Tobacco Treatment Tips

APNA News: The Psychiatric Nursing Voice  |  January 2019 Members' Corner Edition

As the former chair of the Tobacco Dependence Branch of the APNA Addictions Council, CCarol Essenmacher, DNP, NCTTParol Essenmacher, DNP, NCTTP completed her MSN and DNP on tobacco treatment. A Mayo Clinic Certified Tobacco Treatment Specialist, she has an extensive background in providing care to individuals who use tobacco. Here, she gives some tips to promote positive interventions for tobacco use:

Approaching the Topic

When it comes to tobacco use, it is important to accurately ask patients about it. When a patient is asked if they smoke, there may be unintended responses. A person who dips or chews may respond that they don’t, either because they know what you are trying to get at and want to avoid that conversation – or they don’t see dipping or chewing as being as harmful as smoking. The best way to broach the subject is to say, “Do you ever use tobacco or nicotine products?” Phrasing the question this way covers a variety of tobacco and nicotine use methods including smoking, using electronic cigarettes or vaping, dipping, chewing, hookah, occasional cigar, or smoking a pipe.

Checking for Cancer

One very effective, take-to-work intervention for helping a patient who dips or chews is to ask if anyone has shown them how to check their mouth for cancer. In the morning after the individual brushes their teeth, they should thoroughly rinse and spit. Then, using their little finger, pull their lip down (or up) and look at the inside of their cheeks, their gums, or their tongue. If they see white patches that sometimes look like ridges or tough tissue, they should be encouraged to report it ASAP to their provider. This is known as Leukoplakia and while it is not cancer, it may be a precursor to cancer. Encourage your patients who dip or chew to do this at least once a week. Often this alone raises their motivation to get help to quit.

It may take some retraining on all of our practice as usual to ask about tobacco use accurately. But, if we hope to have our patients change their behavior, we first have to change ours! For more information on assessing tobacco use accurately, review the APNA 32nd Annual Conference session Not Your Dad’s (or Mom’s) Cigarettes Anymore: Assessing Tobacco Use Accurately Supports Successful Treatment. (Click here to browse available podcasts from the APNA 32nd Annual Conference).

Have expertise of your own to share? Submit an abstract for consideration as a presentation for the APNA 33rd Annual Conference by March 4th.

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