ASSESSMENT OF TOBACCO CESSATION SYSTEMS OF DENTAL PRACTICES IN NORTHEASTERN NORTH CAROLINA

Objectives: Every year, cigarettes and other tobacco products cause nearly one of every five deaths in the United States. In 2015, 19.0% of the adults in North Carolina (NC) smoked cigarettes. At the same time, NC – particularly Eastern NC -- has substantial challenges in oral health. Dentists have an important role to play in tobacco cessation, and tobacco use is a major risk factor for worse oral health outcomes. The goal of this study was to determine the extent dentists in the northeastern region of NC implement recommended Public Health Services (PHS) Clinical Practice Guidelines in their practice, and how they are using recommended tobacco policies and systems to systematically screen, advise, and assist clients in quitting. Methods: In this qualitative study, general dentists located in northeastern NC (i.e., 252 area code) were identified using purposive sampling. Participating dentists underwent a 15-minute semi-structured interview by phone in January-March 2017. Interviews (n=11) were thematically coded for adherence to PHS clinical systems guidelines and for barriers to implementation. Results: Full implementation of PHS guidelines in NE NC dental practices was rare, although asking about tobacco use in the initial health questionnaire was common. Common reasons for not implementing systems guidelines were: (1) limited training, (2) lack of time, and (3) uncomfortable prescribing tobacco cessation products. Discussion: We found full adherence to evidence-based tobacco cessation systems guidelines was rare in a region with persistent health challenges. Results of this study can be used to help improve training and curricula in dental schools for future dentists. Some aspects of the PHS guidelines may need to be modified for dental practices