Barriers limiting dentists' active involvement in smoking cessation

To assess the experience and attitudes of dental professionals towards smoking cessation and, in particular, to explore perceived barriers limiting their involvement in this area of practice.

A combined quantitative and qualitative methodology was employed in South Essex, an area in South East England. In the first phase a questionnaire survey was conducted with all general dental practitioners on the South Essex Health Authority dental list to assess their current involvement in smoking cessation and their general attitudes to this area of clinical care. In the second phase, ten focus group interviews were conducted with dental teams to uncover in greater depth views towards smoking cessation and, in particular, the barriers preventing progress.

A 60% response rate (n = 149) was achieved for the postal questionnaire and 52 dental team members participated in the focus groups. The questionnaire survey revealed that the majority of the sample reported asking their patients about smoking (90%) and recording this information in their clinical notes (75%). However, a relatively low number indicated active involvement in assisting smokers to stop (30%) or referring them for more detailed support (24%). The focus groups uncovered a range of fundamental barriers limiting greater involvement in smoking cessation. The key issues included a fatalistic and negative concept of prevention; perceived lack of relevance of smoking cessation to dentistry; patient hostility; and organizational factors within the practice setting.

Future action to encourage the provision of smoking cessation in dental practices needs to address the range of barriers that currently limit involvement in this area of clinical practice.