Sains Malaysiana 47(1)(2018): 131–140
http://dx.doi.org/10.17576/jsm-2018-4701-16
A
Randomized Control Trial of Smoking Cessation Interventions Conducted by
Dentists
(Percubaan
Klinikal Terkawal Rawak Intervensi Berhenti Merokok oleh Doktor Pergigian)
NURUL ASYIKIN YAHYA1*, ROSLAN SAUB2 & MARIANI MOHD NOR3
1Department of Dental
Public Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia, 43600 UKM
Bangi, Selangor Darul Ehsan, Malaysia
2Department
of Community Oral Health and Clinical Prevention, Faculty of Dentistry,
University of Malaya, 50603 Kuala Lumpur, Federal Territory, Malaysia
3Department
of Education Psychology and Counselling, Faculty of Education, University of
Malaya, 50603 Kuala Lumpur, Federal Territory, Malaysia
Diserahkan:
29 November 2016/Diterima: 5 Jun 2017
ABSTRACT
The objective of this study was to assess the effectiveness of the
5A’s smoking cessation intervention (5A’s) to that of brief advice (BA)
conducted by dentists. A single-blinded randomized controlled trial was
designed to compare the effectiveness of the interventions. Six Dental Public
Health specialists were recruited, randomized and trained to participate in
this trial. Two hundred and fifty patients were required on both arms. The main
outcome measures were biochemically validated self-reported abstinence and
behaviour change at 6-months follow-up. The odd of quitters in 5A’s
intervention was 3.81 (95% CI: 1.87-7.76; p= 0.00) times higher compared to BA.
After controlling other factors, the odds ratio for the 5A’s was 1.90 (95% CI:
0.652-5.547; p=0.24) higher compared to BA.
The 5A’s was found to be more effective in initiating positive behaviour change
compared to BA. However, after controlling other factors, there was
no difference in the effectiveness although the odds ratio was slightly higher
in 5A’s.
Keywords: Brief advice; dentists; smoking cessation; tobacco
cessation
ABSTRAK
Objektif kajian ini adalah untuk menilai keberkesanan intervensi
berhenti merokok 5A’s (5A’s) berbanding nasihat ringkas (BA)
yang disampaikan oleh doktor pergigian dalam klinik pergigian. Satu percubaan
klinikal terkawal rawak untuk membandingkan keberkesanan 5A’s berbanding BA.
Enam pakar Kesihatan Awam Pergigian telah dikenal pasti secara rawak dan
dilatih untuk mengambil bahagian dalam kajian ini. Dua ratus lima puluh pesakit
diperlukan untuk setiap intervensi. Keputusan utama kajian adalah berhenti
merokok yang disahkan secara biokimia dan perubahan tingkah laku pada rawatan
susulan selepas 6 bulan. Dalam ujian klinikal, nisbah kemungkinan pesakit yang
berhenti merokok dalam 5A’s adalah 3.81 (95% CI:
1,871-7, 76; p= 0.00) kali lebih
tinggi berbanding BA. Selepas mengawal faktor lain, nisbah
kemungkinan bagi 5A’s adalah 1.90 (95% CI: 0,652-5,547; p=0.24)
lebih tinggi berbanding BA. 5A’s didapati lebih berkesan dalam
memulakan perubahan tingkah laku positif berbanding BA.
Walau bagaimanapun, selepas mengawal faktor lain, tidak ada perbezaan dalam
keberkesanan walaupun nisbah kemungkinan yang lebih tinggi sedikit pada 5’As.
Kata kunci: Berhenti merokok; berhenti tembakau;
doktor pergigian; nasihat ringkas
RUJUKAN
Amer Nordin, A.S., Kadir, R.A., Yahya, N.A., Zakaria, H.,
Rashid, R.A. & Habil, M.H. 2014. Empowering Malaysian dentists to tobacco
dependence treatment conduct. Int. Dent. J. 64(4): 206-212.
Anne Yee, H.A., Ng, C.G. & Rusdi, A.R. 2011. Validation
of the Malay version of Fagerström test for nicotine dependence (FTND-M) among
a group of male staffs in a University Hospital. Malaysian Journal of
Psychiatry 01-04-11. http:// repository.um.edu.my/11545/1/MJP_FTND-M.pdf
Báezconde-Garbanati, L., Reyna, F., Portugal, C., Barahona,
R. & Noltenius, J. Train the Trainer Smoking Cessation Tool- Kit.
2011.
Beaglehole, R.H. & Benzian, H.M. 2005. Tobacco or
Oral Health: An Advocacy Guide for Oral Health Professionals. FDI: World
Dental Press.
Beaglehole, R.H. & Watt, R.G. 2004. Helping Smokers
Stop: A Guide for the Dental Team. Health Development Agency.
Bedfont Scientific Ltd. 2012. piCO+ Smokerlyzer Operating
Manual. England: Bedfont Scientific Ltd.
Biener, L. & Abrams, D.B. 1991. The Contemplation
Ladder: Validation of a measure of readiness to consider smoking cessation. Health
Psychol. 10(5): 360-365.
Carr, A.B. & Ebbert, J. 2011. Interventions for tobacco
cessation in the dental setting. Cochrane Db Syst. Rev 6: CD005084.
Coleman, T. 2004. Use of simple advice and behavioural
support. BMJ 328(7436): 397-399.
Croucher, R. 2005. Why and how to get patients to stop
smoking. Dent. Update 32(3): 143-144.
Dawson, G.M., Noller, J.M. & Skinner, J.C. 2013. Models
of smoking cessation brief interventions in oral health. NSW Public Health
Bulletin 24(3): 131-134.
