Knowledge and attitude of tobacco use and cessation among dental professionals

From Impression to Addiction: The Pathways of Adolescent Tobacco Use

Aim

To understand the psychodynamics of tobacco use among 11- to 14-year-olds in Ahmedabad, India.

Materials and Methods

A self-administered questionnaire was used to gather information on tobacco use from 5,266 students, aged 11 to 14, enrolled in government-aided English medium schools in Ahmedabad. IBM® SPSS® 26.0 software along with Chi-square tests were used to analyze the data.

Results

A total of 7.2% (376) had ever used tobacco. Of the users, 96.6% (363) knew it was harmful, 76.3% (287) were boys, and 85.2% (320) were initiated by family and friends.

Conclusion

Despite being aware of the dangers of tobacco and being unable to purchase from vendors, children continued to obtain tobacco products, being influenced by their close social networks. An effective cessation measure should be directed toward this psychodynamic etiology.

Perception of tobacco hazards on general and periodontal health and tobacco cessation counseling among dental students

INTRODUCTION

Tobacco use is one of the leading worldwide health risk factors and a primary cause of premature death and disability. Tobacco cessation programs might work well if provided by all healthcare providers. This study aimed to evaluate dental students' knowledge, attitudes, beliefs, and practices towards tobacco hazards on general and periodontal health and tobacco cessation councling.

METHODS

A descriptive cross-sectional study was conducted among dental students who were in their clinical years (the fourth, fifth and sixth year of study), in Saudia Arabia in 2022. A self-administered questionnaire derived from the TCC questionnaire survey was carried out among 315 dental students. Knowledge was considered poor if correct answers were below the median value. Attitude was on a five-point Likert scale. Adjusted logistic regression analyses were performed.

RESULTS

The study revealed that about 52% have poor knowledge, 64% have negative attitudes, 69% have negative beliefs, and 44% poor practice. All these ratings were below median values. It also showed that younger dental students were 2 times more likely to have poor knowledge (AOR=1.97; 95% CI: 1.1-3.53) and smokers were less likely to have poor knowledge (AOR=0.34; 95% CI: 0.12-0.95). One third of students perceived patient resistance as a barrier to TCC while 50% reported lack of knowledge, 32% lack of time, and 24% lack of materials.

CONCLUSIONS

The study findings urge the inclusion of programs to encourage dental students to help patients quit tobacco use and to make educational material available to them.

KNOWLEDGE AND ATTITUDE OF IRANIAN DENTAL STUDENTS ABOUT SMOKING CESSATION COUNSELING

Introduction and Aims

Today, smoking is recognized as the biggest cause of preventable premature death. dentists can play a very important role in motivating and providing smoking cessation counseling and play this role of line requires gaining sufficient knowledge and education during the student period. Therefore, the purpose of this study is to determine the knowledge and attitude of dental students in Kerman in the field of smoking cessation counseling.

Methods and materials

This study was descriptive-analytical and crosssectional. The study population was fourth, fifth and sixth year dental students. A questionnaire was used to assess participants knowledge and attitude towards smoking cessation, using the 5 As of smoking cessation. Data were collected using a questionnaire and analyzed using SPSS 21, t-test and chi-square software.

Results

This study showed that the mean score of students' knowledge was 2.13 ± 14.12. There was a significant relationship between knowledge score, gender (women more than men) and the presence of a smoker in the family (P = 0.01, 0.001, respectively). Also, the mean attitude score was 36.25 41 5.41. There was a significant relationship between attitude score, gender (women more than men) and the presence of a smoker in the family (P = 0.01, respectively).

Conclusion

Results of this study showed that the students have good knowledge of the 5As (Ask, Advice, Assess, Assist, Arrange) but that they did not have much information about some parameters under Assess. Also, they have a positive attitude in this regard. Moreover, students believed that time limitations in dental visits and concerns on the effectiveness of smoking cessation consultations are the major obstacle in implementing a smoking cessation plan.

