Research Indicates Strong Influence of Dental Clinic Support on Smoking Cessation
The FreSH study, spearheaded by the National Dental Practice-Based Research Network (NDPBRN), is revolutionising the approach to tobacco cessation in dental care settings. Led by principal investigator, Dr. Cyril Meyerowitz, DDS, at the University of Rochester's Eastman Institute for Oral Health, the study is investigating the effectiveness of Ask-Advise-Refer (AAR) and Nicotine Replacement Therapy Sampling (NRT Sampling) methods to help tobacco users quit.
The FreSH study comes at a crucial time, as more than half of adult cigarette smokers reported trying to quit in the past year, according to the Centers for Disease Control. The study aims to address the underutilisation of nicotine replacement therapies and counselling, with less than 30% of patients attempting to quit smoking using these aids, and counselling used by less than 10%.
AAR is a brief tobacco cessation intervention where dental providers ask about tobacco use, advise quitting, and refer to cessation resources. NRT Sampling involves providing tobacco users with a sample of NRT products, such as patches or lozenges, during a dental visit. The combination of these methods in dental practices offers a comprehensive approach, providing timely advice and immediate access to cessation aids.
Preliminary evidence from practice-based research networks like FreSH suggests that this integrated approach yields higher quit rates than advice alone. By reducing barriers to NRT initiation and increasing engagement with cessation interventions, the approach addresses both motivational and pharmacological needs, leading to improved cessation outcomes compared to standard advice alone.
The dental practice is an ideal venue for tobacco cessation efforts, as dentists see patients regularly and can intervene opportunistically to motivate quitting. Studies forecast declines in youth tobacco use with targeted cessation counseling, making dental practices a vital frontline in the fight against tobacco use.
However, some providers are unsure about making recommendations due to concerns about side effects, contraindications, patient resistance, and a lack of knowledge about what to recommend. To address this, the researchers plan to create a brief, prepared presentation with referrals and options for the FreSH study, aiming to eliminate providers' hesitancy to talk to patients about quitting tobacco use.
Another intervention being explored is Nicotine Replacement Therapy Sampling, where patients will be given samples of nicotine patches or lozenges, with no pressure to adhere to a strict treatment plan or even to use them at all. This method directly facilitates quitting by lowering withdrawal symptoms and increasing motivation through immediate access to cessation aids.
Many patients expressed that they would be more likely to try a product that their dentist recommended, especially if they were assured it wouldn't interfere with their current medications. This demonstrates that dental appointments are seen as a good opportunity to educate patients about available resources and the benefits of quitting tobacco use.
The FreSH study is currently underway and is part of the NDPBRN, a consortium of over 5,000 U.S. providers representing dental practices and clinics who are devoted to conducting research with practical impact on care, paying special attention to topics where there are gaps in knowledge. The Network's efforts, such as the FreSH study, could greatly increase the use of resources and ultimately more people quitting tobacco permanently.
In summary, the FreSH study and related practice-based research demonstrate that Ask-Advise-Refer combined with Nicotine Replacement Therapy Sampling is an effective strategy to enhance quit rates among tobacco users by providing timely advice and immediate access to cessation aids in dental care settings. This integrated approach addresses both motivational and pharmacological needs, leading to improved cessation outcomes compared to standard advice alone.
In the context of the FreSH study, the integration of science, health-and-wellness, mental-health, therapies-and-treatments, and nutrition is evident as the research explores the effectiveness of Ask-Advise-Refer (AAR) and Nicotine Replacement Therapy Sampling (NRT Sampling) methods, which aim to address the underutilization of nicotine replacement therapies and counselling in helping tobacco users quit.
The study's findings, if positive, could lead to the development of comprehensive health-and-wellness strategies within dental practices, incorporating mental-health considerations, various therapies-and-treatments, and appropriate nutrition advice to support tobacco cessation and overall well-being.
