Chaffee B W, Urata J, Couch E T, Silverstein S
Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, CA, USA.
JDR Clin Trans Res. 2020 Apr;5(2):133-145. doi: 10.1177/2380084419861384. Epub 2019 Jul 19.
California features low smoking prevalence, cautionary electronic cigarette (e-cigarette) public messaging, and legal recreational cannabis: a unique landscape for dental professionals to navigate tobacco cessation promotion. This cross-sectional study assessed California dental professionals' self-reported tobacco patient counseling behaviors and the correlates of providing such assistance.
Statewide surveys of dental hygienists (n = 701) and dentists (n = 725) were distributed electronically. The dentist survey was weighted for sampling and nonresponse. Prevalence of asking patients about use was compared for cigarette and noncigarette products (e.g., e-cigarettes, cannabis). Multivariable models identified independent correlates of providing cessation assistance to tobacco-using patients.
Respondents reported frequently (often/always) documenting patient tobacco use (hygienists: 80%; dentists: 73%) but less commonly provided forms of assistance (hygienists: 27%-49%; dentists: 10%-31%). Most respondents asked patients about cigarette smoking, but noncigarette product use (cigar, hookah, pipe, e-cigarette, or cannabis) was not commonly assessed. Greater confidence and willingness to assist were positively associated with providing assistance in multivariable models, but perceived barriers (e.g., lack of time and remuneration) were not. Results were robust to model specifications.
California dental professionals often ask about smoking but lag in providing cessation assistance and inquiring about noncigarette products. Successful efforts to encourage dental professionals' engagement in tobacco prevention and cessation must enhance providers' self-efficacy and motivation and likely will require system and organizational change.
Study findings identify substantial gaps in dental professionals' engagement in patient tobacco cessation. The results identify correlates of providing assistance and of dental professionals' willingness and confidence to do so, which could serve to inform interventions to support and enhance engagement.
加利福尼亚州吸烟率较低，有警示性的电子烟公共宣传信息，且娱乐用大麻合法：这为牙科专业人员开展戒烟推广工作提供了独特的环境。这项横断面研究评估了加利福尼亚州牙科专业人员自我报告的烟草患者咨询行为以及提供此类帮助的相关因素。
通过电子方式向全州的牙科保健员（n = 701）和牙医（n = 725）发放调查问卷。对牙医调查问卷进行了抽样和无应答加权处理。比较了询问患者使用香烟和非香烟产品（如电子烟、大麻）的比例。多变量模型确定了为使用烟草的患者提供戒烟帮助的独立相关因素。
受访者报告经常（总是/经常）记录患者的烟草使用情况（牙科保健员：80%；牙医：73%），但较少提供各种形式的帮助（牙科保健员：27%-49%；牙医：10%-31%）。大多数受访者询问患者是否吸烟，但对非香烟产品的使用（雪茄、水烟、烟斗、电子烟或大麻）评估较少。在多变量模型中，更大的信心和帮助意愿与提供帮助呈正相关，但感知到的障碍（如时间和报酬不足）则不然。结果对模型规范具有稳健性。
加利福尼亚州的牙科专业人员经常询问吸烟情况，但在提供戒烟帮助和询问非香烟产品方面滞后。鼓励牙科专业人员参与烟草预防和戒烟的成功努力必须提高提供者的自我效能感和积极性，可能还需要系统和组织变革。
研究结果表明牙科专业人员在患者戒烟方面的参与存在很大差距。结果确定了提供帮助以及牙科专业人员提供帮助的意愿和信心的相关因素，这可为支持和加强参与的干预措施提供参考。
