Dentists' self-perceived role in offering tobacco cessation services: results from a nationally representative survey, United States, 2010-2011.
BACKGROUND
Dental visits represent an opportunity to identify and help patients quit smoking, yet dental settings remain an untapped venue for treatment of tobacco dependence. The purpose of this analysis was to assess factors that may influence patterns of tobacco-use-related practice among a national sample of dental providers.


METHODS
We surveyed a representative sample of general dentists practicing in the United States (N = 1,802). Multivariable analysis was used to assess correlates of adherence to tobacco use treatment guidelines and to analyze factors that influence providers' willingness to offer tobacco cessation assistance if reimbursed for this service.


RESULTS
More than 90% of dental providers reported that they routinely ask patients about tobacco use, 76% counsel patients, and 45% routinely offer cessation assistance, defined as referring patients for cessation counseling, providing a cessation prescription, or both. Results from multivariable analysis indicated that cessation assistance was associated with having a practice with 1 or more hygienists, having a chart system that includes a tobacco use question, having received training on treating tobacco dependence, and having positive attitudes toward treating tobacco use. Providers who did not offer assistance but who reported that they would change their practice patterns if sufficiently reimbursed were more likely to be in a group practice, treat patients insured through Medicaid, and have positive attitudes toward treating tobacco dependence.


CONCLUSIONS
Findings indicate the potential benefit of increasing training opportunities and promoting system changes to increase involvement of dental providers in conducting tobacco use treatment. Reimbursement models should be tested to assess the effect on dental provider practice patterns.
School of Medicine, Department of Population Health, New York University, New York, New York.
Deanna P
DP
Jannat-Khah
School of Medicine, Department of Population Health, New York University, New York, New York.
Jennifer
J
McNeely
Mailman School of Public Health, Department of Sociomedical Sciences, Columbia University, New York, New York.
Margaret R
MR
Pereyra
Mailman School of Public Health, Department of Sociomedical Sciences, Columbia University, New York, New York.
Carrigan
C
Parish
School of Social Service Administration, University of Chicago, Chicago, Illinois.
Harold A
HA
Pollack
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York.
Jamie
J
Ostroff
Mailman School of Public Health, Department of Sociomedical Sciences, Columbia University, New York, New York.
Lisa
L
Metsch
Director of Research Development, Associate Professor of Medicine and Population Health, Department of Population Health, New York University School of Medicine, 227 East 30th St, 6th Fl, New York, NY 10016. E-mail: donna.shelley@nyumc.org.
Donna R
DR
Shelley
D001291:Attitude of Health Personnel; D003625:Data Collection; D003815:Dentists; D006801:Humans; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires; D020340:Tobacco Use Cessation / Q000379:methods*; D014481:United States