Tobacco attitudes, practices, and behaviors: A survey of dentists participating in managed care

Abstract

Tobacco cessation knowledge, attitudes, and behaviors of dentists participating in a large national managed care dental plan were assessed using a mailed survey. The survey was administered to dentists recruited to participate in an evaluation of a CD-ROM and supportive electronic detailing to promote increased tobacco cessation activities. General dentists who met specific technological criteria, had an active E-mail account, and at least 200 adult patients were eligible to participate in this study. A total of 184 dentists, located in 29 states, agreed to participate. The survey instrument included questions that addressed (a) Ask, Advise, Assess, Assist, and Arrange behaviors, (b) self-efficacy including knowledge, confidence, and success regarding tobacco cessation, (c) success of various tobacco cessation strategies, (d) barriers to tobacco cessation, and (e) demographics including year of graduation, gender, and race/ethnicity. Self-reported baseline tobacco intervention-related behaviors were low, with 28% of dentists reporting that they asked their patients about tobacco or recorded tobacco use in their patients' charts at least 41% of the time. For Advise behavior, approximately half of the dentists advised tobacco-using patients to quit at least 41% of the time. Although self-reported lack of knowledge was high, 71% of respondents indicated that their lack of knowledge was either not a barrier or a slight barrier to incorporating tobacco cessation into their practices. The survey revealed that dentists do not routinely incorporate tobacco cessation into their practices. Newer information-transfer technologies may serve as vehicles for increased smoking cessation activities by dentists.

What Factors Need to be Addressed to Support Dental Hygienists to Assist Their Patients to Quit Smoking?

“…The major barriers for dentists and hygienists in the adoption of smoking interventions assisting patients to quit smoking identified in the international literature include practitioner knowledge, skills, and confidence, perceived patient resistance, time barriers, concerns of low effectiveness, and lack of reimbursement (Albert, et al, 2005;Brothwell & Gelskey, 2008;Croucher, 2011;Helgason, et al, 2003;Stacey, et al, 2006).…”

Is provider training effective? Changes in attitudes towards smoking cessation counseling and counseling behaviors of home health care nurses

“…In one study, dentists who believed that tobacco cessation counseling is an important component of dentistry counseled more smokers (Albert et al, 2005). Among HHC nurses, perceived importance of counseling is associated with asking about smoking status, advising patients to quit, and assisting patients with quitting (Borrelli et al, 2001).…”

“…Dentists who believed that they were successful in helping patients quit were three times more likely to advise patients to quit (Albert et al, 2005). Zapka et al (1999) found that pediatricians who believed that counseling was effective were more likely to report counseling.…”

Are Pediatric ED Nurses Delivering Tobacco Cessation Advice to Parents?

“…The questionnaire items were adapted from similar surveys used in previous studies. 16,17 The questionnaire consisted of eight items assessing current tobacco cessation behaviors (based on the "5 A's" model), six items regarding attitudes toward providing tobacco cessation services to parents, and 11 items measuring barriers to providing tobacco interventions. A $5 department store gift certificate was offered upon completion.…”