Tobacco Quitlines: An Adjunct to Dental Interventions

描述（由申请人提供）：拟议的研究将比较两种方法，以提供简短的牙科诊所为基础的干预措施，旨在帮助患者戒烟或无烟烟草的使用，并比较这两种牙科诊所为基础的干预措施与常规护理。虽然许多牙科医生现在经常将“5A”（询问和建议）的前两个纳入他们的实践中，以前的研究表明，简短的办公室为基础的干预措施是有效的，在牙科病人产生适度的戒烟率，牙科医生继续感知一些障碍，以常规提供戒烟服务。许多牙科医生仍然认为，辅导病人戒掉成瘾行为超出了他们的培训或舒适的范围。最近的研究表明，来自国家赞助的电话烟草帮助热线的积极电话咨询对戒烟有积极影响。使用这些帮助热线为牙科专业人员提供了一个独特的补充，可以减轻从业人员的负担，并提高患者戒烟的可能性。牙科和医疗从业者遵循的常见启发式方法是将患者转诊给专科医生。因此，我们相信转介电话求助热线可能是一个创新的方法，使牙医和牙科医生能够鼓励和支持他们的病人戒烟。 我们建议测试两个层次的干预相比，在一项随机临床试验，其中60牙科诊所在密西西比随机三种条件之一。在一种情况下（“5A”），牙科团队将提供一个简短的办公室为基础的干预，是仿照“5A”的倡导的临床实践指南。在第二种情况下（“3A”+ THL），牙科团队将提供前三个“A”（询问，建议，评估），然后将患者转介到国家支持的电话帮助热线，以提供戒烟咨询和后续支持。在第三种情况下（患者护理），志愿者实践将要求他们的患者只完成我们的研究调查。将在基线、入组后6周、3个月和12个月通过邮寄调查和电话随访对所有同意的21岁及以上吸烟患者进行评估。主要结局是干预后3个月和12个月自我报告的连续戒烟。 次要结果是减少使用，在3个月和12个月时尝试戒烟的次数，以及戒烟准备程度的增加。牙科医生将在基线、患者入组开始后3个月和12个月进行评估，以评估戒烟态度和行为的变化。此外，我们将进行经济分析，以确定每项干预措施的相对成本效益。

DESCRIPTION (provided by applicant): The proposed study will compare two methods for providing brief dental office-based interventions designed to help patients quit either cigarette smoking or smokeless tobacco use, and to compare these two dental office-based interventions with usual care. Although many dental practitioners now routinely incorporate the first two of the "5A's" (Ask and Advise) into their practice, and previous research indicates that brief office-based interventions are effective in producing modest tobacco quit rates for dental patients, dental practitioners continue to perceive a number of obstacles to routine provision of tobacco cessation services. Many dental practitioners still believe that counseling patients to quit an addictive behavior is beyond the scope of their training or comfort. Recent studies have shown that proactive phone counseling from State-sponsored telephone tobacco help lines has a positive effect on tobacco cessation. The use of these help lines offers a unique supplement to the dental professional that could reduce the burden on practitioner and enhance the likelihood of their patients' quitting. Referral to a specialist is within the common heuristic followed by dental and medical practitioners. Therefore, we believe referral to a telephone help line may be an innovative way of enabling dentists and dental hygienists to encourage and support their patients to quit tobacco. We propose to test two levels of intervention as compared to usual care in a randomized clinical trial in which 60 dental practices in Mississippi are randomized to one of three conditions. In one condition ("5A's"), the dental team will provide a brief office-based intervention that is modeled on the "5A' s" advocated by the Clinical Practice Guideline. In the second condition ("3A's" + THL), the dental team will provide the first three "A's" (Ask, Advise, Assess), and then refer patients to the State-supported telephone help line for provision of the cessation counseling and follow-up support. In the third condition (Usual Care), volunteering practices will ask their patients only to complete our study surveys. All consenting, tobacco-using patients aged 21 and older will be assessed at baseline, 6 weeks, 3 months, and 12 months following enrollment by mailed surveys and follow-up phone calls to non-responders. The primary outcome is self-reported consecutive quit at 3 and 12 months following intervention. Secondary outcomes are reduction in use, number of quit attempts at 3 and 12 months, and increases in readiness to quit. Dental practitioners will be assessed at baseline, and 3 and 12 months following the start of patient enrollment, to assess changes in tobacco cessation attitudes and behaviors. In addition, we will conduct an economic analysis to determine the relative cost effectiveness of each intervention.