Do faxed quitline referrals add value to dental office-based tobacco-use cessation interventions?
BACKGROUND
The Ask, Advise, Refer (AAR) model of intervening with patients who use tobacco promotes a brief office-based intervention plus referral to a tobacco quitline. However, there is little evidence that this model is effective. The primary aim of this study was to evaluate the effects on patients' tobacco use of two levels of a dental office-based intervention compared with usual care.


METHODS
The authors randomly assigned 68 private dental clinics to one of three conditions: 5 As (Ask, Advise, Assess, Assist, Arrange); 3 As (AAR model); or usual care, and they enrolled 2,160 participants.


RESULTS
At the 12-month assessment, compared with those in usual care, participants in the two intervention conditions combined were more likely to report cessation of tobacco use, as measured by nine-month prolonged abstinence (3 percent versus 2 percent; F(1,66) = 3.97, P < .10) and 12-month point prevalence (12 percent versus 8 percent; F(1,66) = 7.32, P < .01). There were no significant differences between participants in the clinics using the 5 As and 3 As strategies.


CONCLUSIONS
The results of this study are inconclusive as to whether referrals to a quitline add value to brief dental office-based interventions. Patients receiving telephone counseling quit tobacco use at higher rates, but only a small percentage of those proactively referred actually received counseling.


CONCLUSIONS
The results confirm those of previous research: that training dental practitioners to provide brief tobacco-use cessation advice and assistance results in a change in their behavior, and that these practitioners are effective in helping their patients to quit using tobacco.
Gordon
Judith S
JS
Department of Family and Community Medicine, College of Medicine, University of Arizona, 1450 N. Cherry Ave., Tucson, AZ 85719, USA. judithg@email.arizona.edu
Andrews
Judy A
JA
Crews
Karen M
KM
Payne
Thomas J
TJ
Severson
Herbert H
HH
Lichtenstein
Edward
E
D000328:Adult; D001294:Attitude to Health; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D003376:Counseling; D003770:Dental Offices; D003812:Dentist-Patient Relations; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D015277:Hotlines; D006801:Humans; D008297:Male; D009538:Nicotine / Q000031:analogs & derivatives; D018722:Nicotinic Agonists / Q000627:therapeutic use; D009909:Oral Health; D012017:Referral and Consultation; D016540:Smoking Cessation / Q000379:methods; D016636:Telefacsimile; D020340:Tobacco Use Cessation / Q000379:methods*; D014030:Tobacco, Smokeless; D016896:Treatment Outcome; D055815:Young Adult
D000697:Central Nervous System Stimulants; D018722:Nicotinic Agonists; D009538:Nicotine