Patient perceptions of tobacco cessation services in dental offices

Abstract

Background: Tobacco use is a leading cause of periodontitis and other oral diseases. Dental professionals can help patients quit, but few routinely offer tobacco cessation services, or TCS. In this article, the authors examine dental professionals' attitudes toward offering TCS and patients' attitudes toward receiving TCS from their dental offices.

Methods: The authors used baseline data from a three-year randomized controlled trial designed to test the effectiveness of a dissemination strategy aimed at increasing the proportion of tobacco users identified by the dental office, as well as the proportion of tobacco users advised to quit. Fifty-two dental offices in rural communities completed a questionnaire asking for demographic and professional information about their offices, usual TCS offered, barriers to providing TCS and their views on patient receptivity to TCS. A random sample of patients seen during one month were interviewed over the telephone about the TCS provided during their last visit and their comfort in receiving such services from their dental offices.

Results: The authors found that 58.5 percent of the 3,088 dental patients surveyed believed that dental offices should provide TCS to patients. There was equal support among tobacco users and nonusers. Male patients (60.8 percent) and younger patients (69.6 percent) were more likely to believe that dental offices should provide TCS than were female patients (56.8 percent, P < .05) and older patients (57.3 percent, P < .05). The authors also found that patients who had an interest in quitting were more likely to feel comfortable receiving TCS than were those patients who were not interested in quitting (59.7 percent vs. 39.4 percent, P < .01). A total of 61.5 percent of dentists, however, thought patients did not expect such services. When dentists were asked about barriers to providing TCS, 94.3 percent listed patient resistance as a barrier, and 53.9 percent were concerned that patients would leave their practices.

Conclusions: The authors found a wide discrepancy between patients' and dental professionals' views on TCS. A total of 58.5 percent of patients believe dentists routinely should offer such services, while 61.5 percent of dental professionals believed patients did not expect TCS. Patients who were interested in quitting felt more comfortable receiving quit advice.

Clinical implications: Periodontitis and other oral diseases are linked directly to tobacco use. Advising patients to quit is a professional responsibility. Tobacco users expect and are comfortable receiving such advice. It is up to dental professionals to overcome their concerns about patient receptivity and provide these services.