Selected Readings for Specific Disciplines:
This resource will provide health care providers of specific disciplines such as dentists/ hygienists/dental workers, physicians, nurses, social workers, respiratory therapists and clinical perfusionists, and pharmacists with some selected readings to familiarize themselves with useful tobacco intervention information pertaining to their setting.
Dentists/Hygienists/Dental Workers
Carr A, Ebbert J. (2006). Interventions for tobacco cessation in the dental setting.
Cochrane Database of Systematic Reviews, Issue 1. Art. No.: CD005084. DOI: 10.1002/14651858.CD005084.pub2.
Summary: This review indicates that counselling taking place in the dental setting increases tobacco cessation by 1.44 times over usual care or no intervention. The results of counselling were found to be less effective for smokeless tobacco cessation.
Edwards, D., Freeman, T., & Roche, A.M. (2006). Dentists' and dental hygienists' role in
smoking cessation: an examination and comparison of current practice and barriers to service provision. Health Promot J Aust., 17(2): 145-51.
Summary: A survey of dentists and dental hygienists indicates high levels of advising smoking cessation, but lower rates of assisting and referring patients. Both disciplines reported low levels of smoking-specific training and education.
Gordon, J.S., Albert, D.A., Crews, K.M., & Fried, J. (2009). Tobacco education in
dentistry and dental hygiene. Drug Alcohol Rev., 28(5): 517-32.
Summary: There is a lack of training on tobacco interventions available for dentists and hygienists. This paper provides a thorough rationale for increasing training available, and recommendations for implementation in academic settings.
Gordon, J.S. Lichtenstein, E., Severson, H.H., & Andrews, J.A. (2006). Tobacco
cessation in dental settings: research findings and future directions. Drug and Alcohol Review, 25: 27-37.
Summary: Although there is evidence purporting dental settings as an effective setting to provide smoking interventions, adoption of this practice has been slow. This article discusses the positive impact that widespread adoption would have on assisting patients to achieve cessation.
Hanikoa, T., Ojima, M., Tanaka, H., Naito, M., Hamajima, N., & Matsuse, R. (2010).
Intensive smoking-cessation intervention in the dental setting. J Dent Res., 89(1): 66-70.
Summary: Dental patients who wanted to quit smoking were randomly assigned to an intensive intervention group that included behavioural counselling plus NRT, or a non-intervention group. The intervention group was found to have significantly higher cessation rates at all follow-ups, indicating effectiveness.
Heasman, S.F., Heasman, P.A., Heasman, L., Hepburn, S., McCracken, G.I., &
Preshaw, P.M. (2006). Smoking cessation as a dental intervention – views of the profession. Br Dent J., 201(2): 109-13.
Summary: Dental teams in the UK were given surveys assessing their smoking status, along with variables such as level of smoking cessation training and intervention. Barriers to delivering desired brief cessation interventions included lack of time and training, although they were perceived to be important.
Johnson, G.K., & Hill, M. (2004). Cigarette smoking and the periodontal patient. J
Periodontol., 75(2): 196-209.
Summary: Smokers are 3 times more likely to have periodontitis than non-smokers, and do not respond as well to periodontal treatment as non-smokers. This article describes the role of dental professions with smoking cessation, along with the use of pharmacotherapy and behavioural interventions.
Kunzel, C., Lalla, E., & Lamster, I.B. (2006). Management of the patient who smokes
and the diabetic patient in the dental office. J Periodontol., 77(3): 331-40.
Summary: Smoking and diabetes are risk factors for periodontal disease. Results of a survey given to general practice dentists and periodontists indicate that both groups inquire and inform patients about these risk factors more than providing active management and support.
Needleman, I., Warnakulasuriya, S., Sutherland, G., Bornstein, M.M., Casals, E., et al.
(2006). Evaluation of tobacco use cessation (TUC) counselling in the dental office. Oral Health Prev Dent. 4(1):27-47.
Summary: Some of the barriers to tobacco use cessation in dentistry are identified, and suggestions on how to study these barriers include using qualitative or mixed methods design and studies to evaluate the impact removal of barriers will have on practicing tobacco use cessation.
Rosseel, J.P., Jacobs, J.E., Hilberink, S.R., Maassen, I.M., Allard, R.H., et al. (2009).
What determines the provision of smoking cessation advice and counseling by dental care teams? Br Dent J., 206(7): E13; discussion 376-7.
Summary: A survey of dentists and dental hygienists indicates that hygienists provide more general cessation advice and counselling than dentists. Support from colleagues trained in cessation positively affected the advice and counselling given to patients and increase self-efficacy to give such intervention across all dental professionals.