Dentists' perception of health-risk associated with cigarettes and alternative tobacco products: A descriptive study

Cigarettes and alternative tobacco products cause various oral health issues ranging from minor tooth decay/gum-diseases to oral cancer. According to the Centre for Disease Control (CDC), over 40% of adult cigarette smokers have untreated tooth decay which later leads to severe oral health problems. The present study intended to assess the impact of dentists' perceived risk of smoking tobacco products on their attitude and practice toward tobacco cessation advice. It was a cross-sectional study to collect data on the perception of dentists who are smokers, regarding smoking-related health risks. Dentists' attitude was measured using a questionnaire with a 5-point rating scale and a practice list of items with a 3-point rating scale. Descriptive/inferential techniques were applied, and a significance level was fixed at 5%. Among the 31 tobacco users, 80.6% of dentists perceived severe risk with cigarette use as compared to alternative tobacco products (71%). Positive attitude and good practice were observed among those who perceived severe risk; however, no statistical significance was observed (p-value >0.05). Young dentists, males, Arab nationals, highly educated and specialists had a positive attitude toward smoking cessation activities. Among the smokers, dentists recognize their role and responsibility very seriously in building a smoke-free community, but their risk perception and good attitude did not positively reflect on their clinical practice in smoking cessation programs. Though the dentists had a better perception and attitude towards smoking cessation, their clinical practice in offering advising sessions is inversely related to their perception/attitude.

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.

Attitudes and practices of tobacco cessation counseling among Saudi dental professionals: A nationwide cross-sectional survey

Background

Dental professionals can play a pivotal role in educating the public about the harmful effects of smoking and encouraging them to quit the habit.

Aim

This study assesses the attitudes and practices of tobacco cessation counseling (TCC) among dental professionals in Saudi Arabia.

Patients and Methods

This questionnaire-based cross-sectional study targeted dentists and dental interns working in government and private sectors in Saudi Arabia. We conducted a descriptive analysis by using SPSS Statistics, version 25.0.

Results

A total of 895 respondents (314 interns and 581 dentists) participated in this survey. Although the majority of respondents (93%) reported that they always ask patients about tobacco habits, only 59% reported recording tobacco habits in patients' files, and only 55% of the respondents reported explaining to patients the harmful effects of tobacco. Around 91% of the participants believe that a dental clinic is an appropriate place for TCC, and 22% believe that TCC has a negative impact on dental practice. Smoking status, work setting, and the number of years since graduation were found to be significantly associated with the respondents' attitudes and practices. Lack of training, time limitations, and lack of confidence were barriers for TCC.

Conclusions

Dental professionals in Saudi Arabia demonstrated relatively positive attitudes but weak practices of TCC. Continuous education and motivation are needed to improve dentists' confidence, attitudes, and willingness for TCC. Integration of tobacco control education in undergraduate curricula is recommended.

Perception of Tobacco Counseling and Cessation among Dental Practitioners

Objective

To investigate the knowledge and practice of tobacco cessation and counseling (TCC) among dental practitioners and their attitude and perceived barriers.

Methods

A cross-sectional study targeted licensed dental practitioners in Jeddah, Saudi Arabia. Participants answered a pretested and validated self-administered questionnaire consisted of demographic data; smoking status; knowledge of tobacco hazards, attitude, and practice; and perceived barriers of tobacco cessation counseling.

Result

Among the total sample of 529, response rate was 72.2% (mean age (34.20 ± 9.38 years), males (42.4%), and current smokers (23.8%)). Only 13.2% received formal training on TCC. Around (57.1%) reported smoking of dental team as an obstacle for TCC. Half of the participants (49.9%) reported patient's resistance as barrier to TCC. Others (45%-48%) reported insufficient time, knowledge, or training for TCC. Professional responsibility and willingness to provide cessation services constituted the highest median.

Conclusion

The majority showed willingness to participate in TCC. Lack of training, smoking status of providers, females, inadequate materials, and patients' resistance were the most common barriers. Education and training on TCC are recommended and should be allowed as a routine practice in dentistry.

Acquaintance and Approach in the Direction of Tobacco Cessation Among Dental Practitioners-A Systematic Review

Background:

Nowadays, tobacco consumption has become one of the major public health problems and is the leading cause of escapable illness and death. A significant role is played by dental professionals in the identification of smokers; they are, thus, in a better position to offer preventive care. The aim of the present study was to systemically review the knowledge and attitude of dental practitioners toward tobacco cessation.

Methods:

A literature search was performed in PubMed Central and Cochrane Library, Medline—PubMed, Embase, Google Scholar up to 2018 to identify appropriate studies. Full-text original research articles of the cross-sectional design were only included in the study. Our target was to systemically review the knowledge and attitude of dental practitioners toward tobacco cessation.

