Opinions of Romanian Dental Students Toward Tobacco Use Interventions in the Dental Setting

Global Status of Knowledge, Attitude and Practice on Tobacco Cessation Interventions Among Dental Professionals: A Systematic Review

BACKGROUND

With the emergence of the WHO Framework Convention on Tobacco Control, globally the use of tobacco has decreased notably, although, it still requires efforts at individual, organizational, community level to decrease the rate further. Dental professionals are at an excellent position to provide tobacco cessation counselling and interventions, however, it is not practiced much due to lack of training and lack of knowledge. Therefore, this systematic review was conducted to assess the global status of knowledge, attitude and practice on tobacco cessation interventions among dental professionals.

MATERIALS AND METHOD

A systematic search of 6 databases with no language restriction since 2000 was undertaken. Studies were included if they assessed knowledge, attitude and practice on tobacco cessation interventions among dental professionals using a validated or prevalidated tool. The data obtained for assessment of knowledge, attitude, practice, curriculum and barriers were represented through heatmaps. Quality assessment of the studies was done using Newcastle Ottawa scale.

RESULTS

Fifty six studies were included in this systematic review. Majority of the studies were found to be of moderate quality. Knowledge regarding the tobacco cessation interventions was more theoretical than practical. All the studies showed a favorable attitude among dental professionals towards tobacco cessation intervention.

CONCLUSION

The included studies lack homogeneity in assessing knowledge, attitude and practice on tobacco cessation interventions. The development and validation of a standardized questionnaire to assess knowledge, attitude and practice on tobacco cessation interventions could be a potentially effective way to uniformly gather data on the subject.

The barriers for tobacco cessation counseling in teaching health care institutions: A qualitative data analysis using MAXQDA software

Introduction:

Recently, Dental Council of India directed all the teaching dental institutions in the country to set up tobacco cessation centers (TCC). International experiences suggest that there are many barriers for the provision of tobacco cessation counseling at dental clinics. In this context, it is important to understand the dental students’ attitudes toward this initiative of tobacco cessation counseling at dental settings.

Materials and Methods:

This qualitative study to document the dental students’ perspectives toward the provision of tobacco cessation counseling using focus group interviews was conducted in two teaching dental institutions in the state of Andhra Pradesh, India. 133 house surgeons from two dental institutions participated in the study and were interviewed as 13 focus groups. MAXQDA (version 12, VERBI GmbH, Berlin, Germany) was used for data analysis. All the interviews were audio recorded and the transcripts were open coded by three independent investigators.

Results:

The response rate in this study was 78.45%. The following themes were extracted from the views and opinions shared by the students: the reluctance of patients to discuss tobacco-related problems; tobacco use among students discouraging them to actively participate in counseling; an opinion that dental clinics are not suitable for the provision of tobacco cessation counseling; belief among students that they are not qualified enough.

Conclusion:

The directives given by the Ministry of Health and Family Welfare in association with Dental council of India to set up TCC at every teaching dental institution are laudable and demonstrate the commitment at policy level toward bringing down tobacco consumption in the country. However, few reforms need to be made in the curriculum to better execute the delegated responsibilities, which include orientation programs for dental students on the scope of the dental profession and workshops on tobacco cessation counseling.

Smoking Prevalence, Attitudes and Behavior among Dental Students in Poland and Italy

The aim of the study was to perform preliminary research to compare the smoking prevalence, attitudes and behavior between dentistry students in two universities in Europe using the standardized Global Health Professions Student Survey (GHPSS) questionnaire. This was cross-sectional carried out among dentistry students from the Medical University in Bialystok, Poland and Sapienza University of Rome, Italy. There were 582 participants; 282 were Italians, 202 were smokers and 42% were Italians. The response rate was 79.9% of Italian students and 79.6% of Polish students. The prevalence of smoking was significantly higher among Italian students (42% vs. 28.0%). Attitudes and behaviour of smokers and non-smokers differed statistically. Polish and Italian dental students presented statistically different behavior regarding the time to smoke the first cigarette, the willingness to stop smoking and trying to stop smoking in the last year. The multiple logistic regression analysis revealed that two independent variables, exposure to second-hand smoke (SHS) both at home and in public places (OR = 3.26 and OR = 5.9, respectively), showed a significantly higher occurrence of smoking. There is a high use of tobacco among dental students, which is particularly high in Italian dental students. Students realizes the positive perception of their own tobacco counsellor role in a dental setting. Dental students should be role models to their peers and patients.

Effectiveness of an innovative and interactive smoking cessation training module for dental students: A prospective study

BACKGROUND

Smoking is one of the world's major health problems and dental professionals are in a unique position to promote smoking cessation. However, according to the current literature, neither dental students nor dentists feel adequately prepared to counsel smokers. The purpose of this study was to develop and implement a teaching intervention on smoking cessation for fourth-year dental students and assess its effectiveness in terms of learning outcome on knowledge, communication skills and attitudes.

