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8
New Mexico Dental Journal, Summer 2016
Tobacco Use Screening and Advice to Quit,
continued
Screening for smoking
: Of New Mexico adults who saw a
dental care provider, 49.5% reported being asked about to-
bacco use, considerably lower than tobacco screening by other
health care providers (82.7%). Young adult smokers who saw
a dental care provider in the past 12 months were more likely
to report having been asked about tobacco use (62.2%), com-
pared to older adult smokers (44.5%)
[Figure 2]
. No statisti-
cal differences in reporting tobacco use screening were seen
based on smoker ethnicity, race, or poverty status.
Advice to quit:
Among smokers who saw a dental care pro-
vider and reported being asked about tobacco use, 66.9% also
reported being advised to quit using tobacco. Dental care pro-
viders advised their patients who smoke to quit at about the
same rate as other health care providers (68.2%).
Dental care providers who advised smokers to quit using to-
bacco also supported patients by: prescribing or recommend-
ing nicotine patches, lozenges, or gum, or pills such as Zyban
(12.3%); recommending setting a specific date to quit using
tobacco (11.7%); and providing materials or information on
quitting tobacco such as information on the QUIT NOW
helpline or website (21.1%).
Hispanic smokers who saw a dental care provider in the past
12 months and reported being asked about tobacco use were
less likely to report having been advised to quit (53.3%), com-
pared to non-Hispanic smokers (78.4%)
[Figure 3]
. American
Indian smokers were also less likely to report having been ad-
vised to quit (43.8%) by their dental care providers than non-
American Indian smokers (71.6%). No statistically significant
differences in reporting advice to quit were observed based on
respondent’s age or poverty status.
Discussion
Almost two in three New Mexico adults saw a dental care
provider in the past 12 months, indicating that dental care
providers have opportunities to help reduce smoking among
their patients who smoke. Yet only half of those who visited a
dental care provider reported being asked about tobacco use,
and among smokers who were asked about tobacco use, only
two in three reported being advised to quit
[Figure 4]
.
The dental office setting can present unique barriers for den-
tal care providers to implement tobacco use cessation inter-
ventions for their patients. On the part of the provider, some
barriers may include not feeling it’s an appropriate role or
setting; discomfort in discussing tobacco use; lack of time and
financial incentives; lack of knowledge, skills, or confidence
in the topic and available resources; or even tobacco use by
the clinician.
5
The patients themselves may also not want to
discuss their tobacco use with their dental provider or they
may feel that their provider is not interested. One study of
dental patients found that 58% of dental patients “believed
that dental offices should provide tobacco cessation services
to patients.”
6
Strategies to increase tobacco use interventions in the den-
tal setting could include incorporating tobacco dependence
treatment into education curricula and continuing education
for dental care providers; increasing provider awareness of
and referrals to state- or health-plan affiliated QUIT NOW
helplines; promoting changes in work flow or dental team
member roles that support tobacco use screening and inter-
ventions; and exploring insurance reimbursement options for
tobacco dependence treatment by dental care providers. The
Figure 2
Young adult
smokers were
more likely to
report being
asked about
tobacco use
by dental care
providers.
Figure 3
Percent of smokers who reported being
advised to quit by a dental care provider
after being asked about tobacco use