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Tobacco Cessation and Dental Practitioner's Attitudes in Clinical Practice: A

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 IJTOH

REVIEW ARTICLE

Tobacco Cessation and Dental Practitioner’s Attitudes in

Clinical Practice: A Review
Mandar Todkar1, Mukesh Panwar2, Pritam Yadav3, Pradip Chauhan4, Raghvendra Kumar5, Mayank Das6

ABSTRACT How to cite this article: Todkar M, Panwar M, Yadav P,

Chauhan P, Kumar R, Das M. Tobacco Cessation and Dental
Many dental institutes have integrated tobacco cessation into
Practitioner’s Attitudes in Clinical Practice: A Review. Int J Tob
their curriculum. However, dental practitioner’s perceptions Oral Health 2017;3(1):1-6.
should be taken into consideration when designing those cur-
riculum. The aim of this review was to comprehensively review Source of support: Nil
the published literature on dental practitioner’s attitudes and
Conflict of interest: None
perceptions regarding tobacco cessation. The research review
conducted a literature data search for articles using the online
databases such as Medline, Cochrane Library, and PubMed. BACKGROUND
Each abstract and/or article was reviewed for literature; data
were extracted from all articles. The majority of studies were The adverse effects of tobacco in systemic and oral health
cross-sectional, and there was wide variation in the measure- are already identified and registered a long back ago.[1,2]
ment of dental practitioner’s attitudes. Overall, the majority of Perhaps, the outcomes of dental health care are most com-
dental practitioner’s reported believing that it is within the scope monly effected.[3] The dental practitioner is a gatekeeper
of dental practice to address tobacco use with patients, but
for oral health and disease as screening, diagnosis as
there was variability in terms of the practice of specific tobacco
cessation strategies. The most common perceived barrier was well as provide the tobacco counseling to the patients.[4]
patient resistance or lack of motivation. The majority of dental Furthermore, the tobacco-consuming patient can be edu-
practitioners were interested in being trained in tobacco cessa- cate, teach, and motivate on the tobacco’s risks and effects
tion. The findings suggest that dental practitioner will respond during the dental visit.[5] “The tobacco dependence treat-
positively to receiving tobacco cessation education while in ment provided by health-care professionals, including
dental institutes and that educators should include strategies
dentists, is an effective way to prevent and reduce tobacco
to help future dentists deal with patient resistance. Future stud-
ies should focus on the development of a validated measure use,” this guideline also gives brief intervention in dental
of dental practitioner’s attitudes toward tobacco cessation and care settings with all tobacco users based on the five “A”s
longitudinal, multi-institutional research that can provide more model as: Ask, advise, assess, assist, and arrange.[6]
generalizable findings. The tobacco cessation interventions in behavioral
Keywords: Dental education, Dental practitioners, Tobacco aspect delivered by the dental practitioners may increase
cessation education, Tobacco use cessation, Tobacco. abstinence rates among tobacco smokers and smokeless
tobacco users,[7] and the majority of dental practitioners
1-5
Postgraduate Student, 6Resident
do not involve in tobacco cessation counseling efforts with
1
respect to the patients.[8] One of the barriers in tobacco ces-
Department of Public Health Dentistry, Pacific Dental College
and Hospital, Udaipur, Rajasthan, India
sation is a lack of tobacco dependence education in dental
2
college and hospital training.[9] As there are many dental
Department of Pediatric and Preventive Dentistry, Pacific
Dental College and Hospital, Udaipur, Rajasthan, India
college and hospitals have conducted the programs for
3
dental students to address the tobacco addiction.[10] Some
Department of Oral Medicine and Radiology, Pacific Dental
College and Hospital, Udaipur, Rajasthan, India authors have evaluated dental student’s attitude toward
4
tobacco cessation as the tobacco cessation training included
Department of Oral and Maxillofacial Surgery, Darshan Dental
College and Hospital, Udaipur, Rajasthan, India in dental education.[11-13] However, for the development
5 and implementation of tobacco cessation, programs need
Department of Public Health Dentistry, Institute of Dental
Sciences, Bareilly, Uttar Pradesh, India the information on dental student’s attitude and per-
6 spectives. The effective tobacco cessation training should
Department of Public Health Dentistry, Sardar Patel PG
Institute of Dental and Medical Sciences, Lucknow, Uttar include skills and strategies which can address the dental
Pradesh, India student’s perceptions to foster the belief that tobacco cessa-
Corresponding Author: Mandar Todkar, Postgraduate tion efforts are a part of quality clinical practice.[6]
Student, Department of Public Health Dentistry, Pacific The research studies on the dental student’s attitude
Dental College and Hospital, Udaipur, Rajasthan, India. on tobacco cessation are seen with many variations. As, for
e-mail: [email protected]
example, the dental student’s attitudes about the need for
International Journal of Tobacco and Oral Health, January-June 2017;3(1):1-6 1
Todkar M, et al.

