Encouraging patients to quit

Key Points

• The findings of this research confirm that dentists, hygienists and dental nurses appreciate the importance of raising their patients' awareness regarding the role of smoking in dental disease.

• Clinicians may be able to identify their own current barriers to providing smoking cessation advice to patients and then to consider how such barriers may be overcome.

• The paper will hopefully stimulate dentists to consider further training in the area of smoking cessation possibly for themselves and also for other members of their team.

Abstract

Objective To undertake a questionnaire-based survey to determine the attitudes and activities of dental professionals in primary care in the Northern Deanery of the UK in relation to providing smoking cessation advice.

Methods Questionnaires for dentists, hygienists and dental nurses were sent to hygienists to distribute to other members of the team. The information collected included: smoking status of the professionals and the practice; roles of the dental team in giving smoking cessation advice; levels of training received; and potential barriers to giving this brief intervention.

Results Over 90% of practices were smoke-free environments and significantly more dental nurses (23%) were smokers compared to dentists (10%) and hygienists (7%) (p<0.01). The majority of dentists and hygienists enquired about smoking status of their patients and all three groups believed that hygienists and dentists should offer brief smoking cessation advice. Potential barriers to delivering smoking cessation advice were identified: lack of remuneration; lack of time; and lack of training.

Conclusion Dental teams in primary care are aware of the importance of offering smoking cessation advice and, with further training and appropriate remuneration, could guide many of their patients who smoke to successful quit attempts

Main

Smoking cessation as a dental intervention — Views of the profession Stacey F., Heasman P. A., Heasman L., Hepburn S., McCracken G. I. and Preshaw P. M. Br Dent J 2006; 201: 109–113

Comment

The importance of dental health professionals taking an active role in smoking cessation and prevention is undeniable given the impact of smoking on the health of the mouth, and the evidence that advice and support given in dental practices can have a small but significant impact on cessation rates.¹ Recently the FDI have called for oral health professional organisations across Europe to adopt a 14 point code of practice on tobacco control enshrining tobacco control activity as a professional duty.² As part of this, professional organisations are asked to assess and address the tobacco consumption patterns and control attitudes of their members. The survey reported by Stacey and colleagues shows how much progress has been made in this area over the recent past. There remains a proportion of the profession who smoke tobacco, and a proportion who do not engage in smoking cessation. It is this part of the profession who will need support in adopting smoking cessation practices. It is intriguing to consider whether individuals 'cluster' in their smoking practices, for example do dental practitioners that smoke tend to employ other professionals who smoke, and are these groups less likely to support smoking cessation in their care of patients? 'Clustering' if it exists would have implications for the analysis of data, and for the design of interventions to encourage smoking cessation in practices.

While numerous surveys have explored dental practitioners' attitudes towards smoking cessation, the role of the dental team in preventing individuals from starting smoking, and in supporting those who have quit smoking to maintain their abstinence, has been less commonly explored. For practitioners who are working with young people, primary prevention may be a significant contribution, since the practitioner can focus on the aesthetic impact of smoking. Where practices are successful in encouraging quitting, regular follow up appointments and recalls provide the opportunity for monitoring and maintenance. Finally, as a profession, the dental team can contribute to the wider tobacco control agenda through their professional organisations.³