Evaluation of Two Smoking Cessation Protocols in the Dental Setting

Background: Tobacco use has harmful effects on all systems of the body, including the oral cavity. Though the majority of dentists do not currently assist their patients to quit smoking, providing smoking cessation interventions in the dental setting is becoming more widely accepted.

Objective: The primary aim of this study was to assess quit rates among dental patients that received pharmacological assistance or were referred to the New York State Smokers' Quitline. The secondary aim was to determine if the 5A system of smoking cessation coaching and provision of educational materials and pharmacological assistance was being properly implemented.

Methods: This study compares quit rates among smokers in two dental clinics. One directly provides those interested in quitting with pharmacotherapy, while the other refers patients to the New York State Smokers' Quitline to get free NRT and counseling. Of the 317 eligible subjects, 162 (51%) were successfully enrolled.

Results: Fourteen percent of the “patch” clinic and 5% of the “referral” clinic were classified as having not smoked a cigarette since their last clinic visit, on average 10 months earlier (±4.77) with median “patch” clinic time of 9 months and median “referral” clinic time of 15 months. Similar results were observed for the other smoking quit rates. When the use of three (Ask, Advise, Assess) of the 5As was analyzed together, the “patch” clinic used the 3As more consistently, which could explain the higher quit rates observed in this clinic.

Conclusion: The use of a fax-to-quit referral is not as successful as giving nicotine patches directly to dental patients who are trying to quit smoking.