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Rindal DB, Kottke TE, Jurkovich MW, Asche SE, Enstad CJ, Truitt AR, Ziegenfuss JY, Romito LM, Thyvalikakath TP, O'Donnell J, Spallek H. FINDINGS AND FUTURE DIRECTIONS FROM A SMOKING CESSATION TRIAL UTILIZING A CLINICAL DECISION SUPPORT TOOL. J Evid Based Dent Pract 2022; 22:101747. [DOI: 10.1016/j.jebdp.2022.101747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/05/2022] [Accepted: 05/10/2022] [Indexed: 11/29/2022]
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Neumann AS, Kumar SV, Bangar S, Kookal KK, Spallek H, Tokede B, Simmons K, Even J, Mullins J, Mertz E, Yansane A, Obadan-Udoh E, White JM, Walji MF, Kalenderian E. Tobacco screening and cessation efforts by dental providers: A quality measure evaluation. J Public Health Dent 2019; 79:93-101. [PMID: 30566752 PMCID: PMC6570416 DOI: 10.1111/jphd.12298] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 09/12/2018] [Accepted: 10/22/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The purpose of this study was to adapt, test, and evaluate the implementation of a primary care "Preventive care and Screening" meaningful use quality measure for tobacco use, in dental institutions. We determined the percentage of dental patients screened for tobacco use, and the percentage of tobacco users who received cessation counseling. METHODS We implemented the dental quality measure (DQM), in three dental schools and a large dental accountable care organization. An automated electronic health record (EHR) query identified patients 18 years and older who were screened for tobacco use one or more times within 24 months, and who received cessation counseling intervention if identified as a tobacco user. We evaluated EHR query performance with a manual review of a subsample of charts. RESULTS Across all four sites, in the reporting calendar year of 2015, a total of 143,675 patients met the inclusion criteria for the study. Within 24 months, including 2014 and 2015 calendar years, percentages of tobacco screening ranged from 79.7 to 99.9 percent, while cessation intervention percentages varied from 1 to 81 percent among sites. By employing DQM research methodology, we identified intervention gaps in clinical practice. CONCLUSIONS We demonstrated the successful implementation of a DQM to evaluate screening rates for tobacco use and cessation intervention. There is substantial variation in the cessation intervention rates across sites, and these results are a call for action for the dental profession to employ tobacco evidence-based cessation strategies to improve oral health and general health outcomes.
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Affiliation(s)
- Ana S Neumann
- Department of General Dentistry and Dental Public Health. University of Texas Health Science Center, School of Dentistry at Houston, 7500 Cambridge, Houston, TX, 77054
| | - Shwetha V Kumar
- Department of Diagnostic and Biomedical Sciences, Technology Services and Informatics. University of Texas Health Science Center, School of Dentistry at Houston, 7500 Cambridge, Houston, TX, 77054
| | - Suhasini Bangar
- Department of Diagnostic and Biomedical Sciences, Technology Services and Informatics. University of Texas Health Science Center, School of Dentistry at Houston, 7500 Cambridge, Houston, TX, 77054
| | - Krishna K Kookal
- Technology Services and Informatics. University of Texas Health Science Center, School of Dentistry at Houston, 7500 Cambridge, Houston, TX, 77054
| | - Heiko Spallek
- The University of Sydney. Faculty of Dentistry. 1 Mons Road, Westmead, NSW, 2145 Australia
| | - Bunmi Tokede
- Department of Oral Health Policy and Epidemiology. Harvard School of Dental Medicine. 188 Longwood Avenue, Boston, MA 02115
| | - Kristen Simmons
- Willamette Dental Group. 6950 NE Campus Way. Hillsboro, OR 97124
| | - Joshua Even
- Willamette Dental Group. 6950 NE Campus Way. Hillsboro, OR 97124
| | - Joanna Mullins
- Willamette Dental Group. 6950 NE Campus Way. Hillsboro, OR 97124
| | - Elizabeth Mertz
- Department of Preventive & Restorative Dental Sciences University of California San Francisco School of Dentistry. 707 Parnassus Ave., San Francisco, CA 94143
| | - Alfa Yansane
- Department of Preventive & Restorative Dental Sciences University of California San Francisco School of Dentistry. 707 Parnassus Ave., San Francisco, CA 94143
| | - Enihomo Obadan-Udoh
- Department of Preventive & Restorative Dental Sciences University of California San Francisco School of Dentistry. 707 Parnassus Ave., San Francisco, CA 94143
| | - Joel M White
