Japuntich Sandra J, Dunbar Michael S, Predmore Zachary, Bloom Erika Litvin, Fang Pearl, Basile Sarah, Rindal D Brad, Waiwaiole Lisa A, Carpenter Matthew J, Kopycka-Kedzierawski Dorota T, Dahne Jennifer, Lischka Tamara R, Richardson Peggy
Hennepin Healthcare Research Institute, Minneapolis, Minnesota, USA.
Department of Psychiatry, Hennepin Healthcare, Minneapolis, Minnesota, USA.
Community Dent Oral Epidemiol. 2024 Aug;52(4):440-451. doi: 10.1111/cdoe.12937. Epub 2023 Dec 14.
Cigarette smoking negatively affects oral health. Nicotine replacement therapies (NRT; e.g. nicotine patch or lozenge) and brief interventions (e.g. Ask-Advise-Refer; AAR) can improve cessation outcomes but are underutilized. NRT sampling (NRTS) increases NRT utilization by providing patients with samples of NRT as part of routine healthcare. Ask-Advise-Refer is a brief intervention where practitioners: ask patients about tobacco use, advise those using tobacco to quit and refer to the state quit line. The objective of this qualitative study was to explore dental care practitioners' and patients' attitudes and experiences regarding tobacco cessation treatment and perceptions of two brief intervention models, assessed separately: NRTS and AAR.
Twenty-four dental care practitioners and nine patients, recruited through the National Dental Practice-Based Research Network, participated in semi-structured telephone interviews. Interviews assessed experiences with tobacco use intervention and attitudes towards NRTS and AAR. Thematic analysis identified emergent themes related to feasibility and acceptability of NRTS and AAR.
Practitioners varied on how they address tobacco use, from systematically to idiosyncratically. Some practitioners recommend NRT; few had prescribed it. Practitioners had favourable attitudes towards AAR and NRTS, with most believing that both interventions would be acceptable and feasible to implement. Concerns regarding AAR were time and patient resistance to discussing tobacco use. Concerns regarding NRTS were patient resistance to using NRT, side effects or medication interactions, and capacity to provide follow-up. Patients reported that oral health practitioners generally ask about tobacco use but do not provide interventions. Patients were open to discussing their tobacco use with practitioners and had favourable attitudes about NRTS.
This formative work suggests that NRTS and AAR may be feasible to implement in dental care settings. Future studies are needed to assess the effectiveness and implementation potential of NRTS in dental care settings.
吸烟对口腔健康有负面影响。尼古丁替代疗法（NRT，如尼古丁贴片或含片）和简短干预措施（如询问-建议-转介；AAR）可改善戒烟效果，但未得到充分利用。NRT抽样（NRTS）通过向患者提供NRT样本作为常规医疗保健的一部分来提高NRT的利用率。询问-建议-转介是一种简短干预措施，从业者在此过程中：询问患者的烟草使用情况，建议吸烟患者戒烟，并转介至州戒烟热线。这项定性研究的目的是探讨牙科保健从业者和患者对戒烟治疗的态度和体验，以及对两种简短干预模式的看法，这两种模式分别进行评估：NRTS和AAR。
通过国家基于牙科实践的研究网络招募了24名牙科保健从业者和9名患者，参与半结构化电话访谈。访谈评估了烟草使用干预的经历以及对NRTS和AAR的态度。主题分析确定了与NRTS和AAR的可行性和可接受性相关的新出现主题。
从业者在处理烟草使用问题的方式上各不相同，从系统处理到个性化处理。一些从业者推荐NRT；很少有人开过NRT的处方。从业者对AAR和NRTS持积极态度，大多数人认为这两种干预措施实施起来都是可以接受和可行的。对AAR的担忧是时间问题以及患者对讨论烟草使用的抵触情绪。对NRTS的担忧是患者对使用NRT的抵触情绪、副作用或药物相互作用，以及提供后续跟进的能力。患者报告说，口腔保健从业者通常会询问烟草使用情况，但不提供干预措施。患者愿意与从业者讨论他们的烟草使用情况，并对NRTS持积极态度。
这项形成性研究表明，NRTS和AAR在牙科护理环境中实施可能是可行的。未来需要进行研究，以评估NRTS在牙科护理环境中的有效性和实施潜力。
