Interventions for tobacco cessation in the dental setting. A systematic review

Oral health professionals have a unique opportunity to increase tobacco abstinence rates among patients who use tobacco, Objective: To assess the effectiveness of interventions for tobacco cessation offered to cigarette smokers and smokeless tobacco users in the dental office or community setting. Research Design: We searched standard electronic retrieval systems and databases including the specialized registers of the Cochrane Tobacco Addiction Group and the Cochrane Oral Health Group through 2006. Selection criteria included randomised and pseudo-randomised clinical trials assessing tobacco cessation interventions for tobacco users conducted by oral health professionals in the dental office or community setting. The most rigorous abstinence outcome reported with at least six months of follow-up was recorded. Data collection and analysis involved two authors who independently reviewed abstracts for inclusion and abstracted data from included trials. Results: Six clinical trials assessing the efficacy of interventions in dental office or school community settings were included. All studies assessed the efficacy of interventions for smokeless tobacco users, one also included cigarettes smokers, all employed oral exam and behavioral components, and one offered pharmacotherapy. The results showed that interventions conducted by oral health professionals increase tobacco abstinence rates (OR 1.44; 95% CI: 1.16-1.78) at 12 months or longer. Heterogeneity was evident and could not be adequately explained through subgroup or sensitivity analyses. Conclusions: Available evidence suggests that behavioral interventions for tobacco use conducted by oral health professionals incorporating an oral exam component in the dental office and community setting increase tobacco abstinence rates.