Results:

The present review included a total of nine articles (studies) that fulfilled the eligibility criteria. Two articles which were hand searched and one article which was obtained through contact with experts were included. The results of the review revealed that the dental practitioners in most of the included studies lack satisfactory knowledge and were unaware of existing referral pathways to specialist smoking cessation services. At the same time, most of the dentists have a positive attitude toward tobacco cessation.

Conclusions:

Dental professionals are aware of their obligations toward smoking cessation counseling for patients but certain barriers including lack of time, confidence, and training prevent them from practicing the same in their daily routine. The dental professionals should obtain appropriate training and attain knowledge along with quantifiable skills for the prevention and cessation of tobacco use.

Early detection of oral cancer and potentially malignant disorders: Experiences, practices, and beliefs of prosthodontists practicing in Saudi Arabia

STATEMENT OF PROBLEM

Data on the oral cancer screening skills and beliefs of prosthodontists practicing in Saudi Arabia are lacking.

PURPOSE

The purpose of this survey was to assess the beliefs, experiences, and practices of prosthodontists practicing in Saudi Arabia regarding the early detection of oral cancer and potentially malignant disorders.

MATERIAL AND METHODS

A cross-sectional, questionnaire-based survey was conducted on prosthodontists practicing in Saudi Arabia. A 26-item questionnaire was sent to all eligible prosthodontists (N=250). The collected data were analyzed with a statistical software program.

RESULTS

The response rate was 57.2% (N=143). The majority of participants (79%) reported that they routinely examined all new patients for mucosal pathologies. However, only 58% reported that they examine their patients at recall visits, and only 61.5% stated that they provide tobacco use or smoking cessation advice. With regard to the respondents' experiences with suspicious mucosal lesions, the majority said that they had detected a suspicious lesion (79.7%) and had referred affected patients (83.2%) during their career. Most prosthodontists (65%) believed that they were able to detect oral cancer on their own, and 40% believed that they could influence their patients to stop smoking. A lack of training, confidence, time, and financial incentives were reported as barriers to oral cancer screening.

CONCLUSIONS

Most of the prosthodontists surveyed in this study appeared motivated to perform routine oral mucosal screening. However, more efforts are needed to help improve the attitudes, confidence, and skills of prosthodontists when it comes to identifying and referring suspicious oral mucosal lesions.

Popular water pipe smoking, medical sciences students' awareness, perceptions, and motivations

Objectives This study was done to investigate popularity, awareness, perceptions, and motivations regarding water pipe smoking (WPS) among medical sciences students in 2017. Methods This cross sectional study was done among 385 medical sciences student in 2017.The systematic random sampling was used to recruit subjects. Multidimensional questionnaire (demographic characteristics, awareness, perceptions, action, and water pipe motivators) was used. t-test, ANOVA, X2, and logistic regression was used to analyze the data by SPSS. Results The mean ages of participants were 22 ± 2.64 and 89% were male. The majority of the study sample was from health school. Most participants reported having smoked before. Family entertainment was found to be the most common motivator for WPS. The second one was to be fun. WPS use was significantly associated with age (odds ratio [OR], 0.17; 95% Confidence Interval [CI], 0.04-0.61); awareness (OR, 1.55; 95% CI, 1.35-1.78); and perception (OR, 0.71; 95% CI, 0.65-0.78). Conclusions Results show that WPS is very popular among Iranian youth. In designing public health programs, policy makers should consider the motivators for inclination to WPS. Intervention should focus on addressing students' perception and awareness regarding WPS.

Prevalence of tobacco use in healthcare workers: A systematic review and meta-analysis

OBJECTIVES

To estimate tobacco use prevalence in healthcare workers (HCW) by country income level, occupation and sex, and compare the estimates with the prevalence in the general population.

METHODS

We systematically searched five databases; Medline, EMBASE, CINHAL Plus, CAB Abstracts, and LILACS for original studies published between 2000 and March 2016 without language restriction. All primary studies that reported tobacco use in any category of HCW were included. Study extraction and quality assessment were conducted independently by three reviewers, using a standardised data extraction and quality appraisal form. We performed random effect meta-analyses to obtain prevalence estimates by World Bank (WB) country income level, sex, and occupation. Data on prevalence of tobacco use in the general population were obtained from the World Health Organisation (WHO) Global Health Observatory website. The review protocol registration number on PROSPERO is CRD42016041231.

