University in cessation

Postgraduate teaching activityPostgraduate teaching activity

Mandatory courses for residents Testing of courses in progress

Continuing Education (CE courses) In Hungary and abroad

Hungarodent (Budapest, 900 p.) Bucharest,Arad Romania (500 p) Szeged Dental Conference (400 p)

Outcomes and new goals

Publication in prereviewed Hungarian journal Antal M, Ramseier, A, Barabás K, Forster A, Zalai Zs, Nagy K: A dohányzás

megelőzése és a leszokás támogatásának lehetőségei.Fogorvosi Szemle, 2011

Extension of the graduate course for two semesters Under revision and recognition by the Faculty

Board Identical course started in Semmelweis

University, Budapest Staff trained in Szeged

Discussions started with Debrecen University

Zárókép a Hungarodentről, nekünk nincs meg!!!!!!

May, 2011, MOK meeting in Budapest (900 participants) distributing flyers