Terrandes, M., Coulter, W.A., Clarke, H., Mullally, B.H., & Stevenson, M. (2009).
Patients’ knowledge and views about the effects of smoking on their mouths and the involvement of their dentists in smoking cessation activities. Br Dent J., 207(11): 542-3.
Summary: A survey indicates that patients feel positive towards their dentist’s
role in smoking cessation, and are aware of the dangers of smoking but less
aware of the relation between smoking and oral health.
Multidisciplinary Articles
An, L.C., Foldes, S.S., Alesci, N.L., Bluhm, J.H., Bland, P.C., et al. (2008). The impact of
smoking-cessation intervention by multiple health professionals. Am J Prev Med., 34(1): 54-60.
Summary: Intervention by more than one type of health professional such as doctor, nurse, dentists, pharmacists, and others can increase readiness to quit, quit rates, and sustained abstinence among people who are trying to quit smoking.
Bothelho, R., Wassum, K., Benzian, H., Selby, P., & Chan, S. (2009). Address the gaps
in tobacco cessation training and services: Developing professional organizational alliances to create social movements. Drug and Alcohol Review, 28: 558-566.
Summary: Training programs for healthcare professionals targeting smoking cessation should include both evidence-based and experience-based methodologies. This article also advocates for social movements that include bottom-up approaches for such as patient-led programs that change risky behaviour.
Brewster, J.M., Victor, J.C., Ashley, M.J. (2007). Views of Ontarians about health
professionals’ smoking cessation advice. Can J Public Health, 98(5): 395-9.
Summary: A survey of Ontario residents and their views on accepting and seeking smoking cessation advice from various health professionals indicates that people who smoke are most receptive to advice from physicians. Ontarians appear to be less likely to consult pharmacists and dentists for cessation advice, which may illustrate a need for education of the public and increased tobacco intervention from health care professionals.
Tremblay, M., Cournoyer, D., & O’Loughlin, J. (2009). Do the correlates of smoking
cessation counselling differ across health professional groups? Nicotine & Tobacco Research, 11(11): 1330-1338.
Summary: A survey was administered among six disciplines to assess practices and factors associated with providing smoking cessation to patients. More general practitioners and pharmacists counselled patients ready to quit, and more general practitioners and respiratory therapists counselled those not ready to quit, when compared to the other disciplines.
Nurses
Carlebach, S., & Hamilton, S. (2009). Understanding the nurse’s role in smoking
cessation. Br J Nurs., 18(11): 672-4.
Summary: Nurses can play a greater role in smoking cessation for their patients in addition to inquiring about smoking status. This review highlights the importance of continuous smoking cessation support to patients as they may experience challenges along the way.
Kotz, D., Huibers, M.J., West, R.J., Wesseling, G., & van Schayck, O.C. (2009). What
mediates the effect of confrontational counseling on smoking cessation in smokers with COPD? Patient Educ Couns., 76(1): 16-24.
Summary: Patients who were diagnosed with COPD received either confrontational counselling plus nortriptyline or conventional heath education treatment by a nurse. Confrontational counselling was found to increase perceived risk of smoking-related disease and self-efficacy to quit, and decrease risk denial. Combined, these mediators were associated with higher rates of smoking cessation.
Rice VH, Stead LF. (2008). Nursing interventions for smoking cessation. Cochrane
Database of Systematic Reviews, Issue 1. Art. No.: CD001188. DOI: 10.1002/14651858.CD001188.pub3.
Summary: Nursing staff have the ability to significantly increase cessation success for people who want to quit smoking, especially when in a hospital-based setting.
Ritchie, L., Evans, M.K., & Matthews, J. (2010). Nursing students’ and clinical
instructors’ perceptions on the implementation of a best practice guideline. J Nurs Educ., Jan 4:1-5. [Epub ahead of print].
Summary: An overview of a proposed curriculum model for health promotion and counselling for smoking cessation, incorporating the Registered Nurses’ Association of Ontario’s best practice guidelines for smoking cessation.
Sarna, L., Bialous, S., Rice, V.H., & Wewers, M.E.(2009). Promoting tobacco
dependence treatment in nursing education. Drug and Alcohol Review, 28: 507-516.
Summary: Although nurses are the largest group of health-care professionals, training for providing smoking interventions remains inadequate. Barriers include low priority for addressing tobacco, lack of educators, negative attitudes, and smoking status of nurses.
Sarna, L., Bialous, S.A., Wells, M., Kolterman, J., Wewers, M.E., & Froelicher, E.S.
