University of Arizona researchers have proved the effectiveness of quit-tobacco interventions in public dental care settings serving low-income patients, according to a study published online May 13 in the American Journal of Public Health.
People who received an intervention -- advice and assistance, including nicotine patches or lozenges -- were two to three times more likely to have quit smoking 7.5 months afterward than participants who received the usual care, the researchers found.
"The dental setting is different from a medical clinic in that physicians can't pull out a lung and show the patient the damage caused by smoking," said Judith Gordon, Ph.D., an associate professor in the department of family and community medicine and lead study author. "The oral health team has a unique opportunity to show the immediate effects of smoking or tobacco use to their patients."
A dentist or dental hygienist can use something as simple as a hand mirror to show the patient what their tobacco use is doing to them right now, she added.
The study, the first to be conducted in public dental clinics, focused on people who are at increased risk for various health problems because of high rates of smoking and reduced access to healthcare services.
Funded by the National Institutes of Health National Cancer Institute, the study involved 14 federally funded community health center dental clinics in Mississippi, New York, and Oregon that serve racially and ethnically diverse patients. More than 2,000 patients -- all at or below 200% of the federal poverty threshold -- were enrolled in the study from January 2006 through March 2008.
In randomly selected clinics, staff members were trained to provide interventions as recommended by the U.S. Public Health Service. The training included a three-hour, in-service workshop on integrating and delivering a brief, tailored tobacco intervention, including self-help materials, referral to a tobacco quit line, and training on the proper use of nicotine replacement therapy.
Patients who were treated in nonintervention clinics received the usual quit-tobacco protocol established within the clinics, which varied in approach to implementing the Public Health Service recommendations.
The interventions were done in the dental setting because dentists see their patients more frequently than physicians do, the researchers noted.
"Over time, the dental team, especially the hygienist, develops a strong relationship with its patients. They spend more time with patients than a primary care provider can," Gordon said. "The dental team has multiple opportunities to educate, motivate, and assist."
The study assessed participants' quitting, reduction in tobacco use, number of quit attempts, and change in readiness to quit. These data can be used to advocate for routine treatment of tobacco dependence and adequate coverage for these types of interventions in dental settings, Gordon said.
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