- Department of Preventive & Restorative Dental Sciences University of California San Francisco School of Dentistry. 707 Parnassus Ave., San Francisco, CA 94143
| | - Muhammad F Walji
- Department of Diagnostic and Biomedical Sciences, Technology Services and Informatics. University of Texas Health Science Center, School of Dentistry at Houston, 7500 Cambridge, Houston, TX, 77054
| | - Elsbeth Kalenderian
- Department of Preventive & Restorative Dental Sciences University of California San Francisco School of Dentistry. 707 Parnassus Ave., San Francisco, CA 94143
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Schwendicke F, Dörfer CE, Meier T. Global smoking-attributable burden of periodontal disease in 186 countries in the year 2015. J Clin Periodontol 2017; 45:2-14. [PMID: 28965352 DOI: 10.1111/jcpe.12823] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2017] [Indexed: 12/22/2022]
Abstract
AIM We aimed to quantify the smoking-attributable burden of periodontal disease (PD). METHODS The association between smoking and PD was evaluated. Population, smoking and PD data from the Global Burden of Disease Study were used, and the burden in different sex and age groups in 186 countries in 2015 calculated, adjusted for PD prevalence and numbers of cigarettes smoked. No adjustment was performed in a sensitivity analysis. RESULTS The global smoking-attributable burden was 251,160 disability-adjusted life years (DALYs; 95% uncertainty interval: 190,721-324,241; sensitivity analysis: 344,041 DALYs) or 38.5 million cases. The burden was lower in females than males, and highest in the age group of the 50- to 69-year-olds. On super-regional level, the burden was highest in South-East Asia, East Asia and Oceania (83,052 DALYs), and high-income North America and Asia Pacific (55,362 DALYs). On regional level, it was highest in East Asia (70,845 DALYs), South Asia (30,808 DALYs) and North Africa and the Middle East (24,095 DALYs). On national level, it was highest in China (69,148 DALYs), India (29,362 DALYs) and the United States (12,714 DALYs). The relative smoking-attributable burden ranged between >25% in Suriname and <1% in Chad. CONCLUSIONS There is great need to monitor and tackle the smoking-attributable burden of PD.
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Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christof E Dörfer
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Toni Meier
- Institute for Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.,Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Germany
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Nagao T, Fukuta J, Seto K, Saigo K, Hanioka T, Kurita K, Tonai I, Yamashiro M, Kusama M, Satomura K, Izumi Y, Mizutani K, Aoyama N, Tsumanuma Y, Imai Y, Ishigaki Y, Nikaido M, Yoshino H, Sugai T, Kawana H, Hamada S, Matsuo A, Miura K. A national opinion study supports tobacco cessation by oral health professionals in Japan. TRANSLATIONAL RESEARCH IN ORAL ONCOLOGY 2017. [DOI: 10.1177/2057178x17710416] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Toru Nagao
- Department of Oral and Maxillofacial Surgery and Stomatology, Okazaki City Hospital, Okazaki, Japan
| | - Jinichi Fukuta
- Institute for Oral and Maxillofacial Surgery, Shin-yurigaoka General Hospital, Kawasaki, Japan
| | - Kanichi Seto
- Department of Oral and Maxillofacial Surgery, Southern Tohoku Research Institute for Neuroseience, Southern Tohoku General Hospital, Koriyama, Japan
| | | | - Takashi Hanioka
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Fukuoka, Japan
| | - Kenichi Kurita
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - Iwai Tonai
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | | | - Mikio Kusama
- Department of Oral and Maxillofacial Surgery, International University of Health and Welfare Hospital, Shiobara, Japan
| | - Kazuto Satomura
- Department of Oral Medicine and Stomatology, School of Dental Medicine Tsurumi University, Yokohama, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Norio Aoyama
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuka Tsumanuma
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yutaka Imai
- Department of Oral and Maxillofacial Surgery, School of Medicine, Dokkyo Medical University, Tochigi, Japan
| | - Yoshiki Ishigaki
- Oral and Maxillofacial Surgery, The Nippon Dental University Hospital, Tokyo, Japan
| | | | | | | | - Hiromasa Kawana
- Department of Dentistry and Oral Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - Suguru Hamada
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Kinki University, Sayama, Japan
| | - Akira Matsuo
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan
| | - Kazue Miura