tobacco cessation programs in Romanian dental schools.[14] and responsibility of the dentist. In barrier attitudes,
Furthermore, the accessed dental students in American the data that assessed practitioner’s perceived barriers
dental school with an established tobacco dependence edu- to providing tobacco cessation. The literature data to
cation syllabus to determine their barriers to providing the assess attitudes in these four areas varied across studies.
tobacco cessation measures and care.[15] Another research
study evaluated extensively at dental student’s atti- Training Attitudes
tudes and practices across some Indian dental schools.[16] The data on attitudes related to some aspect of training
However, these studies differ in the specific aims but con- in tobacco cessation, that is, whether dental practitioners
tain the some valuable information which could be used reported receiving training, adequacy of training, and
in understanding dental student’s attitudes and behaviors whether practitioners were interested in training. Some
regarding tobacco cessation in the dental practices. studies included reported data on whether practitioners
The aim of this review was thus to comprehensively had received training in tobacco cessation and rates
review the published literature on dental student’s atti- ranged from 6% to 85% having received training.[17,18]
tudes, perceptions regarding tobacco cessation. The fol- The data on the specific type or level of training received
lowing questions to be answered based on the findings by dental practitioners did not include in these studies.
of this review as what are dental student’s attitudes Some studies reported that whether practitioners felt
toward tobacco cessation? What are the barriers to adequately trained or prepared to provide tobacco cessa-
tobacco cessation? Also, to what extent do they engage tion training as rates ranged from 26% to 60% feeling ade-
in tobacco cessation programs? And what are the lim- quately trained or prepared.[19,20] Furthermore, interest in
itations to the research on this topic? The information tobacco cessation training or belief that training should
from this review will be used to identify trends, inform be included in the dental curriculum as rates ranged from
tobacco dependence education, and determine the need 45% to 98% interested in training or believing it should be
for future research on this topic. in the curriculum.[16,21] In most of the studies, the major-
ity of practitioners, more than 75%, reported being inter-
METHODS ested or believing that it should be included.
The following databases were searched for the review
such as Medline, Cochrane Library, and PubMed. The Planning Attitudes
search terms used were “undergraduates or college or uni- The studies reported dental practitioner’s plans for the
versity or student or education or academic” and “dental future practice of tobacco cessation. The specific word-
or dentistry” and “tobacco cessation or smoking cessation ing of the questions varied, with some reporting, plans
or tobacco intervention or tobacco counseling,” and rele- to provide tobacco cessation and others reporting will-
vant articles published in peer‑reviewed journals were ingness as rates ranged from 54% of practitioners will-
obtained. Furthermore, some of the literature was gath- ing to provide tobacco cessation to 96% willing to use
ered by cross-checking the reference lists of the articles anti-tobacco programs in practice to advise patients
were obtained. For reading and understanding purpose, to quit.[22,23] In some of studies, more than 60% of the
only the literature materials that were published in other dental practitioners were willing or planning to address
than the English language were excluded from the study. tobacco use with patients.[16,23-27]

