Evaluation of the Stop Smoking Wales NHS Dental Practice Incentive Scheme

STOP- a training intervention to optimise treatment for smoking cessation in community pharmacies: cluster randomised controlled trial

BACKGROUND

Community pharmacies serve people with high levels of tobacco-related illness, but throughput in NHS Stop Smoking Services in pharmacies remains relatively low. We investigated the effectiveness of a complex intervention to increase service uptake and retention.

METHODS

We randomised 60 pharmacies in England and Wales to the STOP intervention or usual practice in a pragmatic, parallel-group, controlled trial over 11 months. Smokers were blind to the allocation. The intervention was theory-based consultation skills training for pharmacy staff with environmental prompts (badges, calendars and behavioural cues). The primary outcome was the number of smokers attending an initial consultation and setting a quit date.

RESULTS

The intervention made no significant difference in setting a quit date, retention or quit rate. A total of 631 adult smokers (service users) enrolled and set a quit date in intervention pharmacies compared to 641 in usual practice pharmacies, a rate ratio of 0.75 (95% CI 0.46 to 1.23) adjusted for site and number of prescriptions. A total of 432 (68%) service users were retained at 4 weeks in intervention and 500 (78%) in usual practice pharmacies (odds ratio 0.80, 0.41 to 1.55). A total of 265 (42%) service users quit smoking at 4 weeks in intervention and 276 (43%) in usual practice pharmacies (0.96, 0.65 to 1.43). The pharmacy staff were positive about the intervention with 90% (56/62) stating that it had improved their skills. Sixty-eight per cent would strongly recommend the training to others although there was no difference in self-efficacy for service delivery between arms. Seventy of 131 (53%) service users did not complete the 6-month follow-up assessment. However, 55/61 (90%) service users who completed follow-up were satisfied or very satisfied with the service. All usual practice arm service users (n = 33) and all but one in the intervention arm (n = 27) would recommend the service to smokers.

CONCLUSIONS

We found high levels of retention and acceptable quit rates in the NHS pharmacy stop smoking service. Despite pharmacy staff providing positive feedback on the STOP intervention, it made no difference to service throughput. Thus, other factors may currently limit service capacity to help smokers to quit.

TRIAL REGISTRATION

ISRCTN, ISRCTN16351033 . Retrospectively registered.

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.

Tobacco cessation support among dentists: A cross-sectional survey in Saudi Arabia and Kuwait

INTRODUCTION

This study aims to explore the smoking prevalence among a sample of dentists working in two Gulf countries, and to assess the association between smoking habit and socio-professional factors affecting their attitude towards tobacco cessation activities, including barriers that prevent them from practicing such activities.

METHODS

This was a cross-sectional, online questionnaire-based, survey among dentists from Saudi Arabia and Kuwait, during summer 2016. The questionnaire consisted of questions on socio-professional characteristics, tobacco use and attitudes towards the adoption of tobacco cessation programs in dental practices. The questionnaire also enquired about the barriers to adoption of tobacco cessation. Descriptive statistics were used to describe demographic and smoking characteristics while cross tabulation with chi-square test was used to find out statistical significance of association between the groups (P≤0.05).

RESULTS

A total number of 466 responses were included in statistical analysis with 286 males (61.4%) and 180 females (38.6%), age ranged from 23 to 79 years (mean=32.7± 9.32). Most of the sample (N=437, 93.8%) indicated that the dentist has a vital role in educating patients on the health hazards of smoking. A positive attitude toward adoption of tobacco cessation campaigns was associated with older, more experienced, medically compromised, non-smoker dentists. The most frequently cited barrier to tobacco cessation was lack of time (39.2%).

CONCLUSIONS

Dentists who smoke are less likely to adopt smoking cessation campaigns in their clinics. More experienced dentists and those older than 40 years are more likely to engage in smoking cessation activities.