Tobacco cessation counseling: Are dentists doing enough?

Rajput, Soni; Gadiyar, Akshatha; Kumar, Amit; Kamat, Amita Kenkre; Gaunkar, Ridhima; Jain, Abhilash

doi:10.4103/jiaphd.jiaphd_96_19

Cited by 6 publications

(5 citation statements)

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“…The perceived barriers included a range of influences that have been reported in the literature: Lack of knowledge and skills; lack of time; lack of belief in the effectiveness of dentists’ advice; lack of supporting resources 21 , 29 ; lack of referral systems 30 ; use of ST amongst dentists 21 , 31 and perceived patients’ resistance. 19 , 32 , 33 Junior dentists exhibited greater awareness about tobacco cessation guidelines, in line with another study conducted in England. 29 This can be explained by the recent addition of the requirement for continued medical education or more emphasis on history taking during specialist exams in recent times.…”

Section: Discussionsupporting

confidence: 84%

Smokeless Tobacco Cessation Support in Dental Hospitals in Pakistan: Dentists and Dental Patients’ Perspectives on Current Practices, Support Needed, and Opportunities Available

Rasool

Dobbie

Boeckmann

et al. 2023

Nicotine and Tobacco Research

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Introduction Despite evidence on the effectiveness of tobacco cessation interventions in dental settings, the implementation remains low, especially for smokeless tobacco (ST). The purpose of this study was to develop an understanding of the influences governing the implementation of ST cessation support in dental hospitals. Methods A multi-centre qualitative study was conducted at two tertiary-care dental hospitals, in Pakistan. Semi-structured interview guide, guided by the Capability-Opportunity-Motivation-Behaviour (COM-B) model, were used to capture the views of dentists (n=12) and dental patients (n=12), regarding ST cessation support in dental hospitals. Framework approach was used to thematically analyse the data. Results Screening of ST users in routine dental practice was seldom practiced and the cessation support offered was brief advice. Barriers identified by dentists included: fear of offending and stereotyping patients; lack of knowledge and skills; lack of privacy; lack of belief in the effectiveness of behavioural support; lack of time and workload pressure; ST use amongst dentists; lack of referral systems and; the absence of a mandatory requirement of offering ST cessation support. Facilitators included: delivering support through junior dentists and the length of interaction between the dentist and the patient. Naswar was the most common ST product used by dental patients. Patients reported receiving negligible cessation support from any healthcare provider. Conclusions A range of influences governing the implementation of ST cessation support in dental hospitals were identified. These findings can inform the implementation of behavioural interventions for ST cessation in dental and other clinical settings, in low and middle-income countries. IMPLICATIONS Smokeless Tobacco (ST) control considerably lags, in comparison to the control of combustible tobacco. This is the first study that qualitatively explores the implementation of ST cessation support in dental settings in Pakistan. Utilizing the ‘Capability-Opportunity-Motivation-Behaviour’ model, it provides an in-depth understanding of the inability of dentists in implementing effective behavioural interventions for ST cessation support in routine dental practice. Highlighting the striking discrepancy between the patients’ need for and receptivity towards cessation support and the dentists’ concerns over their patients’ receptivity towards cessation support, it calls for the need for effective implementation strategies to optimize dentist-led tobacco cessation interventions in low-resource settings.

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Section: Discussionsupporting

confidence: 84%

Smokeless Tobacco Cessation Support in Dental Hospitals in Pakistan: Dentists and Dental Patients’ Perspectives on Current Practices, Support Needed, and Opportunities Available

Rasool

Dobbie

Boeckmann

et al. 2023

Nicotine and Tobacco Research

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“…Surveys demonstrated 70% to 96% of respondents believing smoking cessation in dental practice is important. Respondents supported that smoking cessation should be regarded as part of the dental treatment and patient management ( 19 , 21 , 22 , 26 ).They showed willingness to provide smoking cessation service and advice to patient ( 24 , 28 ). It was also reported that dental students consider themselves as a role model to patients ( 21 ), showing a sense of professional responsibility.…”