DENTAL PRACTITIONER’S ATTITUDES TOWARD Dentist Role Attitudes

TOBACCO CESSATION IN THE DENTAL SETTING
The studies as reported whether dental practitioners
The reviewed data varied in with respect to the oper- believed that it was within the scope or responsibility of
ational definition of tobacco cessation and assessment dental practice to have a role in tobacco cessation. The
of attitudes about tobacco cessation. The four categories specific wording of items assessing this attitude varied
of attitudes emerged from the data review as training among studies, for examples, asking whether it was
attitudes, planning attitudes, dentist role attitudes, and within the scope to help smokers quit, whether it was the
barrier attitudes. In the training attitudes, the data on professional responsibility of dentists to help smokers
whether students reported any prior training, perceived quit, and whether tobacco cessation counseling is part of
efficacy of training, and interest in training. In the plan- dentist’s professional role[16,24,28] and rates ranged from
ning attitudes, data that evaluated whether students 40% of professionals agreeing it is the responsibility and
intended to address tobacco cessation in dental practice. duty of every dentist to cooperate in anti-tobacco pro-
In dentist role attitudes, the data that asked practitioners grams to 97% of professionals agreeing that the dentist
whether tobacco cessation was within the scope, role, has a role in giving advice about tobacco cessation.[23,29]

International Journal of Tobacco and Oral Health, January-June 2017;3(1):1-6 2

 IJTOH

 A Review on Dental Practitioner’s Attitudes toward Tobacco Cessation

The majority of dental practitioners like more than 60% assist, and arrange. Dental students asked patients about
agreed that it was within the scope or responsibility of den- tobacco use, and rates ranged from 28% to 96% asking all
tal practice to help tobacco users quit. The data on specific or almost all of the time.[15,33] In addition, dental students
practices, for example, prescribing nicotine gum. Anders advised tobacco users to quit and rates ranged from
et al.[30] reported that while 84% of the dental profession- 13% to 94% of student’s agreeing that they performed
als in their study agreed, it was within the scope of dental the advice step.[25,28] Few studies reported percentages
practitioners to advise patients to quit, fewer professionals for the assess step. In one study, 12% and, in the other,
agreed that performing specific cessation strategies were 65% of the students reported assessing whether tobacco
within the scope as 76% for referring to a cessation clinic, users were willing to quit.[24,28] Also, what percentage
74% for discussing specific strategies, 61% for prescribing of students reported assisting patients who were ready
nicotine gum, and 55% for prescribing nicotine patches.[30] to quit and rates ranged from 4% to 24%.[20,28] Another
While the majority of dental professionals in most studies reported on the arrange step, which is arranging
studies agreed, it was within their scope of practice to follow-up contact regarding tobacco quit attempts and
address tobacco use in some way; fewer practitioners those rates ranged from 1% to 22%.[2,20]
agreed that their time providing tobacco cessation was
well spent or would have an effect on the patient’s DISCUSSION
tobacco use. In the study, in which 97% of the dental Tobacco cessation efforts in the dental setting can have
practitioners agreed that dentists have a role in tobacco an impact on patient’s tobacco use.[7] However, the
cessation, only 74% agreed that their advice would dentists report not being sufficiently trained to provide
impact patient quitting.[29] Another study reported that tobacco cessation counseling.[8] Dental practitioners
84% of the dental practitioners agreed, it was within provided with tobacco cessation training may help
the scope of dental practice to advise patients to quit, them feel better prepared to address tobacco use. This
but only 49% agreed that the time was well spent.[30] In comprehensive review of previously published articles
another study, 68% reported feeling tobacco cessation focused to provide an overview of dental practitioner’s
was ineffective unless the patient had a related health attitudes toward tobacco cessation, their perceived bar-
problem.[25] However, the study reported that 86% of riers to tobacco cessation as well as the degree to which
the practitioners believed that patients would be more they engage in tobacco cessation efforts.
likely to quit if a health professional advised it.[31] Dental practitioner’s attitudes toward tobacco
cessation in the dental setting were found in the sur-
Perceived Barriers to Tobacco Cessation vey studies to be generally favorable. The majority of
the practitioners were believed that addressing tobacco
Some of studies reported rates of dental practitioner’s
use was within the scope of dental practice although
perceptions of barriers to tobacco cessation in the
not in every study. Dental practitioner’s attitudes may
dental setting and some reported perceptions that
be greatly influenced by the dental college’s environ-
‘patient resistance’ or ‘lack of patient motivation to
ment. Dental colleges should consider the environment
quit’ was the biggest barrier.[15-17,19,24-26,30,32] Also, few
and dental faculty attitudes when developing tobacco
studies reported ‘inadequate counseling skills’[33,34],
dependence education or implementing tobacco cessa-
‘lack of time’15,35, and ‘lack of resources and referral
tion in the practice. The variation found in the specific
sources’[20,28] as perceived barriers to tobacco cessa-
strategies used, with less favorable attitudes toward
tion. Among the studies, lack of time and patient resis-
practices like prescribing nicotine replacement therapy
tance were tied as the biggest perceived barriers to
and few of the studies evaluated practitioner’s atti-
tobacco cessation counseling.[15] Comparisons between
tudes toward specific strategies for example as refer
America-based studies and non-American-based stud-
to cessation clinic, set quit date, and prescribe nicotine
ies found no significant differences in the top-rated bar-
replacement therapy. It is not clear exactly what these
rier. Comparisons between studies based on clinical vs.
dental practitioners were considered to be within the
non-clinical status of dental practitioners sample found
scope of practice. Dental practitioner may have demon-
no significant differences in the top-rated barrier.
strated favorable attitudes toward asking and advising
about tobacco use but been less positive about specific
DENTAL STUDENT PRACTICE OF TOBACCO
strategies. Dental educators may consider assessing
CESSATION
practitioner’s overall perceptions, their attitudes about
The studies reported information on students reported specific practices, and addressing those perceptions in
practice of some or all of the steps in the five “A”s tobacco dependence education. Therefore, general den-
approach to tobacco cessation as: Ask, advise, assess, tists with prior training and positive attitudes toward
International Journal of Tobacco and Oral Health, January-June 2017;3(1):1-6 3
Todkar M, et al.

