Tobacco Quitlines:Adjunct to Dental Office Tobacco Intervention

Although many dental practitioners now routinely incorporate the first two of the “5A’s”
(Ask and Advise) into their practice, and previous research indicates that brief
office-based interventions are effective in producing modest tobacco quit rates for dental
patients, dental practitioners continue to perceive a number of obstacles to routine
provision of tobacco cessation services. Many dental practitioners still believe that
counseling patients to quit an addictive behavior is beyond the scope of their training or
comfort.

Recent studies have shown that proactive phone counseling from State-sponsored telephone
tobacco help lines has a positive effect on tobacco cessation. The use of these help lines
offers a unique supplement to the dental professional that could reduce the burden on
practitioner and enhance the likelihood of their patients’ quitting. Referral to a
specialist is within the common heuristic followed by dental and medical practitioners.
Therefore, we believe referral to a telephone help line may be an innovative way of enabling
dentists and dental hygienists to encourage and support their patients to quit tobacco.

We will test two levels of intervention as compared to usual care in a randomized clinical
trial in which 60 dental practices in Mississippi are randomized to one of three conditions.
In one condition (“5A’s”), the dental team will provide a brief office-based intervention
that is modeled on the “5A’s” advocated by the Clinical Practice Guideline. In the second
condition (“3A’s” + THL), the dental team will provide the first three “A’s” (Ask, Advise,
Assess), and then refer patients to the State-supported telephone help line for provision of
the cessation counseling and follow-up support. In the third condition (Usual Care),
volunteering practices will ask their patients only to complete our study surveys.