RESULTS

229 studies met our inclusion criteria, representing 457,415 HCW and 63 countries: 29 high-income countries (HIC), 21 upper-middle-income countries (UMIC), and 13 lower-middle-and-low-income countries (LMLIC). The overall pooled prevalence of tobacco use in HCW was 21%, 31% in males and 17% in females. Highest estimates were in male doctors in UMIC and LMLIC, 35% and 45%, and female nurses in HIC and UMIC, 21% and 25%. Heterogeneity was high (I2 > 90%). Country level comparison suggest that in HIC male HCW tend to have lower prevalence compared with males in the general population while in females the estimates were similar. Male and female HCW in UMIC and LMLIC tend to have similar or higher prevalence rates relative to their counterparts in the general population.

CONCLUSIONS

HCW continue to use tobacco at high rates. Tackling HCW tobacco use requires urgent action as they are at the front line for tackling tobacco use in their patients.

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.

Accomplishments and challenges in tobacco control endeavors - Report from the Gulf Cooperation Council countries

Objectives

To review the tobacco governance and national responsibility for control, and existing countering measures to reduce the tobacco use among the Gulf Cooperation Council (GCC) member states.

Methods

We reviewed the data in regards to tobacco control efforts and difficulties encountered during implementation of the policies for all the GCC member states from the respective country profile in the WHO report on the global tobacco epidemic. Also, we utilized the measures outlined in the FCTC’s MPOWER package to not only assess the degree of national commitment, but also compare it against the level of significance that the legislatures give to this matter.

Results

We observed that there have been genuine advancements towards tobacco control in the GCC member states over the past few years. All the countries except Bahrain have national offices committed to tobacco control and 5 nations (excluding Oman) have dedicated support services for smoking cessation accessible to the general public. Similarly, majority of the member states have implemented a national-level ban on tobacco advertisement through national media cells as well as free dissemination of marketing material.

Conclusion

Application and implementation of measures outline in the MPOWER package, formulation and enforcement of sturdy laws on tobacco control, and development of infrastructure and trained workforce are fundamental to manage and reinforce tobacco control measures in the GCC region.

Waterpipe smoking among health sciences university students: Knowledge, attitude and patterns of use

INTRODUCTION

Although waterpipe smoking is common in Gulf counties, its prevalence in Saudi Arabia is uncertain. The purposes of this study were (a) to assess the prevalence of waterpipe smoking among healthcare university students in Saudi Arabia and (b) to determine their attitudes and practices of waterpipe smoking.

MATERIALS AND METHODS

A cross-sectional survey was conducted among university students of three different health sciences colleges, namely medical, dental, and pharmacy, of a public university, through random cluster sampling. The questionnaire was designed to ask specific questions related to smoking in general and to waterpipe smoking specifically. The study was approved by the institutional research & ethics committees.

RESULTS

A total of 535 participants were included in the study. More than one-third of the participants that reported having ever smoked a waterpipe (n = 198, 37%), and the majority of these were current smokers (62.1%, n = 123); dental students were the most common (45.5%, n = 90). Curiosity and pleasure-seeking were the main factors associated with starting waterpipe smoking. About one-sixth (14.9%, n = 80) of the participants failed to identify a single harmful effect, while a vast majority of participants considered waterpipe smoking to be less unhealthy than cigarette smoking.

CONCLUSION

Waterpipe smoking is very popular among Saudi university students, and knowledge among university students about the dangers of waterpipe smoking is alarmingly low.

Experimentation and correlates of electronic nicotine delivery system (electronic cigarettes) among university students - A cross sectional study

OBJECTIVE

E-cigarettes are becoming popular among youth as safe nicotine delivery systems. Many have expressed concern, however, that e-cigarettes may serve as a gateway to future smoking, given their low perceived risk, or that their use may prevent regular smokers from quitting by maintaining their nicotine addiction. The aim of this study was to assess experimentation with and correlates of e-cigarette use among university students.

MATERIAL AND METHODS

A cross-sectional study was carried out among 480 university students from four faculties at a university in Riyadh in August-October 2014. A modified version of the World Health Organization's Global Adult Tobacco Survey was used, and multinomial logistic regression was carried out to assess correlations with e-cigarette variables in the whole study sample and among smokers.

