文章基本信息

标题：Tobacco Cessation via Public Dental Clinics: Results of a Randomized Trial
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作者：Judith S. Gordon ; Judy A. Andrews ; David A. Albert 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2010
卷号：100
期号：7
页码：1307-1312
DOI：10.2105/AJPH.2009.181214
语种：English
出版社：American Public Health Association
摘要：Objectives. We sought to compare the effectiveness of a dental practitioner advice and brief counseling intervention to quit tobacco use versus usual care for patients in community health centers on tobacco cessation, reduction in tobacco use, number of quit attempts, and change in readiness to quit. Methods. We randomized 14 federally funded community health center dental clinics that serve diverse racial/ethnic groups in 3 states (Mississippi, New York, and Oregon) to the intervention (brief advice and assistance, including nicotine replacement therapy) or usual care group. Results. We enrolled 2549 smokers. Participants in the intervention group reported significantly higher abstinence rates at the 7.5-month follow-up, for both point prevalence (F_1,12 = 6.84; P < .05) and prolonged abstinence (F_1,12 = 14.62; P < .01) than did those in the usual care group. Conclusions. The results of our study suggest the viability and effectiveness of tobacco cessation services delivered to low-income smokers via their dental health care practitioner in community health centers. Tobacco cessation services delivered in public dental clinics have the potential to improve the health and well-being of millions of Americans. The prevalence of tobacco use is especially high in lower socioeconomic status (SES) populations in the United States.¹ Intervening with these tobacco users can be difficult, in part because of their limited access to health care services. Community health centers were implemented as a means to address this concern; many are located in areas with health professional shortages. These health centers provide comprehensive primary care services (with 65% including dental services) to large numbers of low-income smokers and smokeless tobacco users.² The typical patient visits the health center dental clinic multiple times per year, receiving treatment or prevention services, and it is routine for the patients to be on a periodic examination schedule.² These dental visits provide an opportunity to offer tobacco cessation advice and counseling by the dental office team. Organized dentistry has long recognized the connection between tobacco use and oral health and the appropriateness for oral health professionals to address tobacco use.^{3 – 6} The American Dental Association urges dentists to assist patients with tobacco cessation.³ The dental team routinely provides educational and preventive services to patients; this model can be extended to tobacco-related topics. With consideration to the oral health effects associated with chronic tobacco use, the dental visit provides a “teachable moment” during which the dental team can relate oral health and systemic problems to tobacco use and provide evidence-based brief interventions to patients who use tobacco.^{7 – 9}