Tobacco Cessation Education in North Carolina Dental Hygiene Programs

Inadequate training in tobacco cessation counseling is a recognized, but mutable, barrier to implementation of tobacco cessation education (TCE) and intervention strategies in dental practice. Without adequate instruction or opportunity to develop competence, dental hygienists are less likely to provide regular tobacco cessation counseling and education to patients. Objectives: To identify the practices and perceptions of senior dental hygiene students (SDHS) in North Carolina (NC) regarding their didactic training in TCE and integration of TCE into their clinical dental hygiene curricula. Methods: A 26-item questionnaire was developed, pre-tested, and administered to a non-random, convenience sample of 241 graduating SDHS enrolled in all 12 NC dental hygiene programs (DHPs) via mail (n=180) or email via SurveyMonkey (n=61). Data analyses including frequency distributions and tests of chi-square were conducted using JMP 6.0.2. Results: Response rate was 65% (n=156). Of respondents, 99% agreed that hygienists should be trained to provide TCE. Most SDHS reported receiving classroom instruction about the American Dental Hygienists' Association's smoking cessation initiative (Ask. Advise. Refer.) (73%) and/or the 5A's of tobacco cessation (68%). Sixty-nine percent stated their classroom instruction was reinforced by clinical instructors. Nearly all SDHS (99%) had one or more patients who smoked and 81% had one or more patients who used spit tobacco. Eight-nine percent had one or more patients that expressed a desire to quit. Most SDHS were comfortable providing TCE to both smokers (92%) and spit tobacco users (93%); however, 26% reported that they were not comfortable providing quit messages to patients unwilling to quit. SDHS who are non-tobacco users were 2.9 times more likely to discuss the potential benefits of quitting than SDHS who are current tobacco users. Conclusions: Deficiencies in TCE exist in NC DHPs. Enhancements to TCE in dental hygiene curricula may increase incorporation of TCE by hygienists' in future practice.