MATERIALS AND METHODS

In this prospective intervention study, students in the intervention group (n = 28) participated in a teaching module consisting of a podcast, an interactive lecture, a seminar, and small-group sessions with role-play interactions. Knowledge, communication skills and attitudes were measured using written examinations and an objective structured clinical examination (OSCE) at the end of the module and 6 months later. Results were compared with data from a historical control group (n = 27) receiving standard teaching.

RESULTS

Compared with the control group, students in the intervention group had higher scores in the knowledge test (67.1% vs 41.8%; P < .001; d = 2.8) as well as in the OSCE (74.9% vs 44.7%; P < .001; d = 2.3) and also retained more knowledge (52.7% vs 36.5%; P < .001; d = 2.0) and skills (71.8% vs 47.6%; P < .001; d = 2.5) over a period of 6 months. Attitudes were similar across groups and time-points.

CONCLUSION

The teaching intervention equipped dental students with specific knowledge and skills required to effectively counsel smoking patients. Further research is required to assess the transfer of these skills to the clinical setting.

Perception of health professions students of their role model status in Toombak cessation: A cross-sectional study from Sudan

INTRODUCTION

Health professionals are to play an essential and effective role in tobacco control. Toombak is a popular form of smokeless tobacco, locally made and used among Sudanese. It is associated with oral and systemic health hazards, particularly oral cancer. This study was set out to assess health professions students' perception of their status as future role models for their patients and the public regarding Toombak use cessation and to explore socio-cognitive covariates of perceived role model status.

MATERIALS AND METHODS

A cross-sectional study was conducted in 2013-2014 using a self-administered questionnaire among health professions students enrolled in Medicine, Pharmacy, Dentistry and Nursing colleges in Khartoum state, Sudan. A total of 1530 participants were recruited from colleges using a cluster stratified sampling procedure.

RESULTS

The majority of the participants (88.2%) were 19-22 year old, females showed predominance (66.1%). Most of the participants (69.7%) scored good knowledge of Toombak-related therapies. The majority (97%) had a positive attitude towards banning Toombak use in public. Half of the participants (50.4%) confirmed availability of Toombak control policy in their college, while 66% reported receiving training in Toombak cessation. Only 9.2% of the participants reported that they have ever used Toombak; among them, 69.5% were current daily users. Less than half (47.8%) reported a positive perception of their status as a role model. Logistic regression model revealed that tobacco cessation training, availability of college policy and positive attitudes towards banning Toombak use in public were strong predictors of with a positive perception of role model status.

CONCLUSION

Imposing Toombak control policies within colleges combined with formal training in cessation methods, would reinforce the positive perception of health professions students as a role model, particularly the students themselves seem to be ready for such systematic training.

Knowledge About the Relation Between Tobacco and Disease and the Attitude Toward Advising the Cessation of Its Consumption Among a Group of Spanish Dental Students

Tobacco is one of the leading causes of preventable death in the developed world. Smoking is associated with a large number of oral pathologies, such as cancer and periodontitis. Dental professionals can play a key role in preventing these health problems. The objectives of this study were (1) to analyze tobacco consumption habits among a group of Spanish dental students, and (2) to assess their knowledge, perceptions, and attitudes regarding procedures to help patients quit smoking. A cross-sectional descriptive study was carried out at the Faculty of Medicine and Dentistry of Santiago de Compostela (Galicia, Spain). Three validated questionnaires were distributed, and the obtained data was processed using SPSS. One hundred twenty out of 220 surveys were completed. Of the students, 18.3% were smokers and the average number of smoked cigarettes per day was 7.5. Tobacco dependence and the intention to give up the habit were low (Fagerström Test) and doubtful (Richmond test), respectively. The majority of students (94.2%) considered it appropriate to promote tobacco use cessation (TUC) activities. A great divergence of criteria regarding tobacco-associated pathologies was found among courses. This article provides positive data about the motivation of dental students to implement TUC strategies. Nevertheless, the usefulness of these interventions makes it necessary to modify the university curricula in order to improve the education on this issue to reduce the incidence of future health problems.

