***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Smoking exerts detrimental effects on dental treatment and oral health . Our goal was to evaluate effectiveness in terms of the abstinence rate in  smoking-cessation intervention delivered by dental professionals . Individuals who were willing to quit smoking were r and omly assigned to either an intervention or a non-intervention group . Intensive intervention was provided , consisting of 5 counseling sessions , including an additional nicotine replacement regimen . Reported abstinence was verified by the salivary cotinine level .  Thirty-three persons in the intervention and 23 in the non-intervention group started the trial . On an intent-to-treat basis , 3- , 6- and 12-month continuous abstinence rates in the intervention group were 51.5 % , 39.4 % , and 36.4 % , respectively , while the rates in the non-intervention group were consistent at 13.0 % . Adjusted odds ratios ( 95 % confidence interval ) by logistic stepwise regression analyses were 7.1 ( 1.8 , 28.5 ) , 8.9 ( 1.7 , 47.2 ) , and 6.4 ( 1.3 , 30.7 ) , respectively .  Intensive smoking-cessation intervention in the dental setting was therefore effective Background Tobacco use continues to be a global public health problem . Helping patients to quit is part of the preventive role of all health professionals . There is now increasing interest in the role that the dental team can play in helping their patients to quit smoking . The aim of this study was to determine the feasibility of undertaking a r and omised controlled smoking cessation intervention , utilising dental hygienists to deliver tobacco cessation advice to a cohort of periodontal patients . Methods One hundred and eighteen patients who attended consultant clinics in an outpatient dental hospital department ( Periodontology ) were recruited into a trial . Data were available for 116 participants , 59 intervention and 57 control , and were analysed on an intention-to-treat basis . The intervention group received smoking cessation advice based on the 5As ( ask , advise , assess , assist , arrange follow-up ) and were offered nicotine replacement therapy ( NRT ) , whereas the control group received ' usual care ' . Outcome measures included self-reported smoking cessation , verified by salivary cotinine measurement and CO measurements . Self-reported measures in those trial participants who did not quit included number and length of quit attempts and reduction in smoking . Results At 3 months , 9/59 ( 15 % ) of the intervention group had quit compared to 5/57 ( 9 % ) of the controls . At 6 months , 6/59 ( 10 % ) of the intervention group quit compared to 3/57 ( 5 % ) of the controls . At one year , there were 4/59 ( 7 % ) intervention quitters , compared to 2/59 ( 4 % ) control quitters . In participants who described themselves as smokers , at 3 and 6 months , a statistically higher percentage of intervention participants reported that they had had a quit attempt of at least one week in the preceding 3 months ( 37 % and 47 % , for the intervention group respectively , compared with 18 % and 16 % for the control group ) . Conclusion This study has shown the potential that trained dental hygienists could have in delivering smoking cessation advice . While success may be modest , public health gain would indicate that the dental team should participate in this activity . However , to add to the knowledge-base , a multi-centred r and omised controlled trial , utilising biochemical verification would be required to be undertaken Background The dental visit is a unique opportunity for tobacco control . Despite evidence of effectiveness in dental setting s , brief provider-delivered cessation advice is underutilized . Objective To evaluate an Internet-delivered intervention design ed to increase implementation of brief provider advice for tobacco cessation in dental practice setting s. Methods Dental practice s ( N = 190 ) were r and omized to the intervention website or wait-list control .  Pre-intervention and after 8 months of follow-up , each practice distributed exit cards ( brief patient surveys assessing provider performance , completed immediately after the dental visit ) to 100 patients . Based on these exit cards , we assessed : whether patients were asked about tobacco use ( ASK ) and , among tobacco users , whether they were advised to quit tobacco ( ADVISE ) . All intervention practice s with follow-up exit card data were analyzed as r and omized regardless of whether they participated in the Internet-delivered intervention . Results Of the 190 practice s r and omized , 143 ( 75 % ) dental practice s provided follow-up data . Intervention practice s ’ mean performance improved post-intervention by 4 % on ASK ( 29 % baseline , adjusted odds ratio = 1.29 [ 95 % CI 1.17 - 1.42 ] ) , and by 11 % on ADVISE ( 44 % baseline , OR = 1.55 [ 95 % CI 1.28 - 1.87 ] ) . Control practice s improved by 3 % on ASK ( Adj . OR 1.18 [ 95 % CI 1.07 - 1.29 ] ) and did not significantly improve in ADVISE . A significant group-by-time interaction effect indicated that intervention practice s improved more over the study period than control practice s for ADVISE ( P = 0.042 ) but not for ASK . Conclusion This low-intensity , easily disseminated intervention was successful in improving provider performance on advice to quit . Trial Registration clinical trials.gov NCT00627185 ; http:// clinical trials.gov/ct2/show/NCT00627185 ( Archived by WebCite at http://www.webcitation.org/5c5Kugvzj BACKGROUND Community dental clinics are good setting s for smoking intervention . The aim here was to put forward a strategy for preventing  adolescent smoking  by means of a brief intervention . METHODS A total of 2,586 12-year-olds participated in this follow-up study . They were asked upon arrival for their annual routine dental examination to complete a smoking question naire and were r and omly assigned to either the intervention group or the usual care control group according to the last digit of their date of birth ( odd or even ) . The intervention comprised annually inquiring about smoking , showing photographs of the harmful effects of  smoking on the teeth , allowing participants to examine their own mouth with a mirror , and finally counselling them in accordance with their answer to the question on smoking habits . The smoking status reported was not verified by other means . RESULTS The prevalence of smoking at the end of the 2-year follow-up was 18.1 % , in the intervention group and 20.8 % among the controls . However , no statistically significant differences between groups were found . CONCLUSIONS These results reflect the difficulties of achieving successful results with long-term smoking cessation programs with adolescents in unstable conditions To examine the effectiveness of advising patients who use tobacco to quit , the authors conducted a r and omized clinical trial to test a brief office-based intervention with all tobacco users in 75 fee-for-service dental practice s in Oregon . The authors found that the dental hygienist-delivered intervention was effective in getting smokeless tobacco users to quit at three and 12 months and to sustain abstinence at both three and 12 months . They found that the program was not effective for cigarette smokers . The authors discuss the public health implication s of program dissemination and widespread program adoption Ninety-eight cigarette smokers attending the Newcastle upon Tyne Dental Hospital , wishing to reduce their tobacco consumption , received smoking reduction advice in combination with dental health instruction and periodontal care . Those advised against smoking showed a greater reduction ( P < 0.001 ) in reported cigarette consumption during treatment and follow-up , compared with 38 control subjects who received  dental health instruction but no advice against smoking . Fifty percent of intervention subjects reported reducing to half or less than half of their initial cigarette consumption , compared with 24 % for controls . Eighty percent of those advised against smoking reported some reduction , against 29 % for controls . The reported smoking cessation rate in the intervention group was 13.3 % , compared with 5.3 % in the control subjects . The results indicate that advice against smoking combined with dental health instruction and periodontal care can be an effective aid to reducing tobacco We describe a r and omized trial design ed to evaluate the effectiveness of a smokeless tobacco cessation intervention delivered by dental hygienists as part of a patient 's regularly scheduled cleaning visit . Seventy-five practice s were r and omized to continue their usual care ( n=25 ; 239 smokeless tobacco using patients enrolled ) or to receive training to provide a tobacco cessation intervention ( n=50 ; 394 smokeless tobacco using patients enrolled ) . Patient reports indicated that the training program was successful in getting hygienists to implement the intervention . The intervention produced a strong effect on sustained quitting for smokeless tobacco users but had no impact on secondary outcomes , including unsuccessful quit attempts , future intent to quit using smokeless tobacco , and change in readiness to quit using . Frequency of smokeless tobacco use and receipt of specific components of the intervention , including the video and written material s , predicted sustained cessation . Since this intervention was delivered by dental hygienists as part of a patient 's regularly scheduled cleaning visit , it is easily disseminable Cigarette smoking is a major risk factor for head and neck cancer , and individuals who continue to smoke past diagnosis and treatment are at elevated risk for further disease . In a r and omized controlled trial , a state of the art provider-delivered smoking cessation intervention was compared to a usual care advice control condition . The intervention consisted of surgeon- or dentist-delivered advice to stop smoking , a contracted quit date , tailored written material s , and booster advice sessions .  