Binnie Vivian I, McHugh Siobhan, Jenkins William, Borland William, Macpherson Lorna M
Glasgow Dental Hospital and School, 378 Sauchiehall St, Glasgow, UK.
BMC Oral Health. 2007 May 2;7:5. doi: 10.1186/1472-6831-7-5.
Tobacco use continues to be a global public health problem. Helping patients to quit is part of the preventive role of all health professionals. There is now increasing interest in the role that the dental team can play in helping their patients to quit smoking. The aim of this study was to determine the feasibility of undertaking a randomised controlled smoking cessation intervention, utilising dental hygienists to deliver tobacco cessation advice to a cohort of periodontal patients.
One hundred and eighteen patients who attended consultant clinics in an outpatient dental hospital department (Periodontology) were recruited into a trial. Data were available for 116 participants, 59 intervention and 57 control, and were analysed on an intention-to-treat basis. The intervention group received smoking cessation advice based on the 5As (ask, advise, assess, assist, arrange follow-up) and were offered nicotine replacement therapy (NRT), whereas the control group received 'usual care'. Outcome measures included self-reported smoking cessation, verified by salivary cotinine measurement and CO measurements. Self-reported measures in those trial participants who did not quit included number and length of quit attempts and reduction in smoking.
At 3 months, 9/59 (15%) of the intervention group had quit compared to 5/57 (9%) of the controls. At 6 months, 6/59 (10%) of the intervention group quit compared to 3/57 (5%) of the controls. At one year, there were 4/59 (7%) intervention quitters, compared to 2/59 (4%) control quitters. In participants who described themselves as smokers, at 3 and 6 months, a statistically higher percentage of intervention participants reported that they had had a quit attempt of at least one week in the preceding 3 months (37% and 47%, for the intervention group respectively, compared with 18% and 16% for the control group).
This study has shown the potential that trained dental hygienists could have in delivering smoking cessation advice. While success may be modest, public health gain would indicate that the dental team should participate in this activity. However, to add to the knowledge-base, a multi-centred randomised controlled trial, utilising biochemical verification would be required to be undertaken.
烟草使用仍是一个全球性的公共卫生问题。帮助患者戒烟是所有卫生专业人员预防工作的一部分。目前，人们对牙科团队在帮助患者戒烟方面所能发挥的作用越来越感兴趣。本研究的目的是确定开展一项随机对照戒烟干预措施的可行性，该措施利用牙科保健员向一组牙周病患者提供戒烟建议。
招募了118名到一家门诊牙科医院科室（牙周病科）的专家门诊就诊的患者参与试验。116名参与者（59名干预组和57名对照组）的数据可供分析，并基于意向性分析原则进行分析。干预组接受基于5A法（询问、建议、评估、协助、安排随访）的戒烟建议，并提供尼古丁替代疗法（NRT），而对照组接受“常规护理”。结局指标包括自我报告的戒烟情况，通过唾液可替宁测量和一氧化碳测量进行验证。未戒烟的试验参与者的自我报告指标包括戒烟尝试的次数和时长以及吸烟量的减少情况。
3个月时，干预组59人中有9人（15%）戒烟，而对照组57人中有5人（9%）戒烟。6个月时，干预组59人中有6人（10%）戒烟，而对照组57人中有3人（5%）戒烟。1年时，干预组有4人（7%）戒烟，对照组有2人（4%）戒烟。在将自己描述为吸烟者的参与者中，在3个月和6个月时，干预组报告在前3个月中至少有过一周戒烟尝试的参与者比例在统计学上更高（干预组分别为37%和47%，对照组为18%和16%）。
本研究表明，经过培训的牙科保健员在提供戒烟建议方面具有潜力。虽然成功率可能不高，但从公共卫生效益来看，表明牙科团队应该参与这项活动。然而，为了增加知识储备，需要开展一项采用生化验证的多中心随机对照试验。