(2009). Frequency of nurses’ smoking cessation interventions: report from a national survey. J Clin Nurs., 18(14): 2066-77.
Summary: This survey of a sample of American nurses indicates that 73% of nurses ask and assist with smoking cessation, but only a quarter recommended pharmacotherapy and less referred patients to community resources or quitlines.
Pharmacists
Ashley, M.J., Victor, J.C., & Brewster, J. (2007). Pharmacists’ attitudes, role perceptions
and interventions regarding smoking cessation: findings from four Canadian provinces. Chronic Dis Can., 28(1-2): 20-8.
Summary: Results of a survey of pharmacists in Ontario, Quebec, Saskatchewan, and PEI regarding their attitudes and practices involving smoking cessation and their patients. Less than 40% of responding pharmacists in all provinces provided intervention to smoking patients; the most popular interventions that were offered included advising reduction or quitting, increasing motivation, and suggesting using pharmacotherapy.
Dent, L.A., Harris, K.J., Noonan, C.W. (2009). Randomized trial assessing the
effectiveness of a pharmacist-delivered program for smoking cessation. Ann Pharmacother., 43(2): 194-201.
Summary: A randomized trial of a face-to-face group intervention compared to brief telephone counselling plus free bupropion for both groups indicates higher cessation rates for those in the pharmacist-led group versus telephone-based counselling.
Dent, L.A., Harris, K.J., & Noonan, C.W. (2007). Tobacco interventions delivered by
pharmacists: a summary and systematic review. Pharmacotherapy, 27(7): 1040-51.
Summary: A review of studies that involved pharmacist-delivered tobacco interventions indicates effectiveness for smoking cessation. Further biochemically-validated studies are needed to strengthen this finding.
Sinclair, H.K., Bond, C.M., & Stead, L.F. (2004). Community pharmacy personnel
interventions for smoking cessation. Cochrane Database of Systematic Reviews, Issue 1. Art. No.: CD003698. DOI: 10.1002/14651858.CD003698.pub2.
Summary: A review of the opportunities community pharmacists have for providing smoking cessation counselling and recommending pharmacotherapy for smoking cessation to patients.
Stead, L.F., Perera, R., Bullen, C., Mant, D., & Lancaster, T. (2008). Nicotine
replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews, Issue 1. Art. No.: CD000146. DOI: 10.1002/14651858.CD000146.pub3.
Summary: Using NRT for smoking cessation doubles the chances of quitting. This review suggests that there is no difference in terms of cessation success with respect to various forms of NRT, and that using NRT just before one’s planned quit date may increase the chances of quitting.
Williams, D.M. (2009). Preparing pharmacy students and pharmacists to provide tobacco
cessation counselling. Drug and Alcohol Review, 28: 533-540.
Summary: The adoption of a train-the-trainer program for pharmacists called “Rx to Change” is described along with a description of the smoking intervention opportunities available to pharmacists.
Physicians
AmericanAcademy of Family Physicians (2006). Information from your family doctor:
Tips to help you quit smoking. American Family Physician, 74(2): 276.
Summary: This handout can be reproduced for distribution to patients who are looking for information about smoking cessation techniques.
Cupertino, P.A., Richter, K.P., Cox, L.S., Nazir, N., Grenier, A.K., et al. (2008). Smoking
cessation pharmacotherapy preferences in rural primary care. Nicotine Tob. Res. 10(2): 301-7.
Summary: Patients in a rural area were offered their choice of free bupropion or
nicotine patches for smoking cessation. Most participants requested
pharmacotherapy, which indicates that when cost is removed as a barrier to quit,
patients in rural areas are interested in addressing their smoking and using
pharmacotherapy as an aid.
Okuyemi, K.S., Nollen, N.L., & Ahluwalia, J.S. (2006). Interventions to facilitate smoking
cessation. Am Fam Physician, 74(2): 262-71.
Summary: Asking each patient about their tobacco use is recommended, along with using the 5A’s and offering pharmacotherapy interventions as part of brief treatment for patients who smoke.
Pederson, L.L., Blumenthal, D.S., Dever, A., & McGrady, G. (2006). A web-based
smoking cessation and prevention curriculum for medical students: why, how, what, and what next. Drug and Alcohol Review, 25: 39-47.
Summary: This article describes the curriculum of a web-based program designed to assist medical students teach other medical students on how to provide tobacco interventions. The training demonstrated to be effective in increasing counselling skills, and confidence levels to provide counselling.
