Patient perceptions of tobacco cessation services in dental offices

Background. Tobacco use is a leading cause of periodontitis and other oral diseases. Dental professionals can help patients quit, but few routinely of fer tobacco cessation services, or TCS. In this article, the authors examin e dental professionals' attitudes toward offering TCS and patients' attitud es toward receiving TCS from their dental offices. Methods. The authors used baseline data from a three-year randomized contro lled trial designed to test the effectiveness of a dissemination strategy a imed 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 fo r demographic and professional information about their offices, usual TCS o ffered, barriers to providing TCS and their views on patient receptivity to TCS. A random sample of patients seen during one month were interviewed ov er the telephone about the TCS provided during their last visit and their c omfort in receiving such services from their dental offices. Results. The authors found that 58.5 percent of the 3,088 dental patients s urveyed believed that dental offices should provide TCS to patients. There was equal support among tobacco users and nonusers. Male patients (60.8 per cent) 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 com fortable 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 d entists were asked about barriers to providing TCS, 94.3 percent listed pat ient 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 den tal professionals' views on TCS. A total of 58.5 percent of patients believ e dentists routinely should offer such services, while 61.5 percent of dent al professionals believed patients did not expect TCS. Patients who were in terested in quitting felt more comfortable receiving quit advice. Clinical Implications. Periodontitis and other oral diseases are linked dir ectly to tobacco use. Advising patients to quit is a professional responsib ility. Tobacco users expect and are comfortable receiving such advice. It i s up to dental professionals to overcome their concerns about patient recep tivity and provide these services.