Variations in tobacco control in National Dental PBRN practices: the role of patient and practice factors
Corresponding Author
Midge N. Ray RN, MSN
Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama
Corresponding author e-mail: [email protected]Search for more papers by this authorJeroan J. Allison MD, MS Epi
Department of Quantitative Health Sciences and Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
Search for more papers by this authorHeather L. Coley MPH
Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
Search for more papers by this authorJessica H. Williams PhD, MPH
Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama
Search for more papers by this authorConnie Kohler PhD
Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
Search for more papers by this authorGregg H. Gilbert DDS, MBA
Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama
Search for more papers by this authorJoshua S. Richman MD, PhD
Birmingham VAMC and Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
Search for more papers by this authorCatarina I. Kiefe PhD, MD
Department of Quantitative Health Sciences and Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
Search for more papers by this authorRajani S. Sadasivam PhD
Division of Health Informatics and Implementation Science, Quantitative Health Sciences and Medicine, University of Massachusetts Medical School, Worcester
Search for more papers by this authorThomas K. Houston MD, MPH
Division of Health Informatics and Implementation Science, Quantitative Health Sciences and Medicine, University of Massachusetts Medical School, Worcester
Center for Health Quality, Outcomes and Economic Research, Bedford VAMC, Bedford, Massachusetts
Search for more papers by this authorfor The National DPBRN Collaborative Group
The National DPBRN Collaborative Group comprises practitioners, faculty and staff who contributed to this activity. A list of these persons is at, http://nationaldentalpbrn.org/publication.php
Search for more papers by this authorCorresponding Author
Midge N. Ray RN, MSN
Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama
Corresponding author e-mail: [email protected]Search for more papers by this authorJeroan J. Allison MD, MS Epi
Department of Quantitative Health Sciences and Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
Search for more papers by this authorHeather L. Coley MPH
Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
Search for more papers by this authorJessica H. Williams PhD, MPH
Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama
Search for more papers by this authorConnie Kohler PhD
Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
Search for more papers by this authorGregg H. Gilbert DDS, MBA
Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama
Search for more papers by this authorJoshua S. Richman MD, PhD
Birmingham VAMC and Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
Search for more papers by this authorCatarina I. Kiefe PhD, MD
Department of Quantitative Health Sciences and Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
Search for more papers by this authorRajani S. Sadasivam PhD
Division of Health Informatics and Implementation Science, Quantitative Health Sciences and Medicine, University of Massachusetts Medical School, Worcester
Search for more papers by this authorThomas K. Houston MD, MPH
Division of Health Informatics and Implementation Science, Quantitative Health Sciences and Medicine, University of Massachusetts Medical School, Worcester
Center for Health Quality, Outcomes and Economic Research, Bedford VAMC, Bedford, Massachusetts
Search for more papers by this authorfor The National DPBRN Collaborative Group
The National DPBRN Collaborative Group comprises practitioners, faculty and staff who contributed to this activity. A list of these persons is at, http://nationaldentalpbrn.org/publication.php
Search for more papers by this authorABSTRACT
We engaged dental practices enrolled in The National Dental Practice-Based Research Network to quantify tobacco screening (ASK) and advising (ADVISE); and to identify patient and practice characteristics associated with tobacco control. Dental practices (N = 190) distributed patient surveys that measured ASK and ADVISE. Twenty-nine percent of patients were ASKED about tobacco use during visit, 20% were identified as tobacco users, and 41% reported being ADVISED. Accounting for clustering of patients within practices, younger age and male gender were positively associated with ASK and ADVISE. Adjusting for patient age and gender, a higher proportion of non-whites in the practice, preventive services and proportion on public assistance were positively associated with ASK. Proportion of tobacco users in the practice and offering other preventive services were more strongly associated with ASK and ADVISE than other practice characteristics. Understanding variations in performance is an important step toward designing strategies for improving tobacco control in dentistry.
References
- 1 Healthy People 2010. Healthy People 2010: Leading health indicators in healthy people: Washington DC: U.S. Government Printing Office; 2000: 6–8.
- 2 Center for Disease Control. Annual smoking attributable mortality, years of potential life lost and productivity losses—United States. MMWR Morb Mortal Wkly Rep. 2005; 54(25): 625–28.
- 3 US Department of Health and Human Services. The health consequences of smoking: a report of the Surgeon General. In: CDC, ed. Atlanta, GA: CDC; 2004.
- 4Baharin B, Palmer RM, Coward P, Wilson RF. Investigation of periodontal destruction patterns in smokers and non-smokers. J Clin Periodontol. Jul 2006; 33(7): 485–90.
- 5Albandar JM, Streckfus CF, Adesanya MR, Winn DM. Cigar, pipe, and cigarette smoking as risk factors for periodontal disease and tooth loss. J Periodontol. Dec 2000; 71(12): 1874–81.
