Dawson Greer M, Noller Jennifer M, Skinner John C
NSW Public Health Officer Training Program, NSW Ministry of Health.
Centre for Oral Health Strategy, NSW Ministry of Health.
N S W Public Health Bull. 2013 Dec;24(3):131-4. doi: 10.1071/NB12090.
The links between tobacco smoking, and periodontal disease and oral cancer make the inclusion of smoking cessation interventions at dental visits an important prevention strategy in oral health services. The 5As (Ask, Advise, Assess, Assist, Arrange), which utilises a stages of change model, is the most commonly recognised framework for the provision of smoking cessation brief interventions and is advocated widely. While the popularity of the 5As continues, increasingly evidence suggests that staged-based interventions in smoking cessation may not be the best approach. Lack of time and expertise are also cited by health professionals as barriers to undertaking brief interventions and thus abbreviated forms of the 5As have been advocated. In 2009, NSW Health introduced a mandatory policy for public dental services in NSW to conduct smoking cessation brief interventions at the chairside based on a three-step approach, which is currently being evaluated. Given the debate and the pending evaluation results, this paper reviews models of smoking cessation brief interventions, to contribute to achieving a best practice model for public oral health in NSW.
吸烟与牙周病和口腔癌之间的联系，使得在牙科就诊时纳入戒烟干预措施成为口腔健康服务中的一项重要预防策略。采用行为改变阶段模型的“5A法”（询问、建议、评估、协助、安排）是提供戒烟简短干预措施时最常认可的框架，并得到广泛倡导。虽然“5A法”依然流行，但越来越多的证据表明，基于阶段的戒烟干预措施可能并非最佳方法。卫生专业人员也提到，时间和专业知识的缺乏是开展简短干预措施的障碍，因此有人主张采用“5A法”的简化形式。2009年，新南威尔士州卫生部出台了一项针对该州公共牙科服务的强制性政策，要求基于一种三步法在诊疗椅旁开展戒烟简短干预措施，目前该政策正在接受评估。鉴于存在的争议以及即将得出的评估结果，本文对戒烟简短干预措施的模式进行了综述，以推动新南威尔士州公共口腔健康最佳实践模式的实现。
