title: Evidence summary: is smoking cessation an effective and cost-effective service to be introduced in NHS dentistry?
abstract: Since August 2009, members of the Primary Care Dentistry Research Forum (www.dentistryresearch.org) have taken part in an online vote to identify questions in day-to-day practice that they felt most needed to be answered with conclusive research. The question that receives the most votes each month forms the subject of a critical appraisal of the relevant literature. Each month a new round of voting takes place to decide which further questions will be reviewed. Dental practitioners and dental care professionals are encouraged to take part in the voting and submit their own questions to be included in the vote by joining the website. The paper below details a summary of the findings of the eighth critical appraisal. In order to address the question raised by the primary care dentistry research forum, first any international study was included that evaluated the effectiveness smoking cessation in dental practice. The aim was to understand whether smoking cessation in dental practice is an effective treatment strategy to increase tobacco cessation and abstinence. Moreover, this rapid assessment intended to identify whether there are certain types of smoking cessation intervention (or components of an intervention) in dental settings that are more effective than the others. In order to determine the applicability of the results to the NHS, we also looked for studies evaluating the cost-effectiveness of these interventions in NHS dentistry, studies reporting the current practice in NHS dentistry and finally qualitative and quantitative studies describing and evaluating the experience and views of dentists in the UK regarding implementing smoking cessation interventions in dental settings. The latter studies would help us to identify the possible barriers and facilitators in implementing these interventions in a dental setting. In conclusion, the critical appraisal of the international literature suggests that behavioural intervention for smoking cessation involving oral health professionals is an effective method of reducing tobacco use in smokers and users of smokeless tobacco and preventing uptake in non-smokers. There is not enough evidence available to assess whether these interventions are cost-effective and the effectiveness of one intervention (or component of the intervention) over another is not clear. The evaluation of the UK-related literature shows that private dental practices deliver more smoking cessation activities than their NHS counterparts. NHS practitioners report lack of reimbursement from the NHS, lack of time and training and fears over patient response as barriers to delivering smoking cessation interventions. We did not find studies evaluating the cost-effectiveness of the intervention in the UK.
authors.affiliation: Evidence Based Dentistry, Peninsula Dental School.
authors.forename: Mona
authors.initials: M
authors.lastname: Nasser
mesh_terms: D003362:Cost-Benefit Analysis; D055094:Evidence-Based Dentistry; D005792:General Practice, Dental / Q000191:economics; D006284:Health Plan Implementation; D006801:Humans; D016540:Smoking Cessation / Q000191:economics / Q000379:methods; D013218:State Dentistry; D006113:United Kingdom