Tobacco cessation hits close to home
Elain Benton, dental hygienist,
In the wake of new Dallas-area, nicotine-free hiring policies, find out how TAMHSC-BCD’s tobacco treatment clinic takes on new importance and how it has changed the lives of 3 former nicotine users
Tobacco cessation programs like the one at Texas A&M Health Science Center Baylor College of Dentistry may just take on new relevance, considering recent announcements from neighboring Baylor University Medical Center at Dallas.
Starting Jan. 1, all new medical center hires must be nicotine free and will be subject to initial nicotine screenings. Current employees will have access to tobacco cessation services free of charge, but employees and their spouses who continue to use nicotine will be responsible for a $25 surcharge each pay period if they’re under the health care system’s medical coverage.
While this nicotine-free hiring policy — the first of its kind for a major Dallas employer — doesn’t directly impact the dental school, as more employers adopt such practices, individuals may increasingly rely on cessation programs like the one at TAMHSC-BCD.
Combining education with patient needs
Since Baylor Tobacco Treatment Services — the only dental tobacco cessation clinic in Texas, to date — opened in 2004, dental hygienist and clinic counselor Elain Benton estimates she’s seen approximately 700 patients, who receive telephone follow-up on a regular basis unless they decline. Benton is Baylor Tobacco Treatment Services’ third counselor; two other certified tobacco treatment counselors who developed the clinic with Dr. K. Vendrell Rankin, professor and associate chair of public health sciences, and director of the clinic, also have worked in the same capacity.
The clinic initially was supported through funds allocated to each of the state’s health science centers from an independent Texas lawsuit because it was not part of the Tobacco Master Settlement agreement. TAMHSC’s grant to Baylor was $50,000, and the public health sciences department elected to use the funds to start the tobacco cessation clinic.
"It’s about helping them to develop their choices and about helping them weigh the pros and cons in order to make the decision for themselves.”
— Dr. K. Vendrell Rankin
It has evolved through direct salary support and grants obtained by the public health sciences department. Its services — which were originally geared to help patients of record, faculty, staff and students quit tobacco use at no cost — has grown to include patient referrals from clinicians outside the dental school.
Having the tobacco cessation center conveniently located on the college’s seventh floor offers dual benefits. Patients can receive counseling from Benton — a certified Mayo Clinic tobacco treatment specialist — and students can learn how to approach chairside counseling.
“It’s about meshing education for the students and the needs of the patients,” says Rankin. Rankin gives three formal D2 lectures as part of the curriculum, and Benton gives two dental hygiene student lectures. Rankin’s other two formal lectures are geared toward helping D3s learn motivational interviewing skills. Benton reinforces this technique with students through one-hour role playing sessions.
Addressing physical cravings and emotional concerns
Services at the cessation clinic are free, but Benton does not distribute medication. Rankin consults with Benton to make recommendations and write prescriptions when indicated, so that the program stays in line with national clinical practice guidelines for treating tobacco use.
Perhaps Benton’s most crucial role is addressing patients’ emotional needs as they start on their quitting journey.
“Patients like the one-on-one contact. A lot of them ask me, ‘Can I come back next week?’ They recognize that they need follow up and support,” says Benton, sitting in the clinic, which exudes a cozy office feel with its circular table and bookshelves filled with brochures and pamphlets.
“I’m very respectful of where they are in their quit attempt,” says Benton. “A lot of people make judgments and try to force them to make decisions when they might not be ready. Our clinic doesn’t work that way.”
Rankin, also a certified Mayo tobacco treatment specialist, offers her perspective, gleaned from 15 years of experience in tobacco cessation.
“It’s about helping them to develop their choices,” says Rankin, “and about helping them weigh the pros and cons in order to make the decision for themselves.”
Breathing easier: in their words
To read more about three patients who made the life-changing decision to quit using tobacco and how Baylor Tobacco Treatment Services helped them through the process, click on each of the story links below.