RESULTS

Almost all students, including the majority of ex-smokers (96.3%) and smokers (94.4%), reported having heard about e-cigarettes. In addition, about one-quarter of the sample (54.2% of smokers, 24.7% of ex-smokers, 6% of never smokers) had experimented with e-cigarettes at least once during their lifetime. Curiosity and peer influence were reported as the main reasons for the use of e-cigarettes. Factors found to be correlated significantly with e-cigarette use were male gender, being a traditional cigarette smoker, having friends who have tried e-cigarettes, and having a strong belief that e-cigarettes could aid smoking cessation.

CONCLUSION

E-cigarettes are popular among Saudi youth, especially among smokers and ex-smokers. Well-designed health education programs and regulatory interventions are required to address this issue.

Smoking Knowledge, Attitude, and Practices Among Health Care Professionals from Sulaymaniyah City/Iraq

BACKGROUND

Smoking is a serious risk to health globally. Health care professionals play a key role in the prevention of smoking as they are considered a role model by patients.

OBJECTIVES

The aims of this study are to evaluate smoking rate among physicians and dentists from Sulaymaniyah, Iraqi Kurdistan, Iraq, and to understand their knowledge and attitudes toward tobacco smoking.

METHODS

A cross-sectional web-based survey was conducted involving physicians and dentists working in both University of Sulaimani and Sulaymaniyah Teaching Hospitals. A questionnaire created based on World Health Organization Global Health Professional Survey with slight modifications was emailed to the study participants and the responses received were analyzed.

RESULTS

Incidence of smoking among physicians and dentists was 26.5%, with a significantly higher rate among male compared to female health care professionals. The mean age of starting smoking was 22.3 (±4.8) years. Only 7.3% of health care professionals received formal training on smoking cessation. All responders agreed that smoking is harmful to health. However, ever smokers compared to never smokers were less likely to agree that health care professionals should set a positive impact by not smoking.

CONCLUSION

Smoking rate is high among physicians and dentists from Sulaymaniyah city/Iraq, and at the same time, there is a low rate of training on smoking cessation.

Smoking cessation advice: the self-reported attitudes and practice of primary health care physicians in a military community, central Saudi Arabia

BACKGROUND

Brief advice on smoking cessation from primary health care (PHC) physicians reduces smoking prevalence. However, few studies have investigated the provision of such advice by PHC physicians providing services to military communities. The aim of this study was to evaluate PHC physicians' attitudes toward and practice of delivering smoking cessation advice to smokers in a military community in central Saudi Arabia.

METHODS

A self-reported survey of PHC physicians was conducted in 2015 using a previously validated tool. The age, sex, educational level, job title, experience and previous smoking cessation training of each physician was recorded. Attitude (ten statements) and practice (six statements) were evaluated on a five-point Likert scale. Scoring system was applied and percentage mean scores (PMS) were calculated. Descriptive/statistical analyses were applied to identify factors that were significantly associated with a positive attitude and favorable practice (PMS >65 each). P-values <0.05 were considered to be significant.

RESULTS

Response rate was 73/150 (48.6%), of which equal sex distribution (52%:48%) was observed, with a mean age of 35.3±9.6 years. General practitioners constituted 71.4%, followed by consultants (17.9%) and specialists (10.7%). Those with a postgraduate education formed 49.3%, while experience averaged 9.5±9.2 years. Approximately 56% had not attended a smoking cessation educational program in the previous year. Approximately 75% of physicians had a positive attitude (PMS =72.4±11.2), while 64.4% reported favorable practice (PMS =65.3±27.7). Higher education levels were significantly more associated with positive attitude than lower education levels (adj. odds ratio [OR] 95% confidence interval [CI] =17.9 [1.3-242.3]; adj. P=0.03). More experienced physicians (adj. OR [95% CI] =9.5 [1.6-54.6]) and those with positive attitude (adj. OR [95% CI] =6.1 [1.6-23.3]) were more likely to report a favorable practice, compared to the less experienced (adj. P=0.012) and physicians with a negative attitude (adj. P=0.008).

CONCLUSION

Provision of smoking cessation advice by primary health care physicians serving a military community is significantly associated with their attitude and years of experience. Patients who are seeking smoking cessation advice should be referred to physicians with higher levels of education. Routinely scheduled training on proper delivery of smoking cessation advice may increase physicians' confidence; improve their attitude, and subsequently, their practice.