treating tobacco use were more likely to routinely offer information since the level of training may impact atti-
cessation assistance, suggesting the importance of tudes toward tobacco cessation. The majority of studies
addressing attitudes in training.[36] that assessed practitioner’s interest in training reported
Patient resistance or lack of motivation was the most a majority interest or need for training in tobacco cessa-
common barrier reported by the dental practitioners. tion. Given dental practitioner’s receptivity to training,
Dentists have reported different barriers such as lack of the dental college years may be an optimal time to train
adequate training, lack of materials and referral sources, students in these practices, so they enter the workforce
and lack of financial incentive.[37,38] Dental practitioner’s prepared to address tobacco use in practice. A survey
perception that patient resistance is the biggest barrier of American and Canadian dental schools found that
may not be consistent with what is observed in clin- the majority provide tobacco dependence education.[43]
ical practice. Indeed, the majority of dental patients However, while that survey found high faculty confi-
have favorable attitudes toward dental professional’s dence in teaching tobacco-related pathology, there was
addressing tobacco use with 89% of patients in the less confidence in teaching dental professionals how to
study agreeing that dental practitioners should offer help patients quit and given the less favorable attitudes
tobacco cessation information to patients who wanted about specific tobacco cessation strategies and concerns
to quit.[20,39] Hence, based on the findings, suggestive about patient resistance, a tobacco dependence educa-
of tobacco cessation training programs consider includ- tion curriculum may benefit from utilizing faculty with
ing strategies to address patient resistance and enhance expertise in these areas to teach professionals how to
motivation such as motivational interviewing tech- help patients quit.
niques and motivational counseling. In terms of scope and quality, there were limitations
This review found variation in dental practi- to the reviewed studies that should be noted. First, many
tioner’s tobacco cessation practice.[16,19,20,24-26,28,32,35] studies were limited in terms of generalizability. The
Furthermore, few studies that reported information on majority sampled dental professionals from single den-
dental practitioner’s practice, <50% of the practitioners tal college. Some only sampled dental professionals from
were reported engaging in certain tobacco cessation certain dental years. The findings may reflect perceptions
practices.[16,19,20,26,28,32,40] However, in some studies or and practices specific to that college or student year.
with certain tobacco cessation strategies, for example, as These data can be very valuable to that institution, partic-
advising user to quit, the majority of practitioners were ularly in designing or evaluating a tobacco dependence
engaging in the practice.[14,15,25,35,39] Dental practitioners education curriculum but are not broadly applicable.
in several studies were more likely to ask and advise Another limitation is that most studies were cross-sec-
about tobacco use than engage in the other five “A”s: tional, which limited the ability to determine whether
Ask, advise, assess, assist, and arrange.[20,24,26,28,32] There attitudes changed and if so, the factors that impacted
is evidence that briefer models of tobacco cessation can such changes. An additional limitation was the lack of a
have an impact, such as ask, advise, refer[41] as well as validated measure to assess tobacco cessation attitudes.
ask, advise, and connect in which patients are connected The majority of studies utilized author-developed scales
directly with state quitlines.[42] In ask, advise, and con- or variations of previously used scales. While the studies
nect, the patient completes a form during the health- assessed dental student attitudes toward tobacco cessa-
care visit and the provider submits information directly tion in the dental setting, the operational definition of
to the quitline through an electronic system. Once “attitudes” varied widely across studies. One, for exam-
the form is received, the quitline contacts the patient ple, assessed attitudes by asking whether it was part
directly to provide services. This process is, in contrast, of the role of the dentist to help patients quit,[14] while
to ask, advise, and refer in which the patient is given another assessed attitudes by asking whether students
information about the quitline or another tobacco ces- felt that patients would be offended if tobacco use was
sation provider and must initiate contact. These models raised.[10] The lack of a consistent, validated measure,
may be suitable for dental college and hospital where along with the varying operational definitions of atti-
dental practitioners may feel most prepared and com- tudes, limited the utility of the findings and prevented
fortable asking and advising about tobacco use and then comparisons across studies or across time. Further, the
connecting the patient with resources to receive more standardized methods of administration involved sam-
in-depth support. In terms of training, there was wide pling 3rd year dental health profession students, which
variation in terms of what was assessed in the stud- limit information from preclinical or advanced students
ies, but few of them included information on the type who have spent more time doing clinical work.
of tobacco cessation education provided at the dental The findings from the review indicate various future
colleges. Therefore, future studies should include this directions that researchers can take on this topic. Future
International Journal of Tobacco and Oral Health, January-June 2017;3(1):1-6 4
 IJTOH

