Evidence-based tobacco cessation treatment by dental hygienists.

Dental hygienists have opportunities to take a substantive role in tobacco control efforts. Previous research has suggested that implementation of tobacco cessation strategies has been sub-optimal, but few studies have examined factors associated with dental hygienists' delivery of evidence-based tobacco cessation treatment. Among dental hygienists, the current study investigated tobacco-related knowledge and attitudes, as well as clinical practices consistent with evidence-based guidelines for tobacco cessation. Practicing dental hygienists in the state of Kentucky (n=308) responded to a paper and pencil questionnaire that collected information regarding their demographic, clinical characteristics and knowledge, attitudes and clinical practices regarding tobacco cessation treatment. Participants were somewhat familiar with evidence-based clinical practice guidelines regarding tobacco cessation treatment, but reported infrequent implementation of the 5 A's (Ask, Advise, Assess, Assist, Arrange). While participants were well aware of health risks associated with tobacco use and the value of cessation, few reported comfort or confidence in their ability to employ evidence-based interventions. However, several key variables were associated with implementation of recommended clinical practices (guideline awareness, comfort with specific tobacco cessation activities and self-efficacy). Results identified potential deficiencies in areas of tobacco control knowledge and confidence among dental hygienists. Correlations with evidence-based tobacco control practices suggest that knowledge and attitudes could serve as targets for education and training programs to promote greater implementation. While dental hygienists have unique opportunities to reduce tobacco-related morbidity and mortality, more education and training is necessary to increase adoption, implementation and sustainability of these important interventions.