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., LesterGeorge, A. & Borland, R. 2015. Healthcare 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

 

 

 

 

 

 

sebelumnya