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In recent years, the stage has been set for all oral health professionals to become actively involved as facilitators and leaders in tobacco education and control efforts. One goal of Healthy People 2020 is to increase the proportion of adults who received information from a dentist or dental hygienist focusing on reducing tobacco use or on smoking cessation.

In this millennium, we expect an ever-increasing number of dentists, dental hygienists, and dental assistants to participate in clinical and community interventions that focus on both tobacco prevention and cessation strategies. Although upwards of 90% of dental providers have reported that they routinely ask patients about tobacco use, only 50-76% counsel patients, and less than half routinely offer cessation assistance such as self-help materials, referral to cessation counseling or providing a prescription for pharmacotherapy. Many lack confidence in providing cessation advice. The fact is, helping dental patients to quit using tobacco can be practically accomplished in clinical settings by oral health care professionals. Twenty years of accumulated evidence has shown the efficacy of this approach. Oral health care providers are able to offer this service with few interruptions in their daily routine. Additionally, many patients who are helped respond with gratitude and loyalty.

Oral health care professionals and other health care workers, have an ethical obligation to inform patients about the hazards of tobacco use and to encourage tobacco users to stop. Additionally, the dental team needs to praise and support those patients (especially impressionable young people who have never used tobacco). Currently, 16.8% of U.S. adults aged 18 and above are smokers and nearly 4% are smokeless tobacco users. About 480,000 tobacco-related premature deaths occur each year in the United States.11 However, nearly 70% of adult smokers desire to quit and U.S. adult smoking rate has decreased substantially from its peak of nearly 45% in the mid-1960s. Nonetheless, approximately 40 million adults continue to smoke and oral health professionals can be effective in motivating and assisting these individuals to quit tobacco.

The purpose of this course is to alert dental professionals to the harmful effects of tobacco, both to the oral cavity and to the body. The course is also designed to teach professionals specific skills that they may utilize to help tobacco users become free of their addiction. A significant amount of the course material applies to both smoked and smokeless tobacco; however, additional information on smokeless tobacco is presented in the ADAA continuing educational course, “Understanding the Dangers and Health Consequences of Spit Tobacco Use.” 


The authors serve on the faculty of Indiana University Schools of Dentistry and Medicine, Indianapolis, and University of Southern Indiana, Evansville, IN.

Laura M. Romito, DDS, MS: Associate Professor, Department of Biomedical and Applied Sciences. Director, Indiana University Nicotine Dependence Program.

Arden G. Christen, DDS, MSD, MA: Professor Emeritus, Department of Biomedical and Applied Sciences, Director, Indiana University Nicotine Dependence Program at Fairbanks Addictions Hospital, Indianapolis.

Lorinda Coan, RDH, MS: Assistant Professor, College of Nursing and Health Professions, Dental Hygiene Program, University of Southern Indiana.

Stephen J. Jay, MD: Emeritus Professor of Medicine and Public Health, Indiana University School of Medicine and Richard M. Fairbanks School of Public Health.

2016 Revision – the course was reviewed by Laura Romito, DDS, MS, Associate Professor, Associate Director for Faculty Development and Leadership, IU Center for Interprofessional Health Education & Practice, Director, Nicotine Dependence Program, Department of Biomedical and Applied Sciences, Indiana University School of Dentistry


Upon completion of this course, the dental professional should be able to:

• Summarize the harmful effects of tobacco on the body and oral health.
• Explain the addictive nature of nicotine.
• Discuss the psychological and sociocultural aspects of tobacco use.
• List the steps which can be initiated to create a smoke-free dental practice.
• Describe the dental professional’s role in a dental office smoking cessation program.
• Identify the cycle of change and its relationship to smoking behaviors.
• Demonstrate the supportive role oral healthcare professionals can have in helping patients to become tobacco-free.


The ADAA has an obligation to disseminate knowledge in the field of dentistry.  Sponsorship of a continuing education program by the ADAA does not necessarily imply endorsement of a particular philosophy, product or technique.

The ADAA cautions participants taking this course on the hazards of using limited knowledge when integrating new techniques into their practices.

Credits earned upon completion of the course may be used to meet DANB’s Recertification Requirements.


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