Section 2 - Brief Intervention What and Why?

This section covers:

Smoking facts

Let’s begin with some key facts about smoking prevalence in Scotland:

Smoking prevalence

More key facts about smoking prevalence in Scotland:

Smoking and the law

What is the law relating to tobacco use in Scotland?

Definition of brief intervention

A Guide to Smoking Cessation in Scotland 2010:  reference 1Planning and providing specialist smoking cessation services defines brief interventions as:

Opportunistic discussion, negotiation or encouragement, and referral to more intensive treatment where appropriate. They are commonly used in many areas of health promotion and are delivered by a range of primary and community care professionals.

You may also hear the term 'brief advice' rather than 'brief intervention' being used - the Guide recognises that these terms are often used interchangeably, and definitions can vary. For smoking cessation, brief interventions typically take between 5 and 10 minutes.

It is recommended that practitioners deliver the most comprehensive intervention which time allows but it is recognised that sometimes it will only be possible to offer a shorter version due to time constraints. If time does not allow for a detailed brief intervention, benefits will still be gained.

Brief interventions may include one or more of the following:

People who want to stop smoking are at least 4 times more likely to quit when combining support from stop smoking services with the use of medications such as NRT, Zyban® or Champix®.  reference 5 You will learn more about this later in this module.

Typically, members of the dental team would not prescribe pharmacotherapy for smoking cessation but would encourage patients to seek this help from other sources such as specialist services or pharmacists.

It is recommended that brief interventions are delivered by those who have undergone a training course such as this one. On-going support to actually aid and assist with a quit attempt is best delivered by trained, specialist staff such as smoking cessation advisers.

Evidence for effectiveness of brief intervention

Note:

At the moment, most of the evidence relating to the effectiveness of brief advice refers to when it is delivered by GPs or hospital physicians.  reference 5 There is emerging evidence for the effectiveness of brief advice delivered by members of the dental team and other healthcare professionals.

It has been suggested that a professional's level of training and commitment to providing brief advice may be more important that their actual professional discipline.

All health professionals therefore have an important role to play in encouraging smokers to stop and promoting local services that can help.  reference 1

Situations where appropriate to deliver brief intervention

Brief interventions are opportunistic and therefore can potentially be delivered anywhere with anyone at any time. It is therefore difficult to define exactly when brief advice is appropriate as this depends on each individual and each situation. There are however, some situations and ways of raising the issue which are better suited than others.

For some people, a diagnosis of periodontal disease or a potentially malignant lesion may be the right time to discuss their smoking. For others it is not! It is therefore important that each situation is considered individually and it is important that you are guided by the individual you are speaking with.

A Guide to Smoking Cessation in Scotland 2010 reference 1 states that;

As a general rule, healthcare professionals should:

* The Guide advises that this action is appropriate for health professionals only.


Your role in delivering a brief intervention is to:

DELIVER the message that smoking is harmful to health and oral health and that stopping is worthwhile.

OFFER factual information about health effects and risks and benefits of quitting.

ALLOW the person to make their own individual choice as to whether they want to quit smoking.

RECOMMEND that if they do want to stop smoking they seek support from a local health board smoking cessation service.

Barriers in delivering brief intervention

If done appropriately and sensitively brief advice can be delivered at anytime. However there can be situations where barriers may be present which can prevent the most effective delivery of brief advice.

Barriers can change with time and situation and what you consider a barrier in one situation, may not be in another. It is therefore important to consider each individual situation separately.  

Example barriers

Some examples of barriers to raising the issue of smoking include:

Key points

You can now proceed to section 3