title: Evaluation of a brief counseling for tobacco cessation in dental clinics among Swedish smokers and snus users. A cluster randomized controlled trial (the FRITT study).
abstract: OBJECTIVE
  The aim of this study is to assess the effectiveness of a very brief structured counseling for tobacco cessation in dentistry clinics.
  
  
  METHODS
  A cluster randomized trial was conducted in Sweden in 2012-2013. Twenty-seven dentistry clinics in two Swedish counties were randomized to provide either a structured brief advice based on the 5 A's model or usual care. Participants were 467 patients currently using tobacco daily (225 in the intervention group and 242 in usual care), of which 97% were retained at follow-up, six months after enrolment. Study outcomes were: 7-day abstinence (primary outcome); 3-month sustained abstinence; 50% reduction of the amount tobacco used; quit attempts lasting at least 24h.
  
  
  RESULTS
  Compared to usual care, brief counseling was not associated to statistically significant increase in the proportion abstinent from tobacco use after 6months. However, there was a statistically significant association with reduction of tobacco consumption (OR=2.07 95% CI 1.28-3.35). Changes in the expected direction for all outcomes were more frequent in the intervention than in the usual care group, and larger among exclusive snus users than among smokers.
  
  
  CONCLUSIONS
  Very brief and structured counseling in dentistry may achieve positive behavioral modifications among tobacco users, with significant reduction of tobacco consumption, particularly among smokeless tobacco users.
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. Electronic address: suvi.virtanen@ki.se.
authors.forename: Suvi E
authors.initials: SE
authors.lastname: Virtanen
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm Health Care District, Sweden. Electronic address: zangin.zeebari@ki.se.
authors.forename: Zangin
authors.initials: Z
authors.lastname: Zeebari
authors.affiliation: Dentistry Clinic Solvändan, Sörmland Health Care Region, Mariefred, Sweden. Electronic address: izloo@hotmail.com.
authors.forename: Izla
authors.initials: I
authors.lastname: Rohyo
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm Health Care District, Sweden. Electronic address: Rosaria.galanti@ki.se.
authors.forename: Maria R
authors.initials: MR
authors.lastname: Galanti
mesh_terms: D000293:Adolescent; D000328:Adult; D016000:Cluster Analysis; D003376:Counseling / Q000379:methods* / Q000706:statistics & numerical data; D003740:Dental Clinics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D013548:Sweden; D013997:Time Factors; D062789:Tobacco Products / Q000706:statistics & numerical data; D020340:Tobacco Use Cessation / Q000379:methods* / Q000706:statistics & numerical data; D014030:Tobacco, Smokeless / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Counseling; Dental care; Randomized controlled trial; Tobacco use cessation