title: The 5A's vs 3A's plus proactive quitline referral in private practice dental offices: preliminary results.
abstract: OBJECTIVE
  The primary aim of our randomised control trial (RCT) was to evaluate the relative efficacy of two dental office based interventions compared to usual care. One intervention consisted of a combination of dental practitioner advice to quit and proactive telephone counselling (3A's), and the other arm consisted of a dental practitioner delivered intervention based on the 5A's of the Clinical Practice Guideline (5A's).
  
  
  METHODS
  2177 tobacco using patients were enrolled from 68 dental practices in Mississippi. We collected 3-month outcome data from 76% (n = 1652) of participants.
  
  
  RESULTS
  Smokers in the two intervention conditions quit at a higher rate than those in usual care; chi2 (1, n = 1381) = 3.10, p<0.05. Although not significant, more patients in the 5A's condition quit than those in the 3A's. Of patients in the 3A's Condition, 50% reported being asked by their dentist or hygienists about fax referral to the quitline, and 35% were referred. Quitline counsellors contacted 143 (70%) referred participants.
  
  
  CONCLUSIONS
  These results suggest that there are both advantages and disadvantages to the use of quitlines as an adjunct to brief counselling provided by dental practitioners. Patients receiving quitline counselling quit at higher rates than those who did not; however, only a small percentage of patients received counselling from the quitline. Therefore, it appears that dental professionals may be most effective in helping their patients to quit by regularly providing the 5A's plus proactively referring only those patients who are highly motivated to a quitline for more intensive counselling.
authors.affiliation: Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR 97405, USA. judith@ori.org
authors.forename: Judith S
authors.initials: JS
authors.lastname: Gordon
authors.forename: Judy A
authors.initials: JA
authors.lastname: Andrews
authors.forename: Karen M
authors.initials: KM
authors.lastname: Crews
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Payne
authors.forename: Herbert H
authors.initials: HH
authors.lastname: Severson
mesh_terms: D003376:Counseling / Q000379:methods*; D003813:Dentistry / Q000379:methods*; D005260:Female; D015277:Hotlines; D006801:Humans; D008297:Male; D008922:Mississippi; D017410:Practice Guidelines as Topic; D011331:Private Practice; D012017:Referral and Consultation / Q000458:organization & administration; D016540:Smoking Cessation / Q000379:methods*; D016896:Treatment Outcome