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. 1996 Dec;86(12):1760–1766. doi: 10.2105/ajph.86.12.1760

An adolescent tobacco-use prevention trial in orthodontic offices.

M F Hovell 1, D J Slymen 1, J A Jones 1, C R Hofstetter 1, S Burkham-Kreitner 1, T L Conway 1, B Rubin 1, D Noel 1
PMCID: PMC1380730  PMID: 9003134

Abstract

OBJECTIVES: This study examined the effect of an orthodontist-delivered tobacco-use prevention program for adolescents. METHODS: Southern California orthodontic offices were randomly assigned to experimental (n = 77) and control (n = 77) groups. Randomly selected adolescents were interviewed at baseline and 2 years later (n = 15,644). Experimental offices received tobacco prevention training, anti-tobacco materials, and 50 cents for each anti-tobacco "prescription" written. RESULTS: The 30-day tobacco use 2-year incidence rates for the control and experimental groups were 12.6% and 12.0%, respectively; incidence rates for using tobacco more than 100 times were 7.6% and 6.8%. Differences between the groups did not reach significance. Mean prescription compliance was 64.4%. A multivariate logistic model, showed a significant dose response: patients who received more prescriptions had lower incidence rates than those who received few or none (10% vs 14%). CONCLUSIONS: Training, payment, and support did not ensure clinician compliance with prevention services. The dose effect suggests that replication under conditions that would ensure clinician compliance and statistical power would more thoroughly test clinicians' ability to prevent tobacco use.