 A Review on Dental Practitioner’s Attitudes toward Tobacco Cessation

studies should include larger samples across multiple 9. Warnakulasuriya S. Effectiveness of tobacco counseling in
dental colleges. Furthermore, longitudinal research the dental office. J Dent Educ 2002;66:1079-87.
10. Romito L, Schrader S, Zahl D. Using experiential learn-
can determine whether there are changes in attitudes
ing and OSCEs to teach and assess tobacco dependence
across dental colleges and factors that predict changes. education with first-year dental students. J Dent Educ
Research is needed to develop a validated measure of 2014;78:703-13.
tobacco cessation attitudes. Moreover, most of the stud- 11. Schoonheim-Klein M, Gresnigt C, van der Velden U.
ies did not include information on the type or level of Influence of dental education in motivational interviewing
tobacco dependence education provided in the dental on the efficacy of interventions for smoking cessation. Eur J
Dent Educ 2013;17:e28-33.
colleges. Hence, level of training may impact attitudes,
12. Amemori M, Mumghamba EG, Ruotoistenmäki J,
and future studies should include this as a variable. Murtomaa H. Smoking and drinking habits and attitudes to
smoking cessation counseling among Tanzanian dental stu-
CONCLUSION dents. Community Dent Health 2011;28:95-8.
13. Virtanen JI, Filppula M, Maldupa I, Patja K. Smoking and
The review found interesting patterns in the findings
attitudes towards it and its cessation among dental students
that warrant discussion about their relevance to tobacco in Latvia. Acta Odontol Scand 2015;73:421-6.
dependence education in dental colleges. Dental prac- 14. Dumitrescu AL, Ibric S, Ibric-Cioranu V. Opinions of
titioners have favorable attitudes toward tobacco ces- Romanian dental students toward tobacco use interventions
sation, and the majority expressed interest in training. in the dental setting. J Cancer Educ 2016;31:172-80.
However, dental practitioners may need more guidance 15. Pendharkar B, Levy SM, McQuistan MR, Qian F, Squier CA,
Slach NA, et al. Fourth-year dental students’ perceived bar-
and information regarding specific tobacco cessation
riers to providing tobacco intervention services. J Dent Educ
skills and strategies to address patient resistance. Dental 2010;74:1074-85.
institute interested in developing or evaluating tobacco 16. Murugaboopathy V, Ankola AV, Hebbal M, Sharma R.
dependence education programs should take this infor- Indian dental students’ attitudes and practices regarding
mation into consideration for modifying or strengthen- tobacco cessation counseling. J Dent Educ 2013;77:510-7.
ing existing tobacco cessation curricula or for including 17. Victoroff KZ, Dankulich-Huryn T, Haque S. Attitudes of
incoming dental students toward tobacco cessation promo-
tobacco dependence education in behavioral sciences
tion in the dental setting. J Dent Educ 2004;68:563-8.
courses where issues related to patient resistance and 18. Fried JL, Reid BC, DeVore LE. A comparison of health pro-
behavior change can be addressed. Furthermore, dental fessions student attitudes regarding tobacco curricula and
