Study Shows a Little Support at the Dentist Office Can Go a Long Way for Smoking Cessation

Mar. 1, 2024

Despite the widely known fact that cigarette smoking and tobacco use can have detrimental effects on oral health, patients revealed in a recent study that while their providers often ask about tobacco use, they are unlikely to provide resources or prescriptions for nicotine replacement therapies.


Published recently in Community Dentistry and Oral Epidemiology, the study explored patient and dental staff attitudes related to educating patients about resources that can help them quit using tobacco products.

This study is part of the National Dental Practice Based Research Network and was conducted to determine the feasibility and acceptability of procedures for a clinical trial that is currently underway, called FreSH (Free Samples for Health).

Counseling and nicotine replacement therapies like patches or lozenges can be very effective in helping patients quit, with studies showing that some of these can double the effectiveness of quit attempts. But resources such as these are under-utilized, with nicotine replacement therapies used by less than 30% of patients attempting to quit smoking, and counseling used by less than 10 percent.


“Dental appointments are a great opportunity for patients to be educated about these available resources and the benefits of quitting tobacco use,” said co-investigator Dorota Kopycka-Kedzierawski, DDS, MPH, professor, Eastman Institute for Oral Health. “This study showed that not only do patients

expect that smoking habits may be discussed at their dental appointments, but they are generally open to discussion, if it is done in a non-judgmental way that avoids fear-based tactics.”

Investigators also learned that some providers are unsure about making recommendations, because they have concerns about side effects and contraindications, anticipate patient resistance and they are generally unsure what to recommend. 

“Their responses highlighted the need for specific strategies that dental staff can incorporate into standard workflows in their dental practices,” Dr. Kopycka-Kedzierawski added. One dentist suggested by having a brief, prepared presentation with referrals and options, it may eliminate providers’ hesitancy to talk to patients about it.

This sort of short protocol is exactly what the researchers plan to do in the FreSH study.

portrait of Dr. Kopycka
Dr. Dorota Kopycka-Kedzierawski, EIOH professor

The first intervention being explored is Ask-Advise-Refer, where patients who use tobacco will be referred to the state quit line for resources. They are also exploring Nicotine Replacement Therapy Sampling, where the patient will be given samples of nicotine patches or lozenges, with no pressure to adhere to a strict treatment plan or even to use them at all.

These ideas were met with enthusiasm by both dentists and patients. Many patients mentioned that they would be more likely to try a product that their doctor or dentist recommended, especially if they were assured it wouldn’t interfere with their current medications. Patients are more comfortable trying products recommended by healthcare providers, rather than just trying something they purchase at the store.

“Efforts such as these could greatly increase use of these resources and ultimately more people quitting permanently,” Dr. Kopycka-Kedzierawski added. In 2018, more than half of adult cigarette smokers reported trying to quit in the past year, according to the Centers for Disease Control website.

As one dentist said during their interview, “I think we have an obligation as practitioners to be able to help educate patients so that if they are not hearing it this time, they are hearing it next time, and then the following time, not as a lecture but just as information.”

Visit FreSH (Free Samples for Health) if you’re interested in becoming a part of this important initiative.

The National Dental PBRN is a community of participating dental professionals and organizations committed to advancing knowledge of dental practices and discovering ways to improve them. Participating dentists investigate research questions and share experiences and expertise with one another to embrace practical science for the benefit of everyone, from dental professionals to patients.


University of Rochester’s Eastman Institute for Oral Health houses one of the six U.S. regional centers and is responsible for research activities in the northeast. Cyril Meyerowitz, DDS, the principal investigator of the Northeast region, leads a team of faculty and research coordinators, developing and implementing studies in the region. Dr. Kopycka-Kedzierawski is assistant node director for the Northeast region.

The Network is a consortium of more than 5,000 U.S. providers representing dental practices and clinics who are devoted to conducting research with practical impact on care, paying special attention to topics where there are gaps in knowledge.