The ADHA has become the first partner of the Smoking Cessation Leadership Center to reach its established goal by doubling over three years the percentage of hygienists who intervene with patients who use tobacco. In September 2003, the ADHA and SCLC convened a summit and set the doubling target. A survey conducted by ADHA recently showed that 56 percent of respondents offered tobacco treatment at all or most visits. In addition, 71 percent of respondents focus on and intervene with higher-risk clients, including clients with tobacco-related oral findings. Since hygienists can indentify tobacco users readily, this means appropriate intervention has become extremely widespread.
When the hygienists convened with SCLC three and a half years ago at the University of California San Francisco, they used small studies and observation to establish a best-chewers. Deciding that they could overcome barriers such as dentists opposition and time constraints if they sent willing tobacco users to quitlines, they set the ambitious doubling target. Tobacco quitlines, available in every state and easily marketed through a national number, 1-800-QUIT NOW, can double or triple the chances of quitting tobacco; clinician advice can double the chances a tobacco user will try to quit. The official 2000 clinical practice guideline on cessation of the Public Health Service calls for clinicians to do five A's "Ask whether patients smoke or chew, advise them to quit, assess readiness to quit, assist with a quit plan and arrange for follow-up." The hygienists made a breakthrough in establishing a shortcut to accomplish these steps: Ask, advise and refer.
The ADHA established a Smoking Cessation Initiative and began to implement the summit's multi-pronged plan with the help of a project manager hired with SCLC support. They created a web site that was shown, in the recent survey, to be influential in changing hygienist practice. Of those who visited the web site, 78 percent said they had incorporated cessation information from the site into their practice. And the shortcut approach has spread dramatically. Other clinician groups including family physicians, physician assistants, pharmacists, anesthesiologists, diabetes educators, emergency physicians, nurses, and respiratory therapists have adopted or adapted the intervention, and it is also being used in state tobacco control programs. Significantly, the ADHA board voted March 12, 2007, to fund a continuation of a project consultant. The hygienists can be credited with an enormous contribution to the cessation field.
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