Kaiser Permanente Dental Care Program Smokeless Tobacco Cessation Intervention

An Evidence-Based Practice


This smokeless tobacco cessation program was delivered by dental hygienists and dentists during routine dental appointments. The intervention was aimed at male patients aged 15 years and older who reported current use of smokeless tobacco in a questionnaire prior to their routine dental visit.

Patients in the intervention group were given a detailed report of precancerous lesions in their mouth and were advised by the hygienist and dentists to stop using tobacco products. The dental care providers patients that all tobacco products are harmful to their health, and likely related to the presence of precancerous lesions.

Following the dental exam, patients were asked to watch a 9-minute video about the health consequences of smokeless tobacco. Then, the hygienist attempted to get the patient to set a specific quit date, and provided them with a self-help booklet, the phone number for a 24-hour advice line, and a quit kit containing oral substitutes for tobacco.

One week following the dental visit, intervention patients were called by a dental hygienist who reinforced the intervention and provided support for quitting efforts. Patients also received monthly mailings of tip sheets and a newsletter.

Goal / Mission

The goal of this dental office based intervention is to reduce smokeless tobacco use and other tobacco use.

Results / Accomplishments

This intervention was evaluated using a randomized controlled trial. When compared with the usual care control group, a larger porportion of dental patients in the intervention goup reported abstaining from smokeless tobacco at the 3-month follow-up (32.2% vs. 21.3%, p < 0.01) and at the 12-month follow-up (33.5% vs. 24.5%, p < 0.01). The intervention group also had a significantly higher quit rate at both the 3- and 12-month follow-ups than the control group (18.4% vs. 12.5%, p < 0.05). At the 3-month follow-up the intervention group also had significantly higher rates of no tobacco use, including smoking (11.7% vs. 6.9%, p < 0.01).

About this Promising Practice

Primary Contact
Victor J. Stevens, PhD
Kaiser Permanente Center for Health Research
3800 N Kaiser Center Dr.
Portland, OR 97227
(503) 335-2400
Health / Substance Abuse
Health / Oral Health
Health / Cancer
Kaiser Permanente Center for Health Research
American Journal of Public Health
Date of publication
Feb 1995
For more details
Target Audience

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