Gordon Judith S, Andrews Judy A, Crews Karen M, Payne Thomas J, Severson Herbert H
Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR 97405, USA.
Tob Control. 2007 Aug;16(4):285-8. doi: 10.1136/tc.2007.020271.
The primary aim of our randomised control trial (RCT) was to evaluate the relative efficacy of two dental office based interventions compared to usual care. One intervention consisted of a combination of dental practitioner advice to quit and proactive telephone counselling (3A's), and the other arm consisted of a dental practitioner delivered intervention based on the 5A's of the Clinical Practice Guideline (5A's).
2177 tobacco using patients were enrolled from 68 dental practices in Mississippi. We collected 3-month outcome data from 76% (n = 1652) of participants.
Smokers in the two intervention conditions quit at a higher rate than those in usual care; chi2 (1, n = 1381) = 3.10, p<0.05. Although not significant, more patients in the 5A's condition quit than those in the 3A's. Of patients in the 3A's Condition, 50% reported being asked by their dentist or hygienists about fax referral to the quitline, and 35% were referred. Quitline counsellors contacted 143 (70%) referred participants.
These results suggest that there are both advantages and disadvantages to the use of quitlines as an adjunct to brief counselling provided by dental practitioners. Patients receiving quitline counselling quit at higher rates than those who did not; however, only a small percentage of patients received counselling from the quitline. Therefore, it appears that dental professionals may be most effective in helping their patients to quit by regularly providing the 5A's plus proactively referring only those patients who are highly motivated to a quitline for more intensive counselling.
我们随机对照试验（RCT）的主要目的是评估两种基于牙科诊所的干预措施与常规护理相比的相对疗效。一种干预措施包括牙科医生建议戒烟和主动电话咨询（3A法），另一组则是基于临床实践指南5A法由牙科医生实施的干预措施。
从密西西比州的68家牙科诊所招募了2177名使用烟草的患者。我们收集了76%（n = 1652）参与者的3个月结局数据。
两种干预条件下的吸烟者戒烟率高于常规护理组；卡方检验（1，n = 1381）= 3.10，p<0.05。虽然不显著，但5A法组戒烟的患者比3A法组更多。在3A法组中，50%的患者报告其牙医或保健员询问过是否将其转介至戒烟热线，35%的患者被转介。戒烟热线咨询员联系了143名（70%）被转介的参与者。
这些结果表明，将戒烟热线作为牙科医生提供的简短咨询的辅助手段有其优缺点。接受戒烟热线咨询的患者戒烟率高于未接受咨询的患者；然而，只有一小部分患者接受了戒烟热线的咨询。因此，牙科专业人员可能最有效地帮助患者戒烟的方式是定期提供5A法，并仅主动将积极性高的患者转介至戒烟热线接受更深入的咨询。