Richmond, R., Zwar, N., Taylor, R., Hunnisett, J., & Hyslop, F. (2009). Teaching about
tobacco in medical schools: A worldwide study. Drug and Alcohol Review, 28: 484-497.
Summary: This study examined the extent to which the topic of tobacco is covered in medical training around the world. A total of 27% of schools taught a component specifically on tobacco, compared with 11% from a previous survey conducted a decade earlier.
Stead LF, Bergson G, Lancaster T. (2008). Physician advice for smoking cessation.
Cochrane Database of Systematic Reviews, Issue 2. Art. No.: CD000165. DOI: 10.1002/14651858.CD000165.pub3.
Summary: Brief advice from physicians can effectively assist patients who want to quit smoking and increase cessation rates and long-term abstinence rates. Follow-up support can provide patients with increased cessation and abstinence.
Zwar, N.A., & Richmond, R.L. (2006). Role of the general practitioner in smoking
cessation. Drug and Alcohol Review, 25: 21-26.
Summary: A reflection on the opportunities general practitioners have to provide smoking cessation interventions to patients, and a discussion of how to overcome barriers to practice.
Zwar, N.A., Richmond, R.L., Davidson, D., & Hasan, I. (2009). Postgraduate education
for doctors in smoking cessation. Drug and Alcohol Review, 28: 466-473.
Summary: A description of a sample of the available postgraduate training
programs and components involved that are available for physicians to learn
about smoking cessation interventions.
Respiratory Therapists and Clinical Perfusionists
Goodfellow, L.T., & Waugh, J.B. (2009). Tobacco treatment and prevention: what works and why. Respir Care, 54(8): 1082-90.
Summary: Some starting points for respiratory therapists and where to begin with clients who may be newly diagnosed with lung disease, in terms of approaching smoking cessation.
HudmonKS, Corelli RL, Prokhorov AV. (2010). Current approaches to pharmacotherapy
for smoking cessation. Ther Adv Respir Dis., Jan 7. [Epub ahead of print].
Summary: A review of the “5A” framework for respiratory therapists along with a detailed description of the seven first-line recommended pharmacotherapies to assist with smoking cessation, and combinations of aids for treatment.
Marlow, S.P., & Stoller, J.K. (2003). Smoking cessation. Respiratory Care, 48(12): 1238-
56.
Summary: Given the high amount of interaction respiratory therapists have with clients who smoke, there are many opportunities to engage clients and demonstrate leadership to promote smoking cessation.
Reid, A. (2008). Respiratory therapy and smoking cessation: Are we doing our part?
Canadian Journal of Respiratory Therapy, 44(5): 32.
Summary: This article describes the impact of the TEACH project on respiratory therapists, and encourages those of this discipline to attend the training in order to enhance tobacco intervention skills and maximize the opportunities of respiratory therapists to address tobacco use.
Schroeder, S.A. The role of the respiratory therapist in tobacco cessation. Presentation.
SmokingCessationLeadershipCenter, University of California, San Fransisco.
Summary: Describes the ample opportunities and interventions respiratory therapists can use for assisting with tobacco cessation.
URL:
Social Workers
Lai, D.T.C., Cahill, K., Qin,Y., & Tang, J.L. (2010). Motivational interviewing for smoking
cessation. Cochrane Database of SystematicReviews 2010, Issue 1. Art. No.: CD006936. DOI: 10.1002/14651858.CD006936.pub2.
Summary: Motivational interviewing may be most effective for smoking cessation when delivered by general practitioners and counsellors, especially when sessions are more than 20 minutes per session.
Lancaster, T., & Stead, L.F. (2005). Individual behavioural counselling for smoking
cessation. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD001292. DOI: 10.1002/14651858.CD001292.pub2.
Summary: There is sufficient evidence to support the use of individual counselling for smoking cessation, but further research is needed to determine if intensive counselling is optimal.
Stead, L.F., & Lancaster, T. Group behaviour therapy programmes for smoking
cessation. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD001007. DOI: 10.1002/14651858.CD001007.pub2.
Summary: Participating in group therapy can double the chances of quitting smoking. It is still unknown whether groups are more effective than individual counselling, but it is known that they are more effective than no treatment.
Stead, L.F., & Lancaster, T. (2007). Interventions to reduce harm from continued
tobacco use. Cochrane Database of Systematic Reviews 2, Issue 3. Art. No.: CD005231. DOI: 10.1002/14651858.CD005231.pub2.
Summary:Reduction of smoking is superior to continuing to smoke. This harm reduction method may involve using NRT to cut down the number of cigarettes smoked per day, and can be a step towards complete cessation.