A review of strategies to stimulate dental professionals to integrate smoking cessation interventions into primary care.
OBJECTIVE
To summarise evidence regarding the effectiveness of various implementation strategies to stimulate the delivery of smoking cessation advice and support during daily dental care.


METHODS
Search of online medical and psychological databases, correspondence with authors and checking of reference lists. Only studies were selected which examined a support strategy to promote tobacco use cessation having a component to be delivered by a dentist, dental hygienist or dental assistant in the daily practice setting. Furthermore only controlled studies and systematic reviews were included. Methodological quality and outcomes were independently summarised and checked by two reviewers.


RESULTS
Eight studies met the inclusion criteria: 4 addressed strategies aimed at the dental professional and 4 addressed strategies aimed at both professional and patient. Only 4 of the studies were of a good quality. The 8 studies used combinations of implementation strategies, which made it difficult to evaluate the effectiveness of distinct components. Professional education appeared to enhance motivation for smoking cessation activities and advice giving. Organisational interventions (e.g., protocols, involvement of the whole team, referral possibilities) and incorporation of patient-oriented tools also contributed to the delivery of smoking cessation interventions.


CONCLUSIONS
Multifaceted support strategies positively influence dental professionals' knowledge of smoking and smoking cessation, their motivation to give advice and their performance. As only 4 studies were of good methodological quality, it was not possible to draw firm conclusions about specific components. Additional research is needed to unravel which strategies best stimulate the provision of smoking cessation advice and support during daily dental practice.
University Medical Centre Nijmegen St Radboud, IQ Centre for Quality ofHealthcare, Nijmegen, The Netherlands. j_rosseel@hotmail.com
J P
JP
Rosseel
J E
JE
Jacobs
A J M
AJ
Plasschaert
R P T M
RP
Grol
D001291:Attitude of Health Personnel; D003376:Counseling; D003727:Dental Auxiliaries; D003729:Dental Care; D003812:Dentist-Patient Relations; D003815:Dentists; D006801:Humans; D011320:Primary Health Care; D011369:Professional-Patient Relations; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology