Evaluation of a brief counseling for tobacco cessation in dental clinics among Swedish smokers and snus users. A cluster randomized controlled trial (the FRITT study)

- We conducted a cluster randomized trial in dentistry clinics.
- A brief counseling for tobacco cessation was compared to usual advice.
- The novel counseling was significantly associated with 50% reduction in tobacco use.
- Complete abstinence and quit attempts were positively, but not significantly affected.
- Users of smokeless tobacco appeared to respond to the counseling better than smokers.

ObjectiveThe aim of this study is to assess the effectiveness of a very brief structured counseling for tobacco cessation in dentistry clinics.MethodA cluster randomized trial was conducted in Sweden in 2012-2013.Twenty-seven dentistry clinics in two Swedish counties were randomized to provide either a structured brief advice based on the 5 A's model or usual care. Participants were 467 patients currently using tobacco daily (225 in the intervention group and 242 in usual care), of which 97% were retained at follow-up, six months after enrolment. Study outcomes were: 7-day abstinence (primary outcome); 3-month sustained abstinence; 50% reduction of the amount tobacco used; quit attempts lasting at least 24 h.ResultsCompared to usual care, brief counseling was not associated to statistically significant increase in the proportion abstinent from tobacco use after 6 months. However, there was a statistically significant association with reduction of tobacco consumption (OR = 2.07 95% CI 1.28-3.35). Changes in the expected direction for all outcomes were more frequent in the intervention than in the usual care group, and larger among exclusive snus users than among smokers.ConclusionsVery brief and structured counseling in dentistry may achieve positive behavioral modifications among tobacco users, with significant reduction of tobacco consumption, particularly among smokeless tobacco users.