Impact of educational intervention on implementation of tobacco counselling among oral health professionals: a cluster-randomized community trial

Objectives Tobacco use adversely affects oral health. Clinical guidelines recommend that oral health professionals promote tobacco abstinence and provide patients who use tobacco with brief tobacco use cessation counselling. Research shows that these guidelines are seldom implemented successfully. This study aimed to evaluate two interventions to enhance tobacco use prevention and cessation (TUPAC) counselling among oral health professionals in Finland. Methods We used a cluster‐randomized community trial to test educational and fee‐for‐service interventions in enhancing TUPAC counselling among a sample of dentists (n = 73) and dental hygienists (n = 22) in Finland. Educational intervention consisted of 1 day of training, including lectures, interactive sessions, multimedia demonstrations and a role play session with standard patient cases. Fee‐for‐service intervention consisted of monetary compensation for providing tobacco use prevention or cessation counselling. TUPAC counselling procedures provided were reported and measured using an electronic dental records system. In data analysis, intent‐to‐treat principles were followed at both individual and cluster levels. Descriptive analysis included chi‐square and t‐tests. A general linear model for repeated measures was used to compare the outcome measures by intervention group. Results Of 95 providers, 73 participated (76.8%). In preventive counselling, there was no statistically significant time effect or group‐by‐time interaction. In cessation counselling, statistically significant group‐by‐time interaction was found after a 6‐month follow‐up (F = 2.31; P = 0.007), indicating that counselling activity increased significantly in intervention groups. On average, dental hygienists showed greater activity in tobacco prevention (F = 12.13; P = 0.001) and cessation counselling (F = 30.19; P