- Omori Tokyo Oral & Maxillofacial Surgery Luz Omori Apl’ Dental Clinic, Tokyo, Japan
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Chang EHE, Braith A, Hitsman B, Schnoll RA. Treating Nicotine Dependence and Preventing Smoking Relapse in Cancer Patients. EXPERT REVIEW OF QUALITY OF LIFE IN CANCER CARE 2016; 2:23-39. [PMID: 28808692 PMCID: PMC5553981 DOI: 10.1080/23809000.2017.1271981] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Despite the well-documented harmful effects of smoking, many cancer patients continue to smoke. Smoking cessation is critical to address in this population given the associated increase in treatment toxicity, risk of second primary tumors, decrease in treatment response and higher disease-specific and all-cause mortality with continued smoking following a cancer diagnosis. This review seeks to summarize the latest recommendations and guidelines on smoking cessation treatment for patients diagnosed with cancer, and the evidence behind those recommendations. AREAS COVERED We reviewed the latest evidence for smoking cessation treatments for cancer patients and the clinical guidelines and recommendation available for oncologists and health care providers. The unique aspects of nicotine dependence among patients diagnosed with cancer, and key challenges and barriers that cancer survivors and health care providers experience when considering smoking cessation treatments, and available clinical resources, are also discussed. Lastly, the authors summarize future directions in the field of smoking cessation treatment for cancer patients. EXPERT COMMENTARY While there are areas of improvement in research of smoking cessation treatment for cancer patients, critical under-explored areas remain. Nonetheless, providers should adhere to the NCCN guidelines and offer a brief counseling intervention to motivate patients to quit smoking when appropriate resources are not available.
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Affiliation(s)
- Eun Hae Estelle Chang
- Department of Otolaryngology Head and Neck Surgery, University of Nebraska Medical Center, 981225 Nebraska Medical Center, Omaha, NE 68198-1225, Phone 402-559-8007 Fax 402-559-8490
| | - Andrew Braith
- College of Medicine, University of Nebraska Medical Center, 42 Street and Emile Street, Omaha, NE 68198
| | - Brian Hitsman
- Department of Preventive Medicine, Feinberg School of Medicine & Robert H. Lurie Comprehensive Cancer Center, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL 60611, Phone 312-503-2074
| | - Robert A Schnoll
- Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, 3535 Market Street, 4 Floor, Philadelphia, PA 19104, Phone 215-746-7143 Fax 215-746-7140
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Kengne Talla P, Gagnon MP, Dawson A. Environmental Factors Influencing Adoption of Canadian Guidelines on Smoking Cessation in Dental Healthcare Settings in Quebec: A Qualitative Study of Dentists' Perspectives. Dent J (Basel) 2016; 4:dj4040040. [PMID: 29563482 PMCID: PMC5806960 DOI: 10.3390/dj4040040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 10/24/2016] [Accepted: 10/25/2016] [Indexed: 11/25/2022] Open
Abstract
Background: This study aimed to understand dentists’ perspective of the environmental determinants which positively or negatively influence the implementation of Canadian smoking cessation clinical practice guidelines (5As: Ask-Advise-Assess-Assist-Arrange) in private dental clinics in Quebec. Methods: This study used a qualitative design and an integrative conceptual framework composed of three theoretical perspectives. Data collection was conducted in individual semi-directed interviews with 20 private dentists lasting between 35 and 45 min. The audio-recorded data were transcribed verbatim, followed by a directed content analysis. Results: Some of the barriers identified to counselling in smoking cessation were lack of time, patient attitude, lack of prescription of nicotine replacement therapies, lack of reimbursement, and the lack of training of the dental team. Enablers cited by participants were the style of dentist’s leadership, the availability of community, human and material resources, the perception of counselling as a professional duty, and the culture of dental medicine. In addition to these variables, dentists’ attitude and behaviour were affected by different organisations giving initial or continual training to dentists, governmental policies, and the compatibility of Canadian smoking cessation guidelines with the practice of dentistry. Conclusion: Our findings will inform the development of smoking cessation interventions in dental healthcare settings.