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Selected References

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  1. Becker M. H., Janz N. K. Practicing health promotion: the doctor's dilemma. Ann Intern Med. 1990 Sep 15;113(6):419–422. doi: 10.7326/0003-4819-113-6-419. [DOI] [PubMed] [Google Scholar]
  2. Best J. A., Thomson S. J., Santi S. M., Smith E. A., Brown K. S. Preventing cigarette smoking among school children. Annu Rev Public Health. 1988;9:161–201. doi: 10.1146/annurev.pu.09.050188.001113. [DOI] [PubMed] [Google Scholar]
  3. Cleary P. D., Hitchcock J. L., Semmer N., Flinchbaugh L. J., Pinney J. M. Adolescent smoking: research and health policy. Milbank Q. 1988;66(1):137–171. [PubMed] [Google Scholar]
  4. Community Intervention Trial for Smoking Cessation (COMMIT): I. cohort results from a four-year community intervention. Am J Public Health. 1995 Feb;85(2):183–192. doi: 10.2105/ajph.85.2.183. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Donner A., Birkett N., Buck C. Randomization by cluster. Sample size requirements and analysis. Am J Epidemiol. 1981 Dec;114(6):906–914. doi: 10.1093/oxfordjournals.aje.a113261. [DOI] [PubMed] [Google Scholar]
  6. Elder J. P., Wildey M., de Moor C., Sallis J. F., Jr, Eckhardt L., Edwards C., Erickson A., Golbeck A., Hovell M., Johnston D. The long-term prevention of tobacco use among junior high school students: classroom and telephone interventions. Am J Public Health. 1993 Sep;83(9):1239–1244. doi: 10.2105/ajph.83.9.1239. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Epps R. P., Manley M. W. The clinician's role in preventing smoking initiation. Med Clin North Am. 1992 Mar;76(2):439–449. doi: 10.1016/s0025-7125(16)30361-3. [DOI] [PubMed] [Google Scholar]
  8. Fiore M. C., Pierce J. P., Remington P. L., Fiore B. J. Cigarette smoking: the clinician's role in cessation, prevention, and public health. Dis Mon. 1990 Apr;36(4):181–242. doi: 10.1016/0011-5029(90)90007-e. [DOI] [PubMed] [Google Scholar]
  9. Glynn T. J., Manley M. W., Pechacek T. F. Physician-initiated smoking cessation program: the National Cancer Institute trials. Prog Clin Biol Res. 1990;339:11–25. [PubMed] [Google Scholar]
  10. Hatziandreu E. J., Pierce J. P., Lefkopoulou M., Fiore M. C., Mills S. L., Novotny T. E., Giovino G. A., Davis R. M. Quitting smoking in the United States in 1986. J Natl Cancer Inst. 1990 Sep 5;82(17):1402–1406. doi: 10.1093/jnci/82.17.1402. [DOI] [PubMed] [Google Scholar]
  11. Hovell M. F., Black D. R. Minimal intervention and arthritis treatment: implications for patient and physician compliance. Arthritis Care Res. 1989 Sep;2(3):S65–S70. doi: 10.1002/anr.1790020316. [DOI] [PubMed] [Google Scholar]
  12. Hovell M. F., Russos S., Beckhelm M. K., Jones J. A., Burkham-Kreitner S. M., Slymen D. J., Hofstetter C. R., Rubin B. Compliance with primary prevention in private practice: creating a tobacco-free environment. Am J Prev Med. 1995 Sep-Oct;11(5):288–293. [PubMed] [Google Scholar]
  13. Hovell M. F., Slymen D. J., Keating K. J., Jones J. A., Burkham-Kreitner S., Hofstetter C. R., Noel D., Rubin B. Tobacco use prevalence and correlates among adolescents in a clinician initiated tobacco prevention trial in California, USA. J Epidemiol Community Health. 1996 Jun;50(3):340–346. doi: 10.1136/jech.50.3.340. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Kottke T. E., Battista R. N., DeFriese G. H., Brekke M. L. Attributes of successful smoking cessation interventions in medical practice. A meta-analysis of 39 controlled trials. JAMA. 1988 May 20;259(19):2883–2889. doi: 10.1001/jama.259.19.2883. [DOI] [PubMed] [Google Scholar]
  15. Luepker R. V., Murray D. M., Jacobs D. R., Jr, Mittelmark M. B., Bracht N., Carlaw R., Crow R., Elmer P., Finnegan J., Folsom A. R. Community education for cardiovascular disease prevention: risk factor changes in the Minnesota Heart Health Program. Am J Public Health. 1994 Sep;84(9):1383–1393. doi: 10.2105/ajph.84.9.1383. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Mittelmark M. B., Luepker R. V., Jacobs D. R., Bracht N. F., Carlaw R. W., Crow R. S., Finnegan J., Grimm R. H., Jeffery R. W., Kline F. G. Community-wide prevention of cardiovascular disease: education strategies of the Minnesota Heart Health Program. Prev Med. 1986 Jan;15(1):1–17. doi: 10.1016/0091-7435(86)90031-9. [DOI] [PubMed] [Google Scholar]
  17. O'Malley P. M., Johnston L. D., Bachman J. G. Adolescent substance use. Epidemiology and implications for public policy. Pediatr Clin North Am. 1995 Apr;42(2):241–260. doi: 10.1016/s0031-3955(16)38945-3. [DOI] [PubMed] [Google Scholar]
  18. Pierce J. P., Fiore M. C., Novotny T. E., Hatziandreu E. J., Davis R. M. Trends in cigarette smoking in the United States. Projections to the year 2000. JAMA. 1989 Jan 6;261(1):61–65. [PubMed] [Google Scholar]
  19. Russell M. A., Wilson C., Taylor C., Baker C. D. Effect of general practitioners' advice against smoking. Br Med J. 1979 Jul 28;2(6184):231–235. doi: 10.1136/bmj.2.6184.231. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Stevens V. J., Severson H., Lichtenstein E., Little S. J., Leben J. Making the most of a teachable moment: a smokeless-tobacco cessation intervention in the dental office. Am J Public Health. 1995 Feb;85(2):231–235. doi: 10.2105/ajph.85.2.231. [DOI] [PMC free article] [PubMed] [Google Scholar]

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