institutes may consider expanding the frequency of clin- interventionist roles. J Dent Educ 2004;68:370-7.
ical opportunities for students to develop these skills 19. Clareboets S, Sivarajasingam V, Chestnutt IG. Smoking ces-
both inside and outside the institute. sation advice: Knowledge, attitude and practice among clin-
ical dental students. Br Dent J 2010;208:173-7.
20. Yip JK, Hay JL, Ostroff JS, Stewart RK, Cruz GD. Dental stu-
REFERENCES
dents’ attitudes toward smoking cessation guidelines. J Dent
1. Chang CM, Corey CG, Rostron BL, Apelberg BJ. Systematic Educ 2000;64:641-50.
review of cigar smoking and all cause and smoking-related 21. Barbouni A, Hadjichristodoulou C, Merakou K,
mortality. BMC Public Health 2015;15:390. Antoniadou E, Kourea K, Miloni E, et al. Tobacco use, expo-
2. Warnakulasuriya S, Dietrich T, Bornstein MM, Casals sure to secondhand smoke, and cessation counseling among
Peidró E, Preshaw PM, Walter C, et al. Oral health risks of health professions students: Greek data from the global
tobacco use and effects of cessation. Int Dent J 2010;60:7-30. health professions student survey (GHPSS). Int J Environ
3. Wallace RH. The relationship between cigarette smoking Res Public Health 2012;9:331-42.
and dental implant failure. Eur J Prosthodont Restor Dent 22. Antal M, Forster A, Zalai Z, Barabás K, Ramseier C, Nagy K,
2000;8:103-6. et al. Attitudes of Hungarian dental professionals to tobacco
4. Christen AG. Tobacco cessation, the dental profession, and use and cessation. Cent Eur J Public Health 2012;20:45-9.
the role of dental education. J Dent Educ 2001;65:368-74. 23. Vanobbergen J, Nuytens P, van Herk M, De Visschere L.
5. Gordon JS, Andrews JA, Albert DA, Crews KM, Payne TJ, Dental students’ attitude towards anti-smoking program-
Severson HH, et al. Tobacco cessation via public dental mers: A study in Flanders, Belgium. Eur J Dent Educ
clinics: Results of a randomized trial. Am J Public Health 2007;11:177-83.
2010;100:1307-12. 24. Ahmady AE, Golmohammadi S, Ayremlou S,
6. Fiore MC, Jaen CR, Baker TB. Treating Tobacco Use and Khoshnevisan MH, Lando HA. Tobacco cessation practices
Dependence: 2008 Update. Clinical Practice Guideline. of senior dental students in Iran. Int Dent J 2011;61:302-6.
Rockville, MD: U.S. Department of Health and Human 25. Rajasundaram P, Sequeira PS, Jain J. Perceptions of den-
Services, Public Health Service; 2008. tal students in India about smoking cessation counseling.
7. Carr AB, Ebbert J. Interventions for tobacco cessation in the J Dent Educ 2011;75:1603-10.
dental setting. Cochrane Database Syst Rev 2012;6:CD005084. 26. Rikard-Bell G, Groenlund C, Ward J. Australian dental stu-
8. Patel AM, Blanchard SB, Christen AG. A survey of U.S. peri- dents’ views about smoking cessation counseling and their
odontists’ knowledge, attitudes, and behaviors related to skills as counselors. J Public Health Dent 2003;63:200-6.
tobacco cessation interventions. J Periodontol 2011;82:367-76. 27. Razavi SM, Zolfaghari B, Doost ME, Tahani B. Attitude and

