ADOLESCENT SMOKING CESSATION IN DENTAL PRACTICES

描述：（申请人的描述） 1995年，34.8%的青少年报告使用烟草-自1995年以来增加了27%。 1991. 只有少数研究评估了增加烟草的干预措施 在这一人群中停止;需要研究来确定潜在的 青少年戒烟的有效策略。 申请人拟开展随机对照试验， 牙科筛查系统的有效性， 由牙科医生进行动机访谈和电话随访 （增强系统条件）与牙科诊所筛查系统相比 单独（单独的系统），以增加所有青少年的戒烟， 14-17岁，每周至少报告一次烟草使用，并预防吸烟 在少数有吸烟风险的青少年中使用。 十七 双子城管理医疗组织的牙科诊所将 随机分配至干预或比较条件。 牙科 所有诊所的工作人员都将接受系统处理烟草问题的培训 控制 使用计算机化的牙科预约记录，所有青少年（n = 6400），在这些诊所预约牙科服务， 确定并筛选合格性。 合格青少年（853名吸烟者 和100名处于风险中的非吸烟者）赢得完成基线电话访谈， 并在牙科检查时接受强化干预， 根据他们的诊所安排。 经过培训的牙科医生 将进行激励性面谈，进行电话随访 电话，提供戒烟材料，推荐青少年使用尼古丁 替代治疗，如果适用，并争取父母的支持， 青少年的许可。 牙科图表将被提取，以记录工作人员 遵守反对吸烟的建议。 在3岁时，将对参与的青少年进行随访 从他们看牙医的时间算起12个月。 访谈 将评估吸烟状况，在12个月的调查中通过唾液验证 可替宁，在干预与对照条件下的青少年中， 将诊所作为分析单位。 其他措施 包括吸烟史、改变阶段、自我效能、 停止和停止咨询。 此外，成本效益分析 将进行的，以确定传播的潜力， 干预，如果有效。

DESCRIPTION: (Applicant's Description) In 1995, 34.8% of adolescents reported use of tobacco--a 27% increase since 1991. Only a few studies have evaluated interventions to increase tobacco cessation in this population; research is needed to identify potentially effective strategies for tobacco cessation in adolescents. The applicants propose to conduct a randomized controlled trial to evaluate the effectiveness of a dental screening system with the addition of tailored motivational interviewing and telephone follow-up by a dental hygienist (enhanced systems condition) compared with a dental clinic screening system alone (systems alone), to increase tobacco cessation among all adolescents, ages 14-17, who report at least weekly tobacco use, and to prevent smoking uptake among a limited number of adolescents at risk of smoking. Seventeen dental clinics that are part of a Twin Cities managed care organization will be randomized to either the intervention or comparison condition. Dental staff in all clinics will be trained in a systems approach to tobacco control. Using computerized dental appointment records, all adolescents (n = 6400) with a scheduled dental appointment at these clinics will be identified and screened for eligibility. Eligible adolescents (853 smokers and 100 at risk non-smokers) win complete a baseline telephone interview, and receive enhanced intervention, or not, at the time of their dental appointment according to their clinic assignment. Trained dental hygienists will perform the motivational interviewing, conduct follow-up telephone calls, provide cessation materials, refer adolescents for nicotine replacement therapy, if applicable, and enlist parental support, with the adolescent's permission. Dental charts will be abstracted to document staff compliance with advice against smoking. Follow-up interviews will be conducted with participating adolescents at 3 and 12 months from the time of their dental appointment. The interviews will assess smoking status, validated during the 12 month survey by saliva cotinine, among adolescents in the intervention versus comparison condition, taking into account the clinic as the unit of analysis. Other measures include smoking history, stages of change, self-efficacy, social support for cessation and cessation advice. In addition, a cost-effectiveness analysis will be conducted to determine the potential for dissemination of the intervention, if effective.