Section: Dental Professionals’ Attitude In Smoking Cessationmentioning

confidence: 96%

“…Respondents supported that smoking cessation should be regarded as part of the dental treatment and patient management ( 19 , 21 , 22 , 26 ).They showed willingness to provide smoking cessation service and advice to patient ( 24 , 28 ). It was also reported that dental students consider themselves as a role model to patients ( 21 ), showing a sense of professional responsibility. In addition to a general statement, a few studies assessed whether a specific cessation strategy is within the scope of dental practice ( 22 , 26 ).…”

Section: Dental Professionals’ Attitude In Smoking Cessationmentioning

confidence: 96%

“…For both dentists with work experience and dental students, there are consistent findings of perceived barriers to carry out smoking cessation. Top cited obstacles were patients lacking motivation to quit ( 25 , 27 ), patients resistance to smoking cessation advice ( 17 , 18 , 21 , 24 ), inadequate training ( 19 , 30 , 31 ), lack of smoking cessation resources ( 22 ), lack of treatment time ( 16 , 23 ), damaging patient-dentist relationship ( 15 ), and lack of reimbursement ( 26 ).…”

Section: Dental Professionals’ Confidence Knowledge and Preparedness ...mentioning

confidence: 99%

“…For smoking status, its association with the amount of cessation interventions are inconclusive. On one hand, smoking dentists were reported less involved in delivering of smoking cessation advice ( 19 ); on the other hand, smoking dentists in some studies showed a more favourable attitude in smoking cessation ( 21 , 22 ). Besides, there are studies showing no correlation between tobacco use of dental professionals and their management of smoking patients ( 17 ).…”

Section: Factors Affecting Dental Professionals’ Practices In Smoking...mentioning

confidence: 99%

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Smoking cessation in dental setting: a narrative review on dental professionals’ attitude, preparedness, practices and barriers

Chan,

Chu

et al. 2023

Front. Oral. Health

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Integration of smoking cessation program into routine oral health care has been advocated by World Health Organization since it brings extensive benefits to oral health. By tobacco cessation, patients are less prone to progression of periodontal disease, have less future tooth loss, have reduced risks of oral mucosal lesions and head and neck cancers. Evidence indicates that dentists are in a favorable position to deliver effective smoking cessation advice to improve patients’ oral health. This article aims to present the current situation of smoking cessation in dental setting, including dental management of smoking patients, perceptions of dentists and dental students towards smoking cessation, challenges dental professionals face when carrying out cessation interventions. Patients’ perspectives are also evaluated to provide a clearer picture of smoking cessation practice in the dental field. Review of past surveys show most patients welcome smoking cessation advice from dental practitioners. Meanwhile dentists may have wrong assumption that patients would disapprove them if they advise patient to quit smoking. On top of that, main obstacles identified are lack of training, inadequate treatment time and insufficient knowledge towards smoking cessation guidelines and referral routes. With regard to the potential barriers, evidence demonstrates that more trainings on smoking cessation strategies are needed. Future research in this aspect is also indicated to further foster the practice of smoking cessation counselling in dental setting.

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The role of dentists in nicotine replacement therapy

Rasmina¹,

Uvais²

2020

J Family Med Prim Care

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Tobacco cessation counseling: Are dentists doing enough?

Cited by 6 publications

References 0 publications

Smokeless Tobacco Cessation Support in Dental Hospitals in Pakistan: Dentists and Dental Patients’ Perspectives on Current Practices, Support Needed, and Opportunities Available

Smokeless Tobacco Cessation Support in Dental Hospitals in Pakistan: Dentists and Dental Patients’ Perspectives on Current Practices, Support Needed, and Opportunities Available

Smoking cessation in dental setting: a narrative review on dental professionals’ attitude, preparedness, practices and barriers

The role of dentists in nicotine replacement therapy

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