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Tobacco – in any form – is hard on the entire body, including the teeth

Monday, September 18, 2023 | Posted in GEHA Connection Dental Network News

Tobacco – in any form – is hard on the entire body, including the teeth. According to the CDC, people who use tobacco are twice as likely to experience tooth decay, and “people who smoke are three times more likely to lose all their teeth.”

The reasons to quit using tobacco are well known. To help support patients as they try to quit using, the World Health Organization developed the five A’s: Ask, Advise, Assess, Assist and Arrange.



Ask -
Systematically identify all tobacco users at every visit.

• Ask ALL of your patients at every encounter if they use tobacco and document it.
• Make it part of your routine.

Advise -
Persuade all tobacco users that they need to quit.

• Urge every tobacco user to quit in a clear, strong, and personalized manner.

Assess -
Determine readiness to make a quit attempt.

• Ask two questions in relation to “importance” and “self-efficacy”:
1. “Would you like to be a non-tobacco user?”
2. “Do you think you have a chance of quitting successfully?”

Assist -
Help the patient with a quit plan.

• Help the patient develop a quit plan.
• Provide practical counseling.
• Provide intra-treatment social support.
• Provide supplementary materials, including information on quit lines and other referral resources.
• Recommend the use of approved medication if needed.

Arrange -
Schedule follow-up contacts or a referral to specialist support.

• Arrange a follow-up contact with your patient either in-person or by telephone.
• Refer the patient to specialist support if needed.

Table 1. The 5 As from the World Health Organization.

Visit the World Health Organization and CDC websites for additional resources (toolkit). Federal employees may find information on the FEHB tobacco cessation benefit, at the OPM's Quit Smoking webpage.

“Dental professionals: Help your patients quit.”, Centers for Disease Control and Prevention, 19 March, 2020.
“Toolkit for delivering the 5 A’s and 5 R’s brief tobacco interventions in primary care”, World Health Organization.