Fiore, M.C., Jaen, C.R., Baker, T.B., Bailey, W.C.,
Benowitz, N. & Curry, S.J. 2008. Treating tobacco use and dependence: 2008
update. US Public Health Service Clinical Practice Guideline executive summary. Respir. Care 53(9): 1217-1222.
Gallagher, J.E., Alajbeg, I., Büchler, S., Carrassi, A.,
Hovius, M., Jacobs, A., Jenner, M., Kinnunen, T., Ulbricht, S. &
Zoitopoulos, L. 2010. Public health aspects of tobacco control revisited. Int.
Dent. J. 60(1): 31-49.
Gordon, J.S., Andrews, J.A., Crews, K.M., Payne, T.J. &
Severson, H.H. 2007. The 5A’s vs 3A’s plus proactive quitline referral in
private practice dental offices: Preliminary results. Tob. Control. 16(4):
285-288.
Gordon, J.S., Lichtenstein, E., Severson, H.H. &
Andrews, J.A. 2006. Tobacco cessation in dental settings: Research findings and
future directions. Drug Alcohol Rev. 25(1): 27-37.
Hanioka, 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.
Heatherton, T.F., Kozlowski, L.T., Frecker, R.C. &
Fagerstrom, K.O. 1991. The Fagerström test for nicotine dependence: A revision
of the Fagerström Tolerance Questionnaire. Brit. J. Addict. 86(9):
1119-1127.
Hu, S., Pallonen, U., McAlister, A.L., Howard, B., Kaminski,
R., Stevenson, G. & Servos, T. 2006. Knowing how to help tobacco users:
Dentists’ familiarity and compliance with the clinical practice guideline. J.
Am. Dent. Assoc. 137(2): 170-179.
Institute for Public Health. 2012. Report of the Global
Adult Tobacco Survey (GATS) Malaysia 2011. Kuala Lumpur. Ministry of Health
Malaysia.
Lancaster, T. & Stead, L.F. 2005. Individual behavioural
counselling for smoking cessation. Cochrane Db Syst. Rev. 2: CD001292.
Lando, H.A., Hennrikus, D., Boyle, R., Lazovich, D., Stafne,
E. & Rindal, B. 2007. Promoting tobacco abstinence among older adolescents
in dental clinics. Journal of Smoking Cessation 2(01): 23-30.
Needleman, I.G., Binnie, V.I., Ainamo, A., Carr, A.B.,
Fundak, A., Koeber, A., Öhrn, K. & Rosseel, J. 2010. Improving the
effectiveness of tobacco use cessation (TUC). Int. Dent. J. 60(1):
50-59.
Nohlert, E., Tegelberg, Å., Tillgren, P., Johansson, P.,
Rosenblad, A. & Helgason, A.R. 2009. Comparison of a high and a low
intensity smoking cessation intervention in a dentistry setting in Sweden-a
randomized trial. BMC Public Health 9(1): 1.
Ochsner, S., Luszczynska, A., Stadler, G., Knoll, N.,
Hornung, R. & Scholz, U. 2014. The interplay of received social support and
self-regulatory factors in smoking cessation. Psychol. Health 29(1):
16-31.
Oral Health Division. 2011. National Oral Health Plan for
Malaysia 2011-2020. Kuala Lumpur: Ministry of Health Malaysia.
Stead, L.F., Hartmann-Boyce, J., Perera, R. & Lancaster,
T. 2013. Telephone counselling for smoking cessation. Cochrane Db Syst. Rev 8:
CD002850.
Unal, B., Critchley, J.A. & Capewell, S. 2004.
Explaining the decline in coronary heart disease mortality in England and Wales
between 1981 and 2000. Circulation 109(9): 1101- 1107.
Velicer, W.F. & Prochaska, J.O. 2004. A comparison of
four self-report smoking cessation outcome measures. Addict Behav. 29(1):
51-60.
Warnakulasuriya, S., Dietrich, T., Bornstein, M.M., Peidró,
E.C., Preshaw, P.M., Walter, C., Wennström, J.L., & Bergström, J. 2010.
Oral health risks of tobacco use and effects of cessation. Int. Dent. J. 60(1):
7-30.
Warnakulasuriya, S. 2002. Effectiveness of tobacco
counselling in the dental office. J. Dent. Educ. 66(9): 1079-1087.
Watt, R.G. & Sheiham, A. 2012. Integrating the common
risk factor approach into a social determinants framework. Community Dent.
Oral Epidemiol. 40: 289-296. doi:10.1111/ j.1600-0528.2012.00680.x
Wee, L.H., Shahab, L., Bulgiba, A. & West, R. 2011. Stop
smoking clinics in Malaysia: Characteristics of attendees and predictors of
success. Addict Behav. 36(4): 400-403.
West, R., McNeill, A. & Raw, M. 2000. Smoking cessation
guidelines for health professionals: An update. Thorax 55(12): 987-999.
West,
R., Raw, M., McNeill, A., Stead, L., Aveyard, P., Bitton, J., Stapleton, J.,
McRobbie, H., Pokhrel, S., Lester‐George, A. &
Borland, R. 2015. Health‐care interventions to
promote and assist tobacco cessation: A review of efficacy, effectiveness and
affordability for use in national guideline development. Addiction 110(9):
1388-1403.
World
Health Organization. 2010. Helping People Quit Tobacco: A Manual for Doctors
and Dentists. Regional Office for South-East Asia: WHO.
Yahya,
N.A., Rani, H., Abang Abdullah, A. & Kadir, R. 2012. Characteristics of
smokers attending a smoking cessation program in a dental setting. The
International Journal of Oral Health 8:22-29.
*Pengarang
untuk surat-menyurat; email: nurulasyikin@ukm.edu.my
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