title: Role and models for compensation of tobacco use prevention and cessation by oral health professionals.
abstract: Appropriate compensation of tobacco use prevention and cessation (TUPAC) would give oral health professionals better incentives to provide TUPAC, which is considered part of their professional and ethical responsibility and improves quality of care. Barriers for compensation are that tobacco addiction is not recognised as a chronic disease but rather as a behavioural disorder or merely as a risk factor for other diseases. TUPAC-related compensation should be available to oral health professionals, be in appropriate relation to other dental therapeutic interventions and should not be funded from existing oral health care budgets alone. We recommend modifying existing treatment and billing codes or creating new codes for TUPAC. Furthermore, we suggest a four-staged model for TUPAC compensation. Stages 1 and 2 are basic care, stage 3 is intermediate care and stage 4 is advanced care. Proceeding from stage 1 to other stages may happen immediately or over many years. Stage 1: Identification and documentation of tobacco use is part of each patient's medical history and included into oral examination with no extra compensation. Stage 2: Brief intervention consists of a motivational interview and providing information about existing support. This stage should be coded/reimbursed as a short preventive intervention similar to other advice for oral care. Stage 3: Intermediate care consists of a motivational interview, assessment of tobacco dependency, informing about possible support and pharmacotherapy, if appropriate. This stage should be coded as preventive intervention similar to an oral hygiene instruction. Stage 4: Advanced care. Treatment codes should be created for advanced interventions by oral health professionals with adequate qualification. Interventions should follow established guidelines and use the most cost-effective approaches.
authors.affiliation: FDI World Dental Federation, Switzerland.
authors.forename: Jon
authors.initials: J
authors.lastname: Crail
authors.forename: Aira
authors.initials: A
authors.lastname: Lahtinen
authors.forename: Johann
authors.initials: J
authors.lastname: Beck-Mannagetta
authors.forename: Habib
authors.initials: H
authors.lastname: Benzian
authors.forename: Birgitta
authors.initials: B
authors.lastname: Enmarks
authors.forename: Tony
authors.initials: T
authors.lastname: Jenner
authors.forename: Ron
authors.initials: R
authors.lastname: Knevel
authors.forename: Martina
authors.initials: M
authors.lastname: Lulic
authors.forename: Seppo
authors.initials: S
authors.lastname: Wickholm
mesh_terms: D039702:Current Procedural Terminology; D003797:Dental Staff / Q000191:economics; D005250:Fees, Dental; D006801:Humans; D007347:Insurance, Dental; D018803:Models, Economic; D020340:Tobacco Use Cessation / Q000191:economics*