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Affiliation(s)
- Pascaline Kengne Talla
- Centre de Recherche du CHU de Québec (CRCHUQ)-Hôpital St-François d'Assise, Québec, QC G1L 3L5, Canada.
| | - Marie-Pierre Gagnon
- Centre de Recherche du CHU de Québec (CRCHUQ)-Hôpital St-François d'Assise, Québec, QC G1L 3L5, Canada
- Faculty of Nursing, Laval University, Quebec, QC G1L 3L5, Canada
| | - Aimée Dawson
- Faculty of Dental Medicine, Laval University, Quebec, QC G1L 3L5, Canada.
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Albert DA, Bruzelius E, Ward A, Gordon JS. Identifying Multilevel Barriers to Tobacco Intervention in Postdoctoral Dental Education. J Dent Educ 2016. [DOI: 10.1002/j.0022-0337.2016.80.4.tb06098.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Emilie Bruzelius
- Mailman School of Public Health and Section of Population Oral Health; College of Dental Medicine; Columbia University
| | - Angela Ward
- Section of Population Health; College of Dental Medicine; Columbia University
| | - Judith S. Gordon
- Department of Family and Community Medicine; University of Arizona
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Jannat-Khah DP, McNeely J, Pereyra MR, Parish C, Pollack HA, Ostroff J, Metsch L, Shelley DR. Dentists' self-perceived role in offering tobacco cessation services: results from a nationally representative survey, United States, 2010-2011. Prev Chronic Dis 2014; 11:E196. [PMID: 25376018 PMCID: PMC4222784 DOI: 10.5888/pcd11.140186] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction Dental visits represent an opportunity to identify and help patients quit smoking, yet dental settings remain an untapped venue for treatment of tobacco dependence. The purpose of this analysis was to assess factors that may influence patterns of tobacco-use–related practice among a national sample of dental providers. Methods We surveyed a representative sample of general dentists practicing in the United States (N = 1,802). Multivariable analysis was used to assess correlates of adherence to tobacco use treatment guidelines and to analyze factors that influence providers’ willingness to offer tobacco cessation assistance if reimbursed for this service. Results More than 90% of dental providers reported that they routinely ask patients about tobacco use, 76% counsel patients, and 45% routinely offer cessation assistance, defined as referring patients for cessation counseling, providing a cessation prescription, or both. Results from multivariable analysis indicated that cessation assistance was associated with having a practice with 1 or more hygienists, having a chart system that includes a tobacco use question, having received training on treating tobacco dependence, and having positive attitudes toward treating tobacco use. Providers who did not offer assistance but who reported that they would change their practice patterns if sufficiently reimbursed were more likely to be in a group practice, treat patients insured through Medicaid, and have positive attitudes toward treating tobacco dependence. Conclusion Findings indicate the potential benefit of increasing training opportunities and promoting system changes to increase involvement of dental providers in conducting tobacco use treatment. Reimbursement models should be tested to assess the effect on dental provider practice patterns.