- 6 Center for Disease Control. Vital signs: current cigarette smoking among adults aged > 18 years—United States, 2005–2010. MMWR Morb Mortal Wkly Rep. 2011; 60(35): 1207–12.
- 7Fiore MC, Bailey WC, Cohen S. Treating Tobacco Use and Dependence: Clinical Practice Guideline 2008 Update, 2008.
- 8Tomar SL. Dentistry's role in tobacco control. J Am Dent Assoc 2001; 132(Suppl): 30S–35S.
- 9Albert DA, Severson H, Gordon J, Ward A, Andrews J, Sadowsky D. Tobacco attitudes, practices, and behaviors: a survey of dentists participating in managed care. Nicotine Tobacco Res. 2005; 7(Suppl 1): S9–18.
- 10Tong EK, Strouse R, Hall J, Kovac M, Schroeder SA. National survey of U.S. health professionals’ smoking prevalence, cessation practices, and beliefs. Nicotine Tob Res. Jul 2010; 12(7): 724–33.
- 11Hu S, Pallonen U, McAlister AL, et al. Knowing how to help tobacco users. Dentists’ familiarity and compliance with the clinical practice guideline. J Am Dent Assoc. Feb 2006; 137(2): 170–79.
- 12Succar CT, Hardigan PC, Fleisher JM, Godel JH. Survey of tobacco control among Florida dentists. J Community Health. Apr 2011; 36(2): 211–18.
- 13Wilson A, McDonald P. Comparison of patient questionnaire, medical record, and audio tape in assessment of health promotion in general practice consultations. Bmj. Dec 3 1994; 309(6967): 1483–85.
- 14Pbert L, Adams A, Quirk M, Hebert JR, Ockene JK, Luippold RS. The patient exit interview as an assessment of physician-delivered smoking intervention: a validation study. Health Psychol. Mar 1999; 18(2): 183–88.
- 15Stange KC, Zyzanski SJ, Smith TF, et al. How valid are medical records and patient questionnaires for physician profiling and health services research? A comparison with direct observation of patients visits. Med Care. Jun 1998; 36(6): 851–67.
- 16Szatkowski L, McNeill A, Lewis S, Coleman T. A comparison of patient recall of smoking cessation advice with advice recorded in electronic medical records. BMC Public Health. 2011; 11: 291.
- 17Conroy MB, Majchrzak NE, Silverman CB, et al. Measuring provider adherence to tobacco treatment guidelines: a comparison of electronic medical record review, patient survey, and provider survey. Nicotine Tob Res. Apr 2005; 7 Suppl 1: S35–43.
- 18Orleans CT, Alper, J., ed. Helping addicted smokers quit: The Foundations Tobacco-Cessation Programs. San Francisco: Jossey-Bass; 2003. [Isaacs S K, J., ed. To Improve Health and Health Care, Volume 6].
- 19Houston T, Richman J, Ray M, et al. Internet delivered support for tobacco control in dental practice: randomized controlled trial. J Med Internet Res 2008; 10(5): e38.
- 20Davis KC, Nonnemaker JM, Farrelly MC, Niederdeppe J. Exploring differences in smokers’ perceptions of the effectiveness of cessation media messages. Tob Control Jan 2011; 20(1): 26–33.
- 21Shiffman S, Gwaltney CJ, Balabanis MH, et al. Immediate antecedents of cigarette smoking: an analysis from ecological momentary assessment. J Abnorm Psychol Nov 2002; 111(4): 531–45.
- 22Janicki DL, Kamarck TW, Shiffman S, Gwaltney CJ. Application of ecological momentary assessment to the study of marital adjustment and social interactions during daily life. J Fam Psychol. Mar 2006; 20(1): 168–72.
- 23Moskowitz DS, Young SN. Ecological momentary assessment: what it is and why it is a method of the future in clinical psychopharmacology. J Psychol Neurosci. Jan 2006; 31(1): 13–20.
- 24Freedman MJ, Lester KM, McNamara C, Milby JB, Schumacher JE. Cell phones for ecological momentary assessment with cocaine-addicted homeless patients in treatment. J Subst Abuse Treat. Mar 2006; 30(2): 105–11.
- 25Pipe A, Sorensen M, Reid R. Physician smoking status, attitudes toward smoking, and cessation advice to patients: an international survey. Patient Educ Couns. Jan 2009; 74(1): 118–23.
- 26Squier C, Hesli V, Lowe J, Ponamorenko V, Medvedovskaya N. Tobacco use, cessation advice to patients and attitudes to tobacco control among physicians in Ukraine. Eur J Cancer Prev. Oct 2006; 15(5): 458–63.
- 27Burgan SZ. Smoking behavior and views of Jordanian dentists: a pilot survey. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Feb 2003; 95(2): 163–68.
