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Figure 11.2: Very Brief Advice pathway Figure 11.2 shows that dental teams should: ask all patients about tobacco use, as part of medical history and recheck and record this at every visit, with questions such as: Do you smoke? Do you use tobacco products, for example snuff, paan, chewing tobacco, or shisha? Have you ever smoked or used tobacco in the past? When did you stop? examine all patients (oral cancer screening, basic periodontal examination, monitor or refer lesions) and record signs of tobacco use, including: staining halitosis mucosal changes advise those at risk on method of quitting, without asking patients if they want to quit (which can lead to defensiveness) and avoiding detailed questions: Research shows the best way to stop is with a combination of specialist support and medication

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Co-consumers were more likely to meet criteria for clinical depression (OR = 1.34, 95% CI 1.121.61) and have same-sex (OR = 1.35, 95% CI 1.031.76) and/or multiple male sex partners (OR = 1.45, 95% CI 1.231.71)