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Internet delivered support for tobacco control in dental practice: randomized controlled trial
Quantitative Health Sciences Publications and Presentations
  • Thomas K. Houston, University of Alabama
  • Joshua S. Richman, University of Alabama
  • Midge N. Ray, University of Alabama
  • Jeroan J. Allison, University of Massachusetts Medical School
  • Gregg H. Gilbert, University of Alabama
  • Richard M. Shewchuk, University of Alabama
  • Connie L. Kohler, University of Alabama
  • Catarina I. Kiefe, University of Massachusetts Medical School
UMMS Affiliation
Department of Quantitative Health Sciences
Publication Date
Document Type
Advertising as Topic; *Dentistry; Health Services Accessibility; Health Surveys; Humans; *Internet; Mouth Neoplasms; Patient Selection; Questionnaires; Smoking; Smoking Cessation; *Social Support; Therapy, Computer-Assisted; Treatment Outcome; User-Computer Interface

BACKGROUND: The dental visit is a unique opportunity for tobacco control. Despite evidence of effectiveness in dental settings, brief provider-delivered cessation advice is underutilized.

OBJECTIVE: To evaluate an Internet-delivered intervention designed to increase implementation of brief provider advice for tobacco cessation in dental practice settings.

METHODS: Dental practices (N = 190) were randomized to the intervention website or wait-list control. Pre-intervention and after 8 months of follow-up, each practice distributed exit cards (brief patient surveys assessing provider performance, completed immediately after the dental visit) to 100 patients. Based on these exit cards, we assessed: whether patients were asked about tobacco use (ASK) and, among tobacco users, whether they were advised to quit tobacco (ADVISE). All intervention practices with follow-up exit card data were analyzed as randomized regardless of whether they participated in the Internet-delivered intervention.

RESULTS: Of the 190 practices randomized, 143 (75%) dental practices provided follow-up data. Intervention practices' mean performance improved post-intervention by 4% on ASK (29% baseline, adjusted odds ratio = 1.29 [95% CI 1.17-1.42]), and by 11% on ADVISE (44% baseline, OR = 1.55 [95% CI 1.28-1.87]). Control practices improved by 3% on ASK (Adj. OR 1.18 [95% CI 1.07-1.29]) and did not significantly improve in ADVISE. A significant group-by-time interaction effect indicated that intervention practices improved more over the study period than control practices for ADVISE (P = 0.042) but not for ASK.

CONCLUSION: This low-intensity, easily disseminated intervention was successful in improving provider performance on advice to quit.


DOI of Published Version
J Med Internet Res. 2008 Nov 4;10(5):e38. Link to article on publisher's site
PubMed ID
Related Resources
Link to Article in PubMed
Citation Information
Thomas K. Houston, Joshua S. Richman, Midge N. Ray, Jeroan J. Allison, et al.. "Internet delivered support for tobacco control in dental practice: randomized controlled trial" Vol. 10 Iss. 5 (2008) ISSN: 1438-8871 (Linking)
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