Ask, Advise & Assist A Program of Tobacco Cessation through Dental Offices Presented by Ellen Murphy, Director of Prevention & Lyle Walton, Tobacco Project and Policy Developer Alberta Cancer Board

Brief, simple help by the dental team can double to triple patient self-help, long- term quit rates. R. Mecklenberg, 2000

The Context Alberta Cancer Board Vision: Vision: excellence in cancer control Mission: Mission: to reduce the burden of cancer through prevention, screening, diagnosis, treatment, palliation, education and research.

Alberta Population: 2,750,000 Size: 661,137 sq. km (255,285 sq. mi.)

The Background Research  Men and adolescents are under- represented in family physician practices.  60% of adults see a dentist yearly.  58% of smokers see a dentist regularly.  18% cessation rates have been seen.

The Background Research Views on whether cessation services should be offered/are expected in dental offices

The Background Research Because of regular interactions with patients, it is believed that dental professionals have a unique opportunity to affect tobacco cessation among patients. R. W. Elford, M. Yeo, P.A. Jennett, 1994 H. S. Campbell, J. M. Macdonald, 1994

The Program - Overview 1. Ask 1. Ask – “Do you use tobacco? Have you thought about quitting?” 2. Advise 2. Advise – “There are many reasons to quit – including improving your oral health.” 3. Assist 3. Assist – “We can refer you to cessation programs.” This will take no more than 5 minutes.

The Program Budget Budget - $180,000 (or $120,000 US) Duration Duration - 18 monthsGoals: 1.to encourage all dental offices in Alberta to participate in a tobacco cessation program. 2.to make it easy for enrolled dental offices to provide tobacco cessation services. 3.to create a sustainable system of delivery.

The Partnership Alberta Cancer Board (ACB) Alberta Dental Association & College (ADA&C) Alberta Dental Hygienists’ Association (ADHA) Alberta Health Regions (RHAs) Alberta Alcohol and Drug Abuse Commission (AADAC)

The Marketing Plan Invitation package mailed out to all dentists and dental hygienists in Alberta: cover letter overview program poster AADAC Smoker's Help Line referral cards (5) baseline survey faxback registration/order form

The Response 97 dental offices registered inside of two months approximately 8% of all offices in the province 300 surveys - 10% of mailing

The Baseline Survey - Ask, Advise & Assist

The Baseline Survey - Barriers to Providing Assistance

The Follow-up Survey Purpose was to determine: 1. Whether dental offices are referring patients to cessation services. 2. If the program was meeting expectations. 3. If referrals are having an impact.

The Follow-up Survey - Responses  65% indicated A,A & A was meeting their expectations Further needs: - resources on how to discuss the issue with patients - literature on tobacco - resources for their patients

Second Marketing Phase  Participant packages to thank those enrolled and provide new materials  Recruitment packages addressing barriers and providing incentives  Hygienist packages encouraged working with dentists to implement program

Second Recruitment Follow-up Contact  In rural and smaller centres AADAC Tobacco Reduction Counselors phone all local dental offices  In major centres callers contracted to phone non-participants

The Recommendations - gather existing information - collaborate with the appropriate professional associations, and use their advice - emphasize the benefits - keep it simple - provide support materials quickly - create linkages to cessation services - be persistent

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