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Affiliation(s)
- Deanna P Jannat-Khah
- School of Medicine, Department of Population Health, New York University, New York, New York
| | - Jennifer McNeely
- School of Medicine, Department of Population Health, New York University, New York, New York
| | - Margaret R Pereyra
- Mailman School of Public Health, Department of Sociomedical Sciences, Columbia University, New York, New York
| | - Carrigan Parish
- Mailman School of Public Health, Department of Sociomedical Sciences, Columbia University, New York, New York
| | - Harold A Pollack
- School of Social Service Administration, University of Chicago, Chicago, Illinois
| | - Jamie Ostroff
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lisa Metsch
- Mailman School of Public Health, Department of Sociomedical Sciences, Columbia University, New York, New York
| | - Donna R Shelley
- Director of Research Development, Associate Professor of Medicine and Population Health, Department of Population Health, New York University School of Medicine, 227 East 30th St, 6th Fl, New York, NY 10016. E-mail:
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Agaku IT, Ayo-Yusuf OA, Vardavas CI. A comparison of cessation counseling received by current smokers at US dentist and physician offices during 2010-2011. Am J Public Health 2014; 104:e67-75. [PMID: 24922172 DOI: 10.2105/ajph.2014.302049] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We compared patient-reported receipt of smoking cessation counseling from US dentists and physicians. METHODS We analyzed the 2010 to 2011 Tobacco Use Supplement of the Current Population Survey to assess receipt of smoking cessation advice and assistance by a current smoker from a dentist or physician in the past 12 months. RESULTS Current adult smokers were significantly less likely to be advised to quit smoking during a visit to a dentist (31.2%) than to a physician (64.8%). Among physician patients who were advised to quit, 52.7% received at least 1 form of assistance beyond the simple advice to quit; 24.5% of dental patients received such assistance (P < .05). Approximately 9.4 million smokers who visited a dentist in 2010 to 2011 did not receive any cessation counseling. CONCLUSIONS Our results indicate a need for intensified efforts to increase dentist involvement in cessation counseling. System-level changes, coupled with regular training, may enhance self-efficacy of dentists in engaging patients in tobacco cessation counseling.
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Affiliation(s)
- Israel T Agaku
- The authors are with the Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA. Olalekan A. Ayo-Yusuf is also with the Office of the Dean/Director, School of Oral Health Sciences, University of Limpopo, MEDUNSA campus, Pretoria, South Africa
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Feinstein-Winitzer RT, Pollack HA, Parish CL, Pereyra MR, Abel SN, Metsch LR. Insurer views on reimbursement of preventive services in the dental setting: results from a qualitative study. Am J Public Health 2014; 104:881-7. [PMID: 24625150 DOI: 10.2105/ajph.2013.301825] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We explored insurers' perceptions regarding barriers to reimbursement for oral rapid HIV testing and other preventive screenings during dental care. METHODS We conducted semistructured interviews between April and October 2010 with a targeted sample of 13 dental insurance company executives and consultants, whose firms' cumulative market share exceeded 50% of US employer-based dental insurance markets. Participants represented viewpoints from a significant share of the dental insurance industry. RESULTS Some preventive screenings, such as for oral cancer, received widespread insurer support and reimbursement. Others, such as population-based HIV screening, appeared to face many barriers to insurance reimbursement. The principal barriers were minimal employer demand, limited evidence of effectiveness and return on investment specific to dental settings, implementation and organizational constraints, lack of provider training, and perceived lack of patient acceptance. CONCLUSIONS The dental setting is a promising venue for preventive screenings, and addressing barriers to insurance reimbursement for such services is a key challenge for public health policy.
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Affiliation(s)
- Rebecca T Feinstein-Winitzer
- Rebecca T. Feinstein-Winitzer and Harold A. Pollack are with the School of Social Service Administration, University of Chicago, Chicago, IL. Carrigan L. Parish, Margaret R. Pereyra, and Lisa R. Metsch are with the Mailman School of Public Health, Columbia University, New York, NY. Stephen N. Abel is with the School of Dental Medicine, University of Buffalo, NY
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Hanioka T, Ojima M, Kawaguchi Y, Hirata Y, Ogawa H, Mochizuki Y. Tobacco interventions by dentists and dental hygienists. JAPANESE DENTAL SCIENCE REVIEW 2013. [DOI: 10.1016/j.jdsr.2012.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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