International Journal of Tobacco and Oral Health, January-June 2017;3(1):1-6 5

Todkar M, et al.

practices among dentists and senior dental students in Iran Attitudes of Nigerian dentists and dental students. J Dent
toward tobacco cessation as an effort to prevent oral cancer. Educ 2011;75:406-12.
Asian Pac J Cancer Prev 2015;16:333-8. 36. Jannat-Khah DP, McNeely J, Pereyra MR, Parish C,
28. Balappanavar AY, Sardana V, Gupta P. Nationwide sur- Pollack HA, Ostroff J, et al. Dentists’ self-perceived role in
vey of fifth-year dental students’ perceptions about tobacco offering tobacco cessation services: Results from a nation-
prevention, control, and curriculum in India. J Dent Educ ally representative survey, United States, 2010-2011. Prev
2013;77:1384-93. Chronic Dis 2014;11:E196.
29. Chowdhury MT, Pau A, Croucher R. Bangladeshi dental 37. Keogana S, Burns A, Babineaua K, Clancy L. Dental practi-
students’ knowledge, attitudes and behaviour regarding tioners and smoking cessation in Ireland. Tob Prev Cessation
tobacco control and oral cancer. J Cancer Educ 2010;25:391-5. 2015;1:5.
30. Anders PL, Davis EL, McCall WD Jr. Dental students’ atti- 38. Al-Mobeeriek A, Al-Qhatani D, Al-Otibi O, Al-Qhatni M.
tudes toward tobacco cessation counseling. J Dent Educ Dentists’ attitudes and practice towards smoking cessation
2014;78:56-63. and intervention in Riyadh, Saudi Arabia. J Dent 2013;1:1-7.
31. Fotedar S, Sogi GM, Fotedar V, Bhushan B, Singh B, 39. Victoroff KZ, Lewis R, Ellis E, Ntragatakis M. Patient recep-
Dahiya P, et al. Knowledge of, attitude towards, and prev- tivity to tobacco cessation counseling in an academic dental
alence of tobacco use among dental students in Himachal clinic: A patient survey. J Public Health Dent 2006;66:209-11.
Pradesh state, India. Oral Health Dent Manag 2013;12:73-9. 40. Tao S, Croucher R, Pau A. Impact of the curriculum on
32. Vered Y, Livny A, Zini A, Shabaita S, Sgan-Cohen HD. Chinese dental students’ tobacco control attitudes and beliefs:
Dental students’ attitudes and behavior toward smoking A case study in Harbin, China. Int Dent J 2008;58:181-6.
cessation as part of their professional education. Teach 41. Gordon JS, Andrews JA, Crews KM, Payne TJ, Severson HH.
Learn Med 2010;22:268-73. The 5A’s vs 3A’s plus proactive quitline referral in private
33. Ehizele A, Azodo C, Umoh A, Akinboboye B. Attitudes of practice dental offices: Preliminary results. Tob Control
dental students to tobacco cessation services. Internet J Dent 2007;16:285-8.
Sci 2009;7:1-7. 42. Vidrine JI, Shete S, Li Y. Efficacy of ask advise connect in a
34. Polychonopoulou A, Gatou T, Athanassouli T. Greek dental safety net health care system. Am J Prev Med 2013;45:737.
students’ attitudes toward tobacco control programmers. Int 43. Davis JM, Arnett MR, Loewen J, Romito L, Gordon SC.
Dent J 2004;54:119-25. Tobacco dependence education: A survey of US and
35. Uti OG, Sofola OO. Smoking cessation counseling in dentistry: Canadian dental schools. J Am Dent Assoc 2016;147:405-12.

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