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CME Objective: To review current evidence for health consequences of smoking, prevention of smoking-related disease, treatment, and practice improvement of smoking cessation.
Funding Source: American College of Physicians.
Disclosures: Dr. Patel, ACP Contributing Author, has disclosed no conflicts of interest. Dr. Steinberg, ACP Contributing Author, reports personal fees from Arena Pharmaceuticals and major league baseball outside the submitted work. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-2670.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that she has no financial relationships or interests to disclose. Darren B. Taichman, MD, PhD, Executive Deputy Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer.
With the assistance of additional physician writers, the editors of Annals of Internal Medicine develop In the Clinic using MKSAP and other resources of the American College of Physicians.
In the Clinic does not necessarily represent official ACP clinical policy. For ACP clinical guidelines, please go to https://www.acponline.org/clinical_information/guidelines/.
This issue provides a clinical overview of smoking cessation, focusing on health consequences of smoking, prevention of smoking-related disease, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.
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According to Chi et al., the different anatomic parts of the oral cavity include the labial and buccal mucosa, floor of mouth, alveolar ridge and gingiva, anterior two-thirds of the tongue, hard palate, and retromolar trigone (3). Cigarette smoking is responsible for one fourth of all oral cavity cancer cases (4). The risk clearly increases when smoking lasts for over 20 years and more than 20 cigarettes are smoked per day (4). The most common malignancy of the head and neck (excluding nonmelanoma skin cancer) is Oral Cavity Squamous Cell Carcinoma (OC-SCC) (3). Oral lesions precede these OC-SCC (5). According to Patel and Steinberg (1), a broad range of health care providers, including dentists, can reduce the impact of tobacco use in our society. We would like to focus on the crucial role of the dentist in the prevention and treatment of smoking-related diseases (including referral to another health professional), which involves not only maintaining teeth and gums in optimal condition but also the early identification of OC-SCC, oral potentially malignant disorders screening and effective care during malignant disease. Dentists should know their patients’ smoking status and routinely closely examine the whole oral mucosa during dental visits. We feel strongly that the evident close connection between dentistry and medicine is essential. The topic of prevention and treatment of tobacco abuse is atypical example of the imperative need for cooperation among health care professionals.
Clinical Slide Set. Smoking Cessation
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