Subjects were 186 patients with newly diagnosed first primary squamous cell carcinomas of the upper aerodigestive tract who had smoked cigarettes within the past year . At r and omization , 88.2 % of subjects were current smokers . At 12-month follow-up , 70.2 % of subjects completing the trial ( n = 114 ) were continuous abstainers ; among baseline smokers alone the continuous abstinence ( CA ) rate was 64.6 % . The cotinine validation rate at 12 months was 89.6 % . Modeling techniques were utilized in order to derive expected CA rates , which included noncompleter subjects ( n = 72 ) . The CA rate expected at 1 year for the entire patient population was 64.2 % , and for smokers alone the expected CA rate was 59.4 % . Logistic regression analysis carried out on baseline smokers identified predictors of 12-month CA status . These included medical treatment , stage of change , age , nicotine dependence , and race . The intervention effect was not significant , although the sign of the effect was positive . Based on these findings , we recommend systematic brief advice to stop smoking for head and neck cancer patients , with a stepped care approach for patients less able to quit Biochemical validation of smoking status has long been considered essential , but recent reports have question ed its utility in certain kinds of field trials . We describe efforts to biochemically vali date self-reports of smoking cessation from participants in four large-scale r and omized trials in outpatient clinics , hospitals , worksites , and dental clinics . These studies included over 5,000 adults smokers who participated in the population -based low-intensity intervention evaluations . At a 1-year follow-up , 798 subjects reported no tobacco use . We attempted to verify these reports using saliva continine/carbon monoxide validation procedures . Overall , there was a moderately high nonparticipation rate ( 27 % ) , a low disconfirmation rate ( 4 % ) , and a high self-reported relapse rate ( 12 % ) in the interval between survey and biochemical validation . There were no differences between intervention and control conditions on any of the above variables . Longer duration s of self-reported abstinence were strongly related to increased probability of biochemical confirmation . Differences in results across projects were related to how biochemical validation was conducted . These results , as well as statistical power considerations , raise questions about whether biochemical validation procedures are practical , informative , or cost-effective in such population -based , low-intensity intervention research A sample of private orthodontic practice s ( n = 40 ) from a controlled trial for clinician-initiated tobacco-use prevention was used to test the effectiveness of preventive medicine representative ( PMR ) visits in creating and maintaining an anti-tobacco office environment . Clinical staff of 20 offices , r and omly assigned to the experimental group , were trained by a PMR on the use of anti-tobacco material s ( no-smoking signs , posters , and print material s ) . Twenty control-group offices did not receive any training or special treatment . Subsequently , experimental-group offices were visited by a PMR once every three months and were telephoned six weeks after each visit over a 12-month period . During visits and phone calls , PMRs prompted offices to order anti-tobacco material s. Visits served to introduce offices to new material s and to encourage their continued use . Data from direct observations and self-report measures showed significant differences between experimental and control offices for display of anti-tobacco material s at 1.5 months and 12 months ( P < .001 ) . Results suggest that PMR visits may serve as an effective method of introducing and maintaining preventive medicine procedures in clinical environments SMILES PLUS was the first study to extend the clinician-delivered logic model to prevention of tobacco use among adolescents . This multi-site trial with 154 participating offices , based on social learning theory and a behavioral ecological model , was design ed 
    Output:
    
Available evidence suggests that behavioral interventions for tobacco cessation conducted by oral health professionals incorporating an oral examination component in the dental office or community setting may increase tobacco abstinence rates among both cigarette smokers and smokeless tobacco users .
Differences between the studies limit the ability to make conclusive recommendations regarding the intervention components that should be incorporated into clinical practice , however , behavioral counselling ( typically brief ) in conjunction with an oral examination was a consistent intervention component that was also provided in some control groups