Department of Family and Community Medicine, College of Medicine, University of Arizona, 1450 N. Cherry Ave., Tucson, AZ 85719, USA.
J Am Dent Assoc. 2010 Aug;141(8):1000-7. doi: 10.14219/jada.archive.2010.0314.
The Ask, Advise, Refer (AAR) model of intervening with patients who use tobacco promotes a brief office-based intervention plus referral to a tobacco quitline. However, there is little evidence that this model is effective. The primary aim of this study was to evaluate the effects on patients' tobacco use of two levels of a dental office-based intervention compared with usual care.
The authors randomly assigned 68 private dental clinics to one of three conditions: 5 As (Ask, Advise, Assess, Assist, Arrange); 3 As (AAR model); or usual care, and they enrolled 2,160 participants.
At the 12-month assessment, compared with those in usual care, participants in the two intervention conditions combined were more likely to report cessation of tobacco use, as measured by nine-month prolonged abstinence (3 percent versus 2 percent; F(1,66) = 3.97, P < .10) and 12-month point prevalence (12 percent versus 8 percent; F(1,66) = 7.32, P < .01). There were no significant differences between participants in the clinics using the 5 As and 3 As strategies.
The results of this study are inconclusive as to whether referrals to a quitline add value to brief dental office-based interventions. Patients receiving telephone counseling quit tobacco use at higher rates, but only a small percentage of those proactively referred actually received counseling.
The results confirm those of previous research: that training dental practitioners to provide brief tobacco-use cessation advice and assistance results in a change in their behavior, and that these practitioners are effective in helping their patients to quit using tobacco.
采用 Ask、Advise、Refer（AAR）模型对使用烟草的患者进行干预，可促进在诊室进行简短的基于干预措施，再加上向戒烟热线转介。然而，几乎没有证据表明该模型有效。本研究的主要目的是评估与常规护理相比，两种基于牙科诊室的干预措施对患者烟草使用的影响。
作者将 68 家私人牙科诊所随机分为三组：5As（Ask、Advise、Assess、Assist、Arrange）组、AAR 模型组和常规护理组，并招募了 2160 名参与者。
在 12 个月的评估中，与常规护理组相比，两种干预措施组的参与者报告停止使用烟草的可能性更高，这通过九个月的持续戒烟（3%比 2%；F（1，66）=3.97，P<.10）和 12 个月的点流行率（12%比 8%；F（1，66）=7.32，P<.01）来衡量。使用 5As 和 3As 策略的诊所的参与者之间没有显著差异。
这项研究的结果对于向戒烟热线转介是否为简短的基于牙科诊室的干预措施增加价值是不确定的。接受电话咨询的患者戒烟率更高，但只有一小部分被主动转介的患者实际上接受了咨询。
研究结果证实了之前的研究结果：培训牙科医生提供简短的烟草使用停止建议和帮助可改变他们的行为，而且这些医生在帮助患者戒烟方面非常有效。
