摘要：Objectives. We compared patient-reported receipt of smoking cessation counseling from US dentists and physicians. Methods. We analyzed the 2010 to 2011 Tobacco Use Supplement of the Current Population Survey to assess receipt of smoking cessation advice and assistance by a current smoker from a dentist or physician in the past 12 months. Results. Current adult smokers were significantly less likely to be advised to quit smoking during a visit to a dentist (31.2%) than to a physician (64.8%). Among physician patients who were advised to quit, 52.7% received at least 1 form of assistance beyond the simple advice to quit; 24.5% of dental patients received such assistance ( P < .05). Approximately 9.4 million smokers who visited a dentist in 2010 to 2011 did not receive any cessation counseling. Conclusions. Our results indicate a need for intensified efforts to increase dentist involvement in cessation counseling. System-level changes, coupled with regular training, may enhance self-efficacy of dentists in engaging patients in tobacco cessation counseling. Tobacco use is associated with several oral and perioral diseases because most tobacco use is administered orally. 1–4 The National Call to Action to Promote Oral Health emphasized the need for tobacco cessation and other community programs to promote health. 5 Hence, dental professionals have a critical role in helping their patients quit tobacco use. 6 The impact of intensified involvement of dental professionals in tobacco prevention and cessation may be significant, considering that in 2010, 37% of US adults aged 19 to 64 years and 46.3% of persons aged 2 to 18 years visited a dentist. 7 The American Dental Association’s goal of reducing oral health disparities among underserved populations further highlights the importance of increased involvement of dentists in tobacco cessation. 8 Oral health disparities may mirror disparities in tobacco use (e.g., individuals of low socioeconomic status have disproportionately high prevalence of tobacco use and also poor oral health care access). 9,10 Hence, in recent years, tobacco cessation counseling by dentists has been prioritized in the United States, as evidenced by some of the Healthy People 2020 targets. 11 The US Public Health Service outlined a 5-step approach known as the 5 A’s to provide a structural framework for health professionals to help their patients quit tobacco use: ask all patients whether they use tobacco, advise all tobacco users to quit, assess tobacco users’ willingness to quit, assist tobacco users by offering medications and providing or referring for counseling or additional treatment, and arrange follow-up contact to prevent relapse. 12 Despite these developments, few nationally representative data exist on the implementation of tobacco cessation counseling among US dentists. To fill this gap in knowledge, we assessed patient-reported receipt of 2 of the 5 A’s (advice and assistance) from a dentist among current smokers who participated in the 2010 to 2011 Tobacco Use Supplement of the Current Population Survey (TUS-CPS), a nationally representative sample of US households with persons aged 18 years or older. To better provide context for the performance of dentists in delivering smoking cessation interventions, we compared patient recall of physician-delivered cessation interventions in the same sample.
