Motivational Interviewing for Smoking Cessation

Motivational Interviewing for Smoking outcomeMaria (titanium number 47144) is a retired, 65-year-old lady who visited the clinic, for the replacement of her teeth in quadrant 4 (33-36) afterwards the removal of the old bridge and the a just nowments by a private dentist due to weakened abutments. consort to the patient, her last visit to the dentist was 2 weeks before her first appointment with me. It was for the removal of the residual reference of 44 which served as one of the abutments for the previous bridge. Maria brushes her teeth twice a day, using a soft bristle toothbrush and fluoridated toothpaste. She also flosses and rinses her mouth with Listerine mouthwash twice a day.The patient has cardinal cardiac arrhythmia, chronic bronchitis, fracture on vertebrae T5 and T7, depression, fibrocystic breast, hypertension, sciatica leg, scoliosis, type 2 diabetes and osteoarthritis on her rotator cuffs as hygienic as her knees. She is allergic to resedronate sodium.Socially, Mar ia is a smoker and she smokes 15 cigarettes a day since she was 17 and she is not thinking of quitting. She drinks occasionally.Upon oral examination, her oral hygiene is generally learningful with some mild plaque and potassium bitartrate deposition. Her PSR score was 0 for all sextants, suggesting no active periodontal disease but generalized gingival recession was present. Her 24-27 as well as 34-36 was replaced by bridges. There were restorations on almost all of the dentitions with entirely 4 sound teeth. However, no active carious lesion was found.Tobacco smoking can ca call injure to almost every system of the humans body, contributing to a variety of diseases thus increase the mortality rate.1 Moreover, studies perk up shown that smoking can affect oral health in diverse address such as increasing occurrence of oral cancer, periodontitis as well as causing teeth discolouration.2 Therefore, it is the responsibility of a dental practitioner to address this issue. In Mari as case, the attire of smoking is rather alarming because it not only can affect the oral health but her general wellness. From her medical history, it has been shown that she is suffering from multiple diseases that can be modified by tobacco smoking. just about significantly, smoking is the major cause of chronic bronchitis and can further exacerbate the symptoms.3 Hence, motivational interviewing was attempted to foster Maria in quitting smoking.I started the motivational interviewing session by exploring the stage of qualify Maria was at. agree to Maria, she has thought of quitting but it was very difficult because smoking provide her a means to relieve perplexity and depression. She also expressed that she was not ready to quit. From here, it can be deduced the she is at pre-contemplation stage. Subsequently, I asked for her permission to cover about this issue, emphasizing that the decision of quitting is up to her. She agreed and in return, I give affirmation by thank ing for her willingness to talk about quitting.To elicit the change talk, I started by further exploring the source of her barrier. She told me that her medical conditions and the need for surgery were making her depressed. From here, I presumed that her concern about health could be a good motivator. Then, I asked her the reason as to why she has thought of quitting. In response, she said that she wanted to be better and that she was aware of the disadvantages of smoking as her GP had always advised her to quit. Furthermore, smoking had also become a financial burden for her. At this point, I summarized that her goal was to improve her health. Hoping to develop a discrepancy surrounded by smoking and her goal, I asked her to think about the advantages of quitting smoking. She replied that by quitting smoking, she might be able to become better and save some money. When I asked her about her world power to pretend the change, she replied with I really dont know. As I was facing resistance, I tried to find an alternative question. When she was asked about what she would do to make the change, I got a similar reply I am not sure. With her permission, I introduced her to the quit line. Finally, I concluded with reiteration of the discrepancy between smoking and her goal to become healthier.A brief evaluative session was done before a restorative procedure when I updated her medical history. She told me that she just had a biopsy done, suspected with breast cancer and still using cigarette to relieve stress. Due to time pressure, the session stopped here.Judging from Marias response during the conversation, it can be seen that although I have successfully encouraged her to think and talk about the issue, the intention of quitting is petty(a). The response I really dont know and I am not sure suggest that she is highly in doubt of her ability to quit. In addition, it is clear that cigarette as a stress reliever is a strong ambivalency that stops her from qu itting.I feel that the session was a good start for both Maria and I but there is still a lot of improvement needed. To illustrate, I lack the experience in giving appropriate affirmations. There were a few instances where my affirmations were rather awkward. Besides, I need to improve my skill in complex reflection. For instance, when she talked about the source of depression which was her health, I could have leaded her to a crude thought whereby smoking cessation can improve health and hence, reducing the source of depression. I could have also asked Maria to compare the advantages and disadvantages of smoking. This might help her to recognize her goal and ambivalence better. As she has low confidence in quitting, there should be more discussion as to how help could make a difference.4In conclusion, motivational interviewing can be a good approach to induce behavioural change in patients however practice is needed to develop the skills and to execute it effectively.ReferencesDol l R, Peto R, Boreham J, Sutherland I. Mortality in singing to smoking 50 yearsobservations on male British doctors. BMJ 2004 3281519-1528.Sham AS, Cheung LK, Jin LJ, Corbet EF. The effects of tobacco use on oral health. Hong Kong Med J 2003 9271277.Rebecca JT, Frank ES, Bernard R, Dimitrios T, Walter CW. Cigarette Smoking and Incidence of Chronic Bronchitis and asthma attack in Women. Chest 1995 108(6)1557-1561.David B. Rosegren. Building Motivational Interviewing Skills A Practitioner Workbook. 1 edn. Washington The Guilford Press, 2009.