To Promote Tobacco Free Life in the Dental Practice in France: Feasibility Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 139
- 试验地点
- 1
- 主要终点
- 5/3A approach
研究概览
简要总结
In France, 34% of the adult population is smoking every day. The links between smoking and the development of several chronic disorders is well established and smoking is directly implicated in most of the oral diseases such as cancers of the oral cavity. Thus, dentists have access to an area of the body that is actively affected and this gives them a central role in dispensing advice and support regarding smoking cessation.
Dentists often cite issues such as lack of time or education as a reason for why they do not offer support for smoking cessation. A brief intervention can increase smoking cessation by 30 to 100% (ie 1-3% in absolute value). The "5A" approach integrates and extends the brief intervention. It consists in Asking about smoking status, Advising smokers of the benefit of stopping, Assessing motivation to quit, Assisting smokers in their quit attempt, Arranging follow-up with stop-smoking services. For practitioners who do not have enough time, a "3A" approach might be acceptable (Ask, Advice and Act) by providing details of local stop smoking services and/or prescribing nicotine replacement therapy (NRT). This very brief advice can be delivered in less than one minute.
To investigators knowledge, the role of dentists in the French national tobacco-free program is not yet documented in France while since 2016, dentists can prescribe NRT with some products taken in charge by the French health insurance.
An intervention taking part in the continuing professional development will be developed so the dentists fell legitimate, motivated and competent to talk with their patients about their tobacco consumption and to assist them in their smoking cessation process. This intervention based on the 5/3A approach and prescription of NRT will include a specific training and provision of management kit, with communication tools and network for appropriate references.
Investigators hypothesize that 5/3A approach is feasible with adequate intervention in dental practices in France (dentists apply the approach to 90% of their patients) and that the format, the conditions, the barriers and the lever actions of its implementation are known.
详细描述
In Europe, 29% of individuals are smokers, and tobacco use is directly related to 650,000 mortalities each year across the continent, around 14% of all deaths. In France, 34% of the adult population is smoking everyday (www.OFDT.fr). The links between smoking and the development of several chronic disorders is well established and long-term smokers are more likely to die from a disease directly related to their habit. Smoking is also responsible for a large burden of evitable morbidity.
From a dental perspective, smoking is directly implicated in most of the oral diseases (periodontal diseases, dermatological disorders of the oral mucosa, bad breath, peri-implantitis...). Smoking is also directly related to the development of potential malignant lesions of the oral mucosa and cancer of the oral cavity. Thus, dentists have access to an area of the body that is actively affected and this gives them a central role in dispensing advice and support regarding smoking cessation. Fifty percent of the EU population regularly visit a dentist and in France, a survey conducted in 2014 showed that 63.5 % of the 15-75 year-old respondents reported to have visited their dentist in the 12 previous months. These data show that dentists have access to a large number of smokers with the opportunity to offer information and support regarding smoking cessation.
Dentists often cite several issues, such as lack of time or limited education, to explain why they do not offer support for smoking cessation. A Cochrane review showed that a brief intervention by health professionals is effective in helping tobacco users to quit. This 'brief' advice in primary care settings has been shown to increase smoking cessation by 1-3%. Whilst this number seems small, it represents a large number of people from a population point of view. By referring to stop smoking services, successful cessation increased to 15%.
The "5A" approach to smoking cessation is the internationally accepted approach integrating a "brief intervention" for nicotine users. The 5A protocol can be summarized as follows:
- Ask about and record smoking status.
- Advise smokers of the benefit of stopping in a personalized and appropriate way.
- Assess motivation to quit (using stages of change model).
- Assist smokers in their quit attempt.
- Arrange follow-up with stop smoking services.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •18 years or older
- •Will to participate to study
排除标准
- 未提供
结局指标
主要结局
5/3A approach
时间窗: 1 month after inclusion (day0)
Acceptability for performing the 5/3A approach in the dental practice
次要结局
未报告次要终点