Global Status of Knowledge, Attitude and Practice on Tobacco Cessation Interventions Among Dental Professionals: A Systematic Review

Abstract

BACKGROUND With the emergence of the WHO Framework Convention on Tobacco Control, globally the use of tobacco has decreased notably, although, it still requires efforts at individual, organizational, community level to decrease the rate further. Dental professionals are at an excellent position to provide tobacco cessation counselling and interventions, however, it is not practiced much due to lack of training and lack of knowledge. Therefore, this systematic review was conducted to assess the global status of knowledge, attitude and practice on tobacco cessation interventions among dental professionals. MATERIALS AND METHOD A systematic search of 6 databases with no language restriction since 2000 was undertaken. Studies were included if they assessed knowledge, attitude and practice on tobacco cessation interventions among dental professionals using a validated or prevalidated tool. The data obtained for assessment of knowledge, attitude, practice, curriculum and barriers were represented through heatmaps. Quality assessment of the studies was done using Newcastle Ottawa scale. RESULTS Fifty six studies were included in this systematic review. Majority of the studies were found to be of moderate quality. Knowledge regarding the tobacco cessation interventions was more theoretical than practical. All the studies showed a favorable attitude among dental professionals towards tobacco cessation intervention. CONCLUSION The included studies lack homogeneity in assessing knowledge, attitude and practice on tobacco cessation interventions. The development and validation of a standardized questionnaire to assess knowledge, attitude and practice on tobacco cessation interventions could be a potentially effective way to uniformly gather data on the subject.

Oral and oropharyngeal cancer screening and tobacco cessation discussions, NHANES 2011–2018

“…In this study of participants who self-identified as currently using tobacco and having had a dental visit within the previous year, overall 22.1% reported having had an OOPC screening by a dental professional within the previous year. Overall, there were 41.1% who reported having had a conversation with a dental professional within the previous year about the benefits of tobacco cessation.…”

“…In another systematic review, the authors indicated that there was only low‐certainty evidence of the effectiveness of behavioural support for tobacco cessation, while there was moderate support of a combined behaviour/pharmacotherapy approach 21 . Dental professionals without pharmacotherapy education for tobacco cessation may use such evidence to justify not including tobacco cessation discussions, particularly if there is concern of alienating patients as 25%–50% globally believed inquiring about tobacco use would have a negative influence on their practice 22 . In terms of current global research on tobacco cessation discussions provided by dental professionals, authors of a systematic search indicated that although the studies showed a favourable attitude to tobacco cessation discussions, knowledge was more theoretical than practical: knowledge of the 5As of tobacco cessation was >80%, but practice of using the 5A's (Ask, Advise, Assess, Assist, Arrange) was as low as 11%; knowledge of pharmacotherapy was <75%, but only ten of the studies reported dental professionals prescribing pharmacotherapeutics 22 .…”

“…22 In terms of current global research on tobacco cessation discussions provided by dental professionals, authors of a systematic search indicated that although the studies showed a favourable attitude to tobacco cessation discussions, knowledge was more theoretical than practical: knowledge of the 5As of tobacco cessation was >80%, but practice of using the 5A's (Ask, Advise, Assess, Assist, Arrange) was as low as 11%; knowledge of pharmacotherapy was <75%, but only ten of the studies reported dental professionals prescribing pharmacotherapeutics. 22 Tobacco cessation counselling and interventions were not practiced much due to lack of time and training. 22 Conducting oral cancer screenings may have the same constraints of time and knowledge.…”

“…22 Tobacco cessation counselling and interventions were not practiced much due to lack of time and training. 22 Conducting oral cancer screenings may have the same constraints of time and knowledge. Although the ADA supports screenings, most national organizations, including the US Preventive Services Task Force, have not due to lack of evidence that screening will lead to a reduction in mortality associated with oral cancer.…”