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Tobacco and the Dental Office: Encouraging Patients to Quit
This study evaluated the effectiveness of a CD-ROM intervention combined with academic detailing email messages for dentists to increase tobacco cessation activities in the dental practices within a dental managed care organization. The grant also evaluated dentists’ knowledge, attitudes, and behaviors towards tobacco cessation services within their practice, as well as patient cessation behaviors. One hundred eighty-four dentists from 29 states completed a baseline survey on their tobacco cessation knowledge, attitudes, and behaviors. Seventy-three percent of respondents indicated that they conducted tobacco cessation activities in their offices. Of these, 57% of dentists identified themselves as the primary person responsible for tobacco cessation in the office. Approximately two thirds of these dentists occasionally (defined as less than 40% of the time) asked their patients about their tobacco use or flagged the patient’s chart if the patient was a tobacco user. Half of these dentists occasionally advised their patients to quit (defined as less than 40% of the time). Only one-third of these dentists asked and advised their patients frequently (defined as at least 81% of the time). Dentists reported many barriers to incorporating tobacco cessation into their practice, such as patient resistance, amount of time involved, lack of reimbursement, concerns about effectiveness, lack of educational materials, and lack of referral services. At follow-up, approximately half of the dentists reported using the CD-ROM. Of the dentists who loaded the program, 62% rated the CD-ROM as useful or very useful, and 32% shared the program with other clinicians in the office. Dentists in the intervention arm reported spending more time on tobacco cessation counseling than dentists in the control arm of the study. (Patients of dentists in the intervention arm reported a decrease in the number of cigarettes smoked each week and an increase in the number of quit attempts compared to patients of dentists in the control arm of the study.) The study found that an intervention delivered via CD-ROM and email was an effective strategy to enhance dentists’ knowledge and increase delivery of tobacco cessation services. Further training and research is needed to facilitate seamless integration of tobacco dependence treatment into dental practices. Citation: Albert D, Severson H, Gordon J, Ward A, Andrews J, Sadowsky D. Tobacco attitudes, practices, and behaviors: A survey of dentists participating in managed care. Nicotine Tob Res 2005; 7(Suppl 1): S9-S18. For more information, contact: David A. Albert, DDS, MPH
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