United Health Centers of San Joaquin Valley, CA, USA.
J Public Health Dent. 2013 Spring;73(2):94-102. doi: 10.1111/j.1752-7325.2012.00347.x. Epub 2012 Jun 26.
This study assessed attitudes, behaviors, and barriers among general dentists in California, Pennsylvania, and West Virginia, related to patient tobacco cessation counseling.
From 2004 to 2008, a baseline survey was mailed to 271 study dentists randomly selected from a master Delta Dental Insurance Company provider list in each state who had agreed to participate in a tobacco cessation randomized clinical trial. Four backward logistic regression models assessed correlates of the five As related to tobacco cessation: Asking about tobacco use, Advising users to quit, Assessing readiness to quit, Assisting with quitting, and Arranging follow-up.
Most respondents (n=265) were male, had practiced dentistry for over 15 years, asked about tobacco use (74%), and advised tobacco users to quit (78%). Only 19% assessed readiness to quit; 39% assisted with quitting; 4% arranged follow-up; and 42% had formal training in tobacco cessation. Believing that tobacco cessation counseling was an important professional responsibility, practicing <15 years, and asking about tobacco use significantly related to advising users to quit. Providing cessation advice and feeling effective intervening related to assessing readiness to quit. Advising users to quit, assessing readiness to quit, feeling effective intervening, and having had formal tobacco cessation training related to assisting with quitting. Barriers to cessation counseling were perceived patient resistance (66%), lack of insurance reimbursement (56%), not knowing where to refer (49%), and lack of time (32%).
Study dentists reported not fully performing the five As. Advising, assessing, having formal training, and feeling effective increased the likelihood of cessation counseling.
本研究评估了加利福尼亚州、宾夕法尼亚州和西弗吉尼亚州的普通牙医在患者戒烟咨询方面的态度、行为和障碍。
2004 年至 2008 年，从每个州的 Delta Dental Insurance Company 提供的主要牙医名单中随机抽取 271 名参与戒烟随机临床试验的研究牙医，向他们邮寄了基线调查。四个向后逻辑回归模型评估了与戒烟相关的五个 As（询问烟草使用情况、建议用户戒烟、评估戒烟准备情况、协助戒烟和安排随访）的相关性。
大多数受访者（n=265）为男性，从事牙科工作超过 15 年，询问了烟草使用情况（74%）并建议吸烟者戒烟（78%）。只有 19%评估了戒烟准备情况；39%协助戒烟；4%安排随访；42%接受过烟草戒烟培训。认为戒烟咨询是一项重要的专业职责、从事牙科工作不足 15 年和询问烟草使用情况与建议吸烟者戒烟显著相关。提供戒烟建议和感觉有效干预与评估戒烟准备情况相关。建议吸烟者戒烟、评估戒烟准备情况、感觉有效干预以及接受过正式的烟草戒烟培训与协助戒烟相关。戒烟咨询的障碍包括患者的阻力（66%）、缺乏保险报销（56%）、不知道在哪里转介（49%）和缺乏时间（32%）。
研究牙医报告称并未完全执行五个 As。建议、评估、接受正式培训和感觉有效增加了戒烟咨询的可能性。
