Do Faxed Quitline Referrals Add Value to Dental Office–Based Tobacco-Use Cessation Interventions?

Abstract

Background The Ask, Advise, Refer (AAR) model of intervening with patients who use tobacco promotes a brief office-based intervention plus referral to a tobacco quitline. However, there is little evidence that this model is effective. The primary aim of this study was to evaluate the effects on patients’ tobacco us of two levels of a dental office-based intervention compared with usual care. Methods The authors randomly assigned 68 private dental clinics to one of three conditions: 5 A’s (Ask, Advise, Assess, Assist, Arrange); 3 A’s (AAR model); or Usual Care, and they enrolled 2,160 participants. Results At the 12-month assessment, compared with those in usual care, participants in the two intervention conditions combined were more likely to report cessation of tobacco use, as measured by 9-month prolonged abstinence (3% vs. 2%; F (1,66) = 3.97, P<.10) and 12-month point prevalence (12% vs. 8%; F (1,66) = 7.32, P<.01). There were no significant differences between participants in the clinics using the 5 A’s and 3 A’s strategies. Conclusions The results of this study are inconclusive as to whether referrals to a quitline add value to brief dental office-based interventions. Patients receiving telephone counseling quit tobacco use at higher rates, but only a small percentage of those proactively referred actually received counseling. Clinical Implications The results confirm previous research that training dental practitioners to provide brief tobacco-use cessation advice and assistance results in a change in their behavior, and that these practitioners are effective in helping their patients to quit using tobacco.

Development and evaluation of the See Me Smoke-Free multi-behavioral mHealth app for women smokers

“…Nicotine dependence was assessed using the Fagerström item BHow soon after you wake up do you usually smoke your first cigarette?^based on previous research showing this one item to be most predictive of abstinence [66][67][68][69][70]. Readiness to quit (using the Biener and Abrams Contemplation Ladder; 0 = not ready to quit to 10 = ready to quit now) [71] and self-efficacy to quit smoking (using five items from the Condiotte and Lichtenstein Confidence Questionnaire) [72] were administered at baseline and re-assessed during followup measurement points based on the answer to current tobacco use.…”

Evidence summary: is smoking cessation an effective and cost-effective service to be introduced in NHS dentistry?

“…We did not find studies evaluating the cost-effectiveness of the intervention in the UK. [5][6][7][8][9] were excluded as they were either published before 2008 or did not match the inclusion criteria. Nohlert's 2009 9 study was omitted as it compared two methods of smoking cessation rather than examining individual effectiveness.…”

Challenges to be overcome: Current situation involving smoking cessation in Dental setting

“…The demonstration of a cause-effect relationship between oral alterations and tobacco use and the benefits of dental treatment may encourage patients to quit smoking. Interventions performed by oral health professionals are effective and can improve the knowledge about the risks of smoking and increase tobacco abstinence rates [14,[22][23][24][25][26][27][28][29][30][31][32].…”

“…This training should also be included in the undergraduate course and education curriculum of dental students [32]. Some studies evaluating the impact of new training techniques on tobacco cessation interventions among dental students have reported satisfactory results [15,25,26,[34][35][36][37][38][39].…”

“…These diseases justify an approach targeting smokers in order to obtain a satisfactory response [8]. Both short-term and structured interventions have shown positive effects on reducing tobacco consumption [17,23,25,26,38,40].…”