Cotinine, whatever the collection method and analysed by EIA kits, shows good differentiation between smokers and non-smokers. Salivary samples have the advantage of being non-invasive, although collection methodology is important, as cotinine levels may vary.
BackgroundTobacco use continues to be a global public health problem. Helping patients to quit is part of the preventive role of all health professionals. There is now increasing interest in the role that the dental team can play in helping their patients to quit smoking. The aim of this study was to determine the feasibility of undertaking a randomised controlled smoking cessation intervention, utilising dental hygienists to deliver tobacco cessation advice to a cohort of periodontal patients.MethodsOne hundred and eighteen patients who attended consultant clinics in an outpatient dental hospital department (Periodontology) were recruited into a trial. Data were available for 116 participants, 59 intervention and 57 control, and were analysed on an intention-to-treat basis. The intervention group received smoking cessation advice based on the 5As (ask, advise, assess, assist, arrange follow-up) and were offered nicotine replacement therapy (NRT), whereas the control group received 'usual care'. Outcome measures included self-reported smoking cessation, verified by salivary cotinine measurement and CO measurements. Self-reported measures in those trial participants who did not quit included number and length of quit attempts and reduction in smoking.ResultsAt 3 months, 9/59 (15%) of the intervention group had quit compared to 5/57 (9%) of the controls. At 6 months, 6/59 (10%) of the intervention group quit compared to 3/57 (5%) of the controls. At one year, there were 4/59 (7%) intervention quitters, compared to 2/59 (4%) control quitters. In participants who described themselves as smokers, at 3 and 6 months, a statistically higher percentage of intervention participants reported that they had had a quit attempt of at least one week in the preceding 3 months (37% and 47%, for the intervention group respectively, compared with 18% and 16% for the control group).ConclusionThis study has shown the potential that trained dental hygienists could have in delivering smoking cessation advice. While success may be modest, public health gain would indicate that the dental team should participate in this activity. However, to add to the knowledge-base, a multi-centred randomised controlled trial, utilising biochemical verification would be required to be undertaken.
Whilst several studies have investigated the views of North American dentists on providing advice to patients on stopping smoking, the role of their UK counterparts in this area is uncertain. Thus this study aimed: 1. to examine dentists' awareness of the effect of smoking on general and oral health, 2. to determine their views on counselling patients to give up smoking, 3. to investigate the extent to which they currently engage in this activity, and 4. to survey barriers to providing such advice. Data were collected via a postal questionnaire mailed to 587 Scottish dental practitioners, of which 448 (76.3%) were completed and returned. The importance of smoking as a cause of ill health and death was acknowledged universally, and most were aware of the adverse consequences of smoking on the oral tissues. Over half the respondents (245 or 54.7%) thought dentists had a role in counselling patients to give up smoking and whilst 107 (23.8%) were uncertain, the remaining 95 (21.2%) felt this was outside their remit. Nonetheless, 384 (85.6%) reported that, at least occasionally, they advised patients to quit. Lack of time was seen as an important barrier to tobacco counselling, as was lack of training. Further studies are required to determine the most useful strategies or approaches, and to determine their effectiveness.
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