Implementing a tobacco assisted referral program in dental practices.

Area of Science:

• Public Health
• Dental Public Health
• Behavioral Science

Background:

• Tobacco use remains a significant public health concern, with dental settings offering a unique opportunity for intervention.
• Previous tobacco control efforts in dental practices have shown variable success, necessitating system-level approaches.

Purpose of the Study:

• To design and implement a system-level tobacco control intervention within a large prepaid dental group practice.
• To evaluate the impact of the intervention on dental staff performance and patient satisfaction.

Main Methods:

• A randomized controlled trial matched 14 dental facilities, assigning them to either the "Assisted Referral" intervention or usual care.
• Intervention staff received training on tobacco use assessment, tailored advice, and encouraging patients to engage with telephone counselors.
• Telephone counselors provided support for quitting, reviewed cessation strategies, and identified next steps for patients.

Main Results:

• High rates of tobacco assessment (97%) and advice (93%) were observed in both intervention and control groups.
• Intervention patients were significantly more likely to receive additional chair-side counseling (69% vs. 3%) and agree to telephone counseling (11%).
• Patients in the intervention group reported higher satisfaction with the dental team's tobacco control efforts compared to controls.

Conclusions:

• The "Assisted Referral" approach was successfully integrated into routine dental care, demonstrating feasibility and patient acceptance.
• The intervention led to increased patient satisfaction with tobacco control services in the dental setting.
• This approach is a practical strategy for dental practices, especially given the availability of free telephone-based cessation support.