More Smoking Cessation Efforts Needed
July 14, 2010

By Nancy Volkers
InteliHealth News Service

INTELIHEALTH - Dentists, dental hygienists and other health professionals could do more to help people stop smoking, a survey suggests.

Researchers from the University of California, Davis, did the study. They surveyed 2,804 health care professionals. The groups included primary-care doctors, emergency medicine doctors, psychiatrists, registered nurses, dentists, dental hygienists and pharmacists. About 400 people from each group were surveyed.

The survey asked people whether they smoked. It also asked how often they followed the U.S. Public Health Service guidelines to help their patients stop smoking. The guidelines are known as the "5 A's":

• Asking
• Advising
• Assessing
• Assisting
• Arranging follow-up

Very few health providers said that they smoke tobacco. In 6 of the 7 groups, fewer than 6% smoked. However, rates were higher among nurses: 13% of them smoked.

Nearly all types of providers asked their patients whether they smoked. Between 66% and 95% advised patients about quitting. Fewer of them assessed whether smokers wanted to quit. Primary-care doctors were most likely to do this (85%). Emergency-medicine doctors (38%) and dentists (50%) were least likely.

All groups did poorly at arranging follow-up visits to help people quit smoking. About 23% of primary-care doctors and 20% of psychiatrists arranged follow-up. In the other groups, 1% to 8% took this step.

Dentists and dental hygienists were the groups most likely to express discomfort with asking patients if they smoked. Also, 45% of dentists and 31% of dental hygienists said it wasn't appropriate for their professions to provide this type of counseling.

Most providers had not been trained to provide tobacco cessation counseling. Among dentists, 21% had this training. About 33% of dental hygienists had the training. Among other professions, 34% of primary care doctors and 26% of psychiatrists had the training.

Those most likely to perform all of the "5 A's":

• Were primary-care doctors
• Were aware of the guidelines for treating tobacco use
• Had training in smoking cessation
• Believed that treatment for smoking cessation was an important responsibility

Those least likely to help patients try to quit:

• Were smokers themselves
• Were uncomfortable asking patients if they smoked
• Did not believe that their profession should counsel people about quitting tobacco

The U.S. Centers for Disease Control and Prevention says that 70% of smokers would like to quit. But a 2008 study found that each year, only 2.5% are able to quit without help.

The study appears in the July issue of the journal Nicotine and Tobacco Research.