Key messages
- Advice and support from oral health professionals involving nicotine replacement therapy or e‐cigarettes are more likely to help clients stop smoking.
- Single or multiple sessions of advice and support may help clients stop smoking or using tobacco products.
Background Tobacco can be smoked, chewed, or sniffed (as snuff). Tobacco cessation lowers the risk of lung cancer and other diseases, including oral cancer and periodontal disease. Oral health professionals are well-placed to help clients stop using tobacco products. Many people visit an oral health professional regularly. In addition, the adverse effects of tobacco use on oral health provide a context oral health professionals can use to motivate a quit attempt.
Objectives The objectives of this Cochrane Review were to assess the effectiveness, adverse events, and oral health effects of tobacco cessation interventions offered by oral health professionals.
Selection criteria Randomized and quasi‐randomized clinical trials assessing tobacco cessation interventions conducted by oral health professionals in oral healthcare practices or community settings, with at least six months of follow‐up, were included.
Main results The review included twenty clinical trials involving 14,897 participants who used tobacco products (smoked, chewed, or sniffed tobacco). Sixteen studies assessed the effectiveness of tobacco-use cessation interventions in oral health clinics and four in community (school or college) settings. Five studies included only smokeless tobacco users, and the remaining studies included either smoked tobacco users only or a combination of both smoked and smokeless tobacco users. All studies employed behavioural interventions, with four offering nicotine treatment (nicotine replacement therapy [NRT] or e‐cigarettes) as part of the intervention. Three studies were assessed at a low risk of bias, one at an unclear risk of bias, and the remaining 16 studies at a high risk of bias.
Compared with usual care, brief advice, very brief advice, or less active treatment, the researchers found very low‐certainty evidence of benefit from behavioural support provided by oral health professionals (either one or more sessions) on tobacco use abstinence at least six months from baseline. They found moderate‐certainty evidence of benefit from behavioural interventions provided by oral health professionals combined with NRT or e‐cigarette use, compared with no intervention, usual care, or brief or very brief advice only. No benefit was detected from multiple‐session behavioural support provided by oral health professionals in a high school or college instead of an oral health setting. Only one study reported adverse events or oral health outcomes, making it difficult to draw conclusions.
Conclusions There is moderate‐certainty evidence that behavioural interventions combined with NRT, provided by oral health professionals, may increase tobacco abstinence rates in cigarette smokers. There is very low‐certainty evidence that behavioural tobacco cessation interventions delivered by oral health professionals can increase quit rates. There is insufficient evidence of whether these interventions lead to adverse effects. However, there is no reason to suspect these effects would be specific to interventions delivered by oral health professionals. There was insufficient evidence that interventions affected oral health. Further well-designed randomized controlled trials of smoking cessation interventions in oral health settings are required.
