141st APHA Annual Meeting and Exposition

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281156
Advise and refer: Disparities among patients receiving tobacco cessation advice from dentists


Monday, November 4, 2013

Mariaelena Gonzalez, PhD, Center for Tobacco Control Research & Education, University of California, San Francisco, San Francisco, CA
Ashley Sanders-Jackson, PhD, Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA
Kai-wen Cheng, PhD, National Taiwan University, Institute of Health Policy and Management, School of Public Health
Stanton A. Glantz, PhD, Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA
  
Background: Smoking causes oral diseases and dental therapy failures. Full implementation of the 5As, including a referral to a quitline in the dentist's office, promotes cessation, however use of the 2As+R (ask, advise, and refer) is also effective. This study tests for demographic disparities regarding dentists' (1) advice to quit smoking and (2) referral to a cessation helpline, using patient reported data from smokers who visited the dentist in the last 12 months.

Methods: Two logistic regressions were completed.

Data: 2006/07 Tobacco Use Supplement of the Current Population Survey.

Dependent variables: being (1) advised by the dentist to quit smoking, and (2) referred to a tobacco cessation hotline. The survey instrument did not contain a question regarding dentists asking about tobacco use.

Independent variables: age, sex, marital status, education, employment status, income, race/ethnicity.

Results: Women (OR: 0.77, p=0.001), individuals age 50 to 64 (OR: 0.69, p=0.001) and 65 and over (OR: 0.45, p=0.001) were less likely, while respondents with less than a high school education were more likely (OR: 1.40 p=0.001) to report being advised to quit smoking. Respondents with a high school education or less were more likely (OR: 1.24, p=0.04) and NH whites less likely (OR: 0.77, p=0.046) to be referred to a cessation hotline.

Conclusion: Significant disparities regarding 2A+R exist in the dental healthcare setting. Older smokers in particular are being underserved, even though they are more likely to be socially disadvantaged, have higher rates of cigarette smoking, and are less likely to be offered cessation services.

Learning Areas:

Epidemiology
Implementation of health education strategies, interventions and programs
Other professions or practice related to public health
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public

Learning Objectives:
Explain the importance of tobacco cessation 2As + R (ask, advise, and refer) in the dental setting. Describe which types of patients are more likely to report receiving cessation advice from their dentist. Discuss the importance of addressing disparities in the oral health care setting.

Keyword(s): Oral Health Needs, Tobacco Control

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am primarily responsible for the design and execution of this research. I have a Ph.D. in Sociology and have completed postdoctoral training in Tobacco Control. Among my scientific interests have been the study of individual and provider tobacco-related health behaviors.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3164.0: Community Approaches for Oral Health Promotion and Prevention