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Module 2: Ask, Advise, Assist, Refer Module 3: Quit Smoking Medications Module 4: Smokeless Tobacco, Dental Health Intervention and E-cigarettes Module 5: Office Systems and Creating a Quit Plan Babalola Faseru, MD, MPH Department of Preventive Medicine and Public Health University of Kansas Medical Center Objectives Types of Smokeless Tobacco Prevalence, Health Effects, and How to Treat Ask, Advise, Refer Model for Dental Practice E-cigarettes What we know What we dont know What do you tell your patients Babalola Faseru, MD, MPH Department of Preventive Medicine and Public Health University of Kansas Medical Center Smokeless TobaccoHarmful & Highly Addictive Types of smokeless tobacco Snus (snoose)Scandinavian moist powder tobacco product (place under upper lipless need to spit) SnusAmerican similar to Scandinavian but no regulation Dipping tobacco moist snuff (lower lip and gums) causes excess saliva, could require spitting Nasal Snuff Finely ground dry form of tobacco snuffed through the nose Chewing tobacco long strands placed between cheeks, gum, or teeth (plugs, wads, chew) Dissolvables strips, sticks, orbs and compressed tobacco lozenges HEALTH EFFECTS OF Smokeless tobacco Cancer Risk Smokeless tobacco contains 28 carcinogens Increases the risk of developing several cancers Oral Health Dangers Increases the risk of developing precancerous mouth lesions Strongly associated with recession of the gums

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An unspecified concn of acetone was detected in rain in Japan(2)