Tobacco Cessation Counseling: Attitudes and Practices among Yemeni Dental Professionals

Tobacco use is a significant health problem in Yemen and worldwide. Dental practitioners can play a pivotal role in educating their patients on the risk of smoking and motivating them to quit. This study aimed to assess the attitudes towards and practices of tobacco cessation counseling (TCC) among Yemeni dental professionals and to evaluate whether such attitudes and practices are associated with gender, smoking status, and years since graduation. In this cross-sectional study, a self-administered questionnaire containing questions regarding the practice and attitudes towards TCC in dental clinic was used. SPSS version 20 was used for data analysis. For statistical analysis, Chi-square test was used with a significance level of P < 0.05. Of the 400 distributed questionnaires, 182 were completed and analyzed. 53.3% of the respondents were males and 46.7% were females. Around one fifth of the respondents were smokers. The majority reported that they routinely ask their patients about their tobacco habits (83.5%), and advise against tobacco use (85%). Around half of the respondents believed that tobacco cessation intervention may affect their clinical practice and their income negatively through decreasing number of attending patients and believed that provision of dental treatment is more important than TCC. The majority (92%) believe that health professionals should refrain from tobacco, and 83% agree that TCC should be included in dental school curricula. Recent graduates and non-smokers showed relatively better attitudes and practices. There is an urgent need for continuing educational programs in TCC. Also, inclusion of TCC to dental curriculum is highly required.

Dental Students' Attitudes Toward Tobacco Cessation in the Dental Setting: A Systematic Review

Many dental schools have integrated tobacco cessation into their predoctoral curricula. However, dental students' perceptions should be taken into consideration when designing those curricula. The aim of this study was to systematically review the published literature on dental students' attitudes and perceptions regarding tobacco cessation. The research team conducted a search for articles through April 2016 using the following electronic databases: Medline, PsychInfo, Cochrane Library, and CINAHL. Each abstract and/or article was reviewed for inclusion. Data were extracted from all included articles. Each was rated for quality appraisal by two reviewers. The initial search identified 2,035 articles, and 38 of those were included in the review. The majority were cross-sectional and sampled students from one dental school. There was wide variation in the measurement of dental student attitudes. Overall, the majority of students in these studies reported believing it is within the scope of dental practice to address tobacco use with patients, but there was variability in terms of the practice of specific tobacco cessation strategies. The most common perceived barrier was patient resistance/lack of motivation. In most of the studies, the majority of students were interested in being trained in tobacco cessation. The findings suggest that dental students will respond positively to receiving tobacco cessation education while in dental school and that educators should include strategies to help future dentists deal with patient resistance. Future studies should focus on the development of a validated measure of dental student attitudes toward tobacco cessation and longitudinal, multi-institutional research that can provide more generalizable findings.

Using a videotaped objective structured clinical examination to assess Knowledge In Smoking cessation amongst medical Students (the K.I.S.S. Study)

INTRODUCTION

Brief smoking cessation advice from physicians is an effective smoking cessation intervention and is therefore an important skill medical students should master. We sought to assess the ability of medical students at the University of Auckland, New Zealand at different stages of their clinical education to provide accurate smoking cessation advice.

METHODS

Seventy-five medical students participated in a five-minute videotaped objective structured clinical examination (VOSCE) with a standardized patient. We marked them using a 10-point scale based on the "5As" of smoking cessation, with a score of 7/10 or more considered a pass. We used the general inductive method to analyze student feedback for key themes.

RESULTS

The mean score was 5.81/10, with only 15 (20%) students reaching the pass mark. Qualitative analysis revealed three themes: students had breadth of knowledge but lacked depth; their preference was to prescribe medications; and students were unable to identify where further smoking cessation support could be sourced.

DISCUSSION AND CONCLUSION

University of Auckland medical students performed poorly when giving smoking cessation advice. Inclusion of smoking cessation education in the undergraduate curriculum is required to ensure all graduates are capable of providing evidence-based and accurate cessation advice.

Opinions of dental students toward tobacco cessation intervention in the United Arab Emirates

OBJECTIVE

The objective of this study was to investigate the opinions of dental students, in one of the dental colleges in the United Arab Emirates (UAE), toward providing tobacco cessation interventions to their patients.

MATERIALS AND METHODS

Three-hundred-and-fifty students were administered a questionnaire including questions about tobacco cessation interventions (with a response rate of 77%). We generated descriptive statistics for all questions and examined the frequency distribution and percentages of all answers. Data were analysed using cross-tabulations and χ(2) -tests. The statistical significance was set at P < 0.05.

RESULTS

While 83.4% of students agreed that dentists should be trained in tobacco cessation, 56% of students disagreed that they are adequately trained to assist the patient in stopping tobacco use. As the year of study increased, the students' 'agree' responses increased to the statements that the dentist should be trained and that the dentist has a role in assisting patients to stop smoking. Non-Arab students were more confident than Emiratis in tobacco cessation counselling. The percentage of female students who felt greatly confident in assisting was double that of male students. There was a significant difference between tobacco-user students and non-users in response to the question about dentist's role in assisting tobacco cessation.

CONCLUSION

A comprehensive tobacco cessation education and training program should be included in dental schools' curriculum in the UAE to further improve student confidence in providing tobacco cessation services to their patients.