A Cochrane review [Abstract] 1 included 20 clinical trials assessing the efficacy of interventions in the dental office or a school community setting. Five studies evaluated the effectiveness of interventions among smokeless tobacco (ST) users. All studies employed behavioural interventions and included an oral examination component. Four studies offered pharmacotherapy as an interventional component. Interventions conducted by oral health professionals increased tobacco abstinence rates (RR 1.86, 95% CI 1.01 to 3.41; 4 studies, n=6328, or more than one session RR 1.90, 95% CI 1.17 to 3.11; 7 studies, n=2639) at 6 months or longer.
A study 2 examined the association between dentists' advice, use of cessation medications and quitting behaviours in the general population of adult smokers (n=2714) in Canada. Those who received dentists' advice were more addicted to tobacco than those who did not receive advice (self-perceived addiction to tobacco: 96% vs. 89%, p < 0.001). Dentists' advice alone was not effective. Dentists' advice in conjunction with cessation medications was associated with a higher likelihood of quit attempts (adjusted odds ratio [aOR] 9.85, 95% CI 7.77 to 12.47) and short-term quitting (aOR 3.19, 95% CI 2.20 to 4.62), compared with not receiving dentists' advice and not using cessation medications.
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment, lack of blinding) and by inconsistency (heterogeneity).
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