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The 13th World Conference on Tobacco OR Health

Building capacity for a tobacco-free world

July 12-15, 2006, Washington, DC, USA

Friday, July 14, 2006 - 12:00 PM

Implementation of smoking cessation guidelines in dental practice

Johanna E. Jacobs, MSc and I. Maassen. Centre for Quality of Care Research (WOK), Radboud University Nijmegen The Netherlands, PO Box 9101, 117 KWAZO, Nijmegen, 6500 HB, Netherlands

Objective: National guidelines for treatment of tobacco addiction recommend active involvement of dental professionals in cessation advice and support. The study explored methods to integrate cessation support in routine dental practice as well as a strategy to stimulate professionals' performance.

Methods: The implementation strategy (STAP) included a 4 hour central training for dental teams on tobacco addiction and counseling techniques, patient education material, a practice protocol with choice options concerning counseling intensity and task division as well as regular patient reported monitoring and feedback of professional performance. By means of prestructured questionnaires and interviews feasibility and acceptability were tested among patients and professionals in 12 practices of various composition.

Results: The patient reported monitoring data (N = 260 and 116) showed a significant increase in counseling activities after the training: checking smoking status raised from 60 to 72%, assessing cessation stage from 42 to 62%, offering support from 22 to 40%. A large majority of smoking patients accepted the advisory role of the dental team members (74 to 85 %) and a majority (59%) had a positive attitude towards more intensive counseling support, only 5 % had unpleasant feelings about the counseling. The professionals (N = 47) themselves were positive about the training and monitoring and feedback procedure. Almost all considered a limited advisory protocol implementable in routine practice. Practice composition and organisation, e.g. the role of the oral hygienist, limited choosing the more intensive counseling option. Details and repercussions for a large scale implementation RCT will be discussed.