Factors that influence delivery of tobacco cessation support in general dental practice: A narrative review

Objectives: To review the literature reporting factors that are associated with the delivery of lifestyle support in general dental practice. Methods: A systematic review of the quantitative observational studies describing activities to promote the general health of adults in primary care general dental practice. Behaviour change included tobacco cessation, alcohol reduction, diet, weight management and physical activity. Tooth brushing and oral hygiene behaviours were excluded as the focus of this review was on the common risk factors that affect general health as well as oral health. Results: Six cross sectional studies met the inclusion criteria. Five studies only reported activities to support tobacco cessation. As well as tobacco cessation one study also reported activities related to alcohol usage, physical activity and Body Mass Index. Perceptions of time availability consistently correlated with activities and beliefs about tobacco cessation, alongside the smoking status of the dental professional. Dentists who perceive having more available time were more likely to discuss smoking with patients, prescribe smoking cessation treatments and direct patients towards (signpost to) lifestyle support services. Dental professionals who smoke were less likely to give smoking cessation advice and counselling than non-smokers. Finally, the data showed that professional support may be relevant. Professionals who work in solo practices or those who felt a lack of support from the wider professional team (peer support) were more likely to report barriers to delivering lifestyle support. Conclusion: Organisational changes in dental practices to encourage more team working and professional time for lifestyle support may influence delivery. Dental professionals who are smokers may require training to develop their beliefs about the effectiveness of smoking cessation interventions.