title: North Carolina dental hygienists' assessment of patients' tobacco and alcohol use.
abstract: OBJECTIVE
  North Carolina is the 11th most populous state and ranks 14th among all states in the age-adjusted mortality rate for oral and pharyngeal cancer (OPC). This study assessed North Carolina dental Hygienists' knowledge of tobacco and alcohol use as OPC risk factors, assessment practices of tobacco and alcohol use in patient medical histories, and opinions regarding tobacco and alcohol cessation education. Characteristics of dental hygienists who screen for tobacco and alcohol use in medical histories were also analyzed.
  
  
  METHODS
  A 40-item survey was mailed to a simple random sample of 1,223 dental hygienists from a registry of 4,076 licensed in North Carolina. Data were included from 651 completed surveys, giving an effective response rate of 57%.
  
  
  RESULTS
  Most respondents correctly identified tobacco and alcohol use as risk factors for OPC. A majority assessed patients' tobacco and alcohol use. Less than 10% assessed no tobacco factors, while nearly 42% assessed no alcohol factors. A number of background and practice characteristics were found to be positively associated with tobacco and alcohol screening in patient medical histories. A majority agreed or strongly agreed that dental hygienists should be trained to provide tobacco and alcohol cessation education to their patients; however, few felt trained to provide such education.
  
  
  CONCLUSIONS
  Improvements in knowledge regarding tobacco and alcohol use as OPC risk factors are needed. Future interventions might include educational programs for currently practicing dental hygienists and increased tobacco and alcohol cessation education in the professional entry-level dental hygiene curricula.
authors.affiliation: Department of Dental Ecology, School of Dentistry, University of North Carolina, Chapel Hill, USA.
authors.forename: Tanya E
authors.initials: TE
authors.lastname: Ashe
authors.forename: John R
authors.initials: JR
authors.lastname: Elter
authors.forename: Janet H
authors.initials: JH
authors.lastname: Southerland
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Strauss
authors.forename: Lauren L
authors.initials: LL
authors.lastname: Patton
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects; D019973:Alcohol-Related Disorders / Q000150:complications / Q000175:diagnosis*; D003756:Dental Hygienists / Q000193:education* / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000209:etiology; D015999:Multivariate Analysis; D009657:North Carolina; D010353:Patient Education as Topic; D018570:Risk Assessment; D012494:Sampling Studies; D011795:Surveys and Questionnaires; D020340:Tobacco Use Cessation; D014029:Tobacco Use Disorder / Q000150:complications / Q000175:diagnosis*; D062789:Tobacco Products