Interventions for tobacco cessation in the dental setting

BACKGROUND:

Tobacco use has significant adverse effects on oral health. Oral health professionals in the dental office or community setting have a unique opportunity to increase tobacco abstinence rates among tobacco users.

OBJECTIVES:

This review assesses the effectiveness of interventions for tobacco cessation offered to cigarette smokers and smokeless tobacco users in the dental office or community setting.

SEARCH STRATEGY:

We searched the Cochrane Tobacco Addiction group Specialized Register (CENTRAL), MEDLINE (1966-April 2006), EMBASE (1988-April 2006), CINAHL (1982-April 2006), Healthstar (1975-April 2006), ERIC (1967-April 2006), PsycINFO (1984-April 2006), National Technical Information Service database (NTIS, 1964-April 2006), Dissertation Abstracts Online (1861-April 2006), Database of Abstract of Reviews of Effectiveness (DARE, 1995-April April 2006), and Web of Science (1993-April 2006).

SELECTION CRITERIA:

We included randomized and pseudo-randomized clinical trials assessing tobacco cessation interventions conducted by oral health professionals in the dental office or community setting with at least six months of follow up.

DATA COLLECTION AND ANALYSIS:

Two authors independently reviewed abstracts for potential inclusion and abstracted data from included trials. Disagreements were resolved by consensus.

MAIN RESULTS:

Six clinical trials met the criteria for inclusion in this review. Included studies assessed the efficacy of interventions in the dental office or a school community setting. All studies assessed the efficacy of interventions for smokeless tobacco users, one of which included cigarettes smokers. All studies employed behavioural interventions and only one offered pharmacotherapy as an interventional component. All studies included an oral examination component. Pooling of the studies suggested that interventions conducted by oral health professionals increase tobacco abstinence rates (odds ratio [OR] 1.44; 95% confidence interval [CI]: 1.16 to 1.78) at 12 months or longer. Heterogeneity was evident (I2 = 75%) and could not be adequately explained through subgroup or sensitivity analyses.

AUTHORS' CONCLUSIONS:

Available evidence suggests that behavioural interventions for tobacco use conducted by oral health professionals incorporating an oral examination component in the dental office and community setting may increase tobacco abstinence rates among smokeless tobacco users. Differences between the studies limit the ability to make conclusive recommendations regarding the intervention components that should be incorporated into clinical practice.