Attitude and Practices Among Dentists and Senior Dental Students in Iran Toward Tobacco Cessation as an Effort to Prevent Oral Cancer

Abstract

Background: Oral health professionals are responsible in Iran for providing a brief tobacco cessation program to smoker patients. The aim of this study was to assess Iranian dental student and dentist practice, knowledge and attitudes toward smoking cessation programs. Materials and Methods: A valid and reliable self-administered questionnaire was designed and distributed to 150 dentists working in Isfahan-Iran and 60 dental students. Some questions were developed based on the expected 5A tobacco cessation protocol. Statements on attitudes focused on professional responsibility towards smoking cessation and its effectiveness. Chi-square, ANOVA, and t test were used for statistical analysis. Results: The cessation program in dental settings covers a small group of patients (18%). Some 69.1% (n=96) of dentists reported asking their patients about tobacco use, 64% (n=83) advising their patients to quit, 33.8% (n=47) assessing their patients willingness to quit and 20% (n=28) reported helping their patients in changing their behavior. A far lower percentage reported active involvement in arranging assistance for smokers to quit (4.3%, n=5). Some 22% of students and 26% of dentists disagreed that the tobacco cessation programs should be as part of dentists' professional responsibility and 70% of them were willing to follow the protocol of tobacco cessation for patients. Conclusions: Iranian dentist performance regarding tobacco cessation is weak. Dentists and students indicated their lack of knowledge as the major reason for non-adherence to the protocol. Therefore, planning to encourage dentist to follow the protocol needs continuous educational programs.

Dental Students’ Attitudes Toward Tobacco Cessation in the Dental Setting: A Systematic Review

“…46 The remaining 31 studies (81.6%) utilized author-created surveys or surveys based on items from previous studies. [21][22][23][24][25][26][27][28][29][30][31][32][33][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64] Of those 31 studies, ten (33.3%) reported pilot testing the measure. Nine (29%) reported conducting some psychometric testing of the measure (e.g., Cronbach's alpha, split-half reliability, testretest reliability, factor analysis).…”

“…Nine studies (23.7%) reported students' plans for future practice of tobacco cessation. 33,49,51,53,55,[62][63][64] Dentist role attitudes. Rates ranged from 54% of students willing to provide tobacco cessation 61 to 96% willing to use anti-tobacco programs in practice in order to advise patients to quit.…”

Training instances related to health psychology and counseling in the curricula of Chilean dentistry

“…Another instance of counseling that can be advantageous in the dental box is smoking cessation, not only for its impact on oral cancer, but because of its negative impact on overall health. Unfortunately, numerous recent studies have shown that dentists do not have the necessary skills to provide this type of counseling, which is usually of very poor quality 14,15 . While a direct reference to smoking cessation was not found in the curricula, it is important to note that there are guidelines established by the Chilean Ministry of Health to encourage dentists to provide counseling in this area 16 .…”

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

“…They include the lack of time, fear of the patient's reaction or resistance in accepting the approach, fear that the patient will lose trust in the professional, difficulty in addressing the topic, also being a smoker, lack of knowledge about the topic, lack of reimbursement, and fear of the reaction of colleagues [9,14,16,17,27,28,39,[41][42][43][46][47][48][49][50][51][52][53][54][55][56]. Once receiving training on tobacco cessation the graduation students and dental health professionals perceive significantly reduction on the pointed barriers [43].…”

“…Important aspects such awareness, attitude, practices, willingness and barriers were evaluated using hand-delivered, self-administered or via electronic contact were searched. Studies were conducted in many different clusters like dental universities [62], dental health professionals [7,9,12,13,17,32,46,48,[50][51][52]55,56,[63][64][65], dental insurance companies [61], students [1 5,21,28,31,32,38,39,45,47,49,51,53,55,66], dental patients who use tobacco [30,67,68] and dental teachers [44].…”