Tobacco cessation introduced in the graduate and postgraduate dental curriculum

1. Tobacco cessationintroducedinthegraduate and postgraduatedental curriculum Katalin Nagy, Katalin Barabás, Márk Antal, András Forster, Zsolt Zalai University of Szeged Faculty of Dentistry Faculty of Medicine

2. 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 Smoking among dentists and general practitioners?

3. Current data on medical and dental student’s smoking attitude (Univ. of Szeged, 2011.)

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

5. Is it possible to make changes?

6. International Tobacco and Health Research and Capacity Building Program (RFA-TW-06-006 ) pursue observational, intervention and policy research build capacity in epidemiological and behavioral research, prevention, treatment, communications, health services and policy research promote international collaboration **Sponsored by Fogarty International Center, National Cancer Institute, and National Institute on Drug Abuse

7. Hungary Conduct researchthat has the potential to significantly reduce tobacco use at the local and national level. Create institutional capacitythat will support scientists and advocates engaged in tobacco research and translate research findings into programs and policies to reduce tobacco use. Build individual capacityamong Hungarian and U.S. research partners.

8. Curriculum developmentin the Faculty of Dentistry, University of Szeged, 2009/2010 • The new course is part of a complex development of European Curriculum „Health professionals as role model for patients and students”

9. Message 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 dramaticchances of cessation

10. Dental Team • Dentist • Dental Nurse • Dental Hygienist

11. Why??? • Dentist-as „role-model” • Good example for patients, what theyshouldfollow • 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

12. Goal of the course After 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

13. Outcome of thecourse The dentist’s role in healthcare* Patient management* The dentist as a representative of his profession Personal development Patient examination How do they implement this practically? Attitude, ethical, legal responsibility Practical skills Capable of: Communication* Decision making capability Practical methods Health promotion, disease prevention* Clinical/practical knowledge, knowledge in behaviour sciences

14. 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

16. Professionals responsible for teaching in the course • Professor of dental sciences • Associate professor (Behavior sciences) • General practitioner (family doctor/SHO) • Assistant lecturer (specialist) • Communication professional

17. Motivation for taking the course „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””

18. Educational methods of the graduate course 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

19. How to progress? Execution Feedback Authorization Experiences Next course Preparation Interpretation Modifications Reflexions Explanations

20. Feedback from students

21. Receivedhelpincessation(%) Role of the University in cessation

22. Postgraduate 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)

23. 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

24. Zárókép a Hungarodentről, nekünk nincs meg!!!!!! May, 2011, MOK meeting in Budapest(900 participants) distributing flyers