Tobacco prevention in Swedish dental care

Objective: To assess tobacco prevention in Swedish dental care and to identify barriers. Also, to investigate whether dentists and dental hygienists were familiar with recently published review of smoking cessation methods. Methods: A questionnaire was mailed to all 353 dental hygienists and 528 dentists in Stockholm County. Results: The overall response rate was 61% for the dentists and 67% for the dental hygienists. Nearly all considered smoking to be a major health issue, but one out of two was not convinced that smokeless tobacco use was a major health problem. A small minority was routinely engaged in cessation support. However, on the aggregate level, the active dentists and hygienists advised annually approximately 70 000 and 40 000 smokers, respectively. The main barrier to cessation counseling was lack of smoking cessation experts to refer to and was followed by a lack of reimbursement, a lack of knowledge, time constraints, and a feeling of inadequacy. Also, one out of two dentists and 3 out of 10 hygienists did not see it as a part of their job to help patients stop smoking. Approximately 10% in both groups made use of the review of smoking cessation methods. Fifty per cent of these had increased their cessation consultations by an average of 30% because of the guidelines. On the average, dentists and hygienists had spent approximately 1.4 and 2.9 h, respectively, during the previous month on all smoking cessation activities. Conclusions: Despite several barriers, there is an excellent potential for a more active role in tobacco cessation counseling in Swedish dental care.