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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Smoking in the Household.

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Strategy. Oral Health Care Services (Household)

Approach. Integrate comprehensive tobacco cessation programs into routine oral health clinical practice

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Overview. A comprehensive tobacco cessation program integrated into routine oral health practice provides tailored behavioral counseling, pharmacotherapy (such as Nicotine Replacement Therapy (NRT) and structured, long-term follow-up to adult smokers, including those who reside in households with children. Oral health professionals are uniquely positioned to deliver these interventions due to their regular and ongoing contact with patients, offering a "teachable moment" to link tobacco use directly to observable oral health consequences like periodontal disease and oral cancer. (1,2)

Evidence. Emerging Evidence. Strategies based on emerging evidence show promise but have not undergone extensive testing. While these approaches demonstrate potential, their effectiveness remains unconfirmed. Prioritize rigorous monitoring to ensure they achieve desired outcomes for all MCH populations.

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).
  • Morbidity Reduction. This strategy addresses factors that can decrease the incidence or prevalence of diseases and illnesses.
  • Patient Experience of Care. This study improves individuals' perceptions, feelings, and satisfaction with the healthcare services they receive.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Counseling (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Individual/Family-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of oral health clinics or practices that adopt the comprehensive tobacco cessation protocol, including screening, counseling, and referral pathways. (Measures the adoption and spread of the strategy)
  • Number of oral health professionals (dentists, hygienists, assistants) trained in delivering motivational interviewing and brief tobacco cessation counseling techniques. (Assesses the workforce capacity and readiness for the strategy)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of eligible adult patients screened for tobacco use status during routine preventative or treatment dental visits. (Measures adherence to universal screening standards)
  • Percent of identified tobacco users who receive comprehensive counseling and are offered evidence-based pharmacotherapy or nicotine replacement options. (Measures fidelity to the structured intervention model)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of adult smokers who achieve continuous tobacco abstinence confirmed at 6 months post-intervention. (Measures population-level impact on cessation)
  • Number of partnerships established between dental clinics and state quit lines or behavioral health specialists for referral and co-management of high-dependency users. (Measures the integration of services across the continuum of care)
  • Number of cessation participants who report high levels of satisfaction with the support, counseling, and follow-up provided by the dental team. (Measures positive patient perception of the intervention effectiveness)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of participants who successfully maintain tobacco abstinence 12 months after their designated quit date. (Measures long-term sustainability of behavior change)
  • Percent of participants who achieve harm reduction (defined as a 50% or greater decrease in daily tobacco use) at 12 months post-intervention. (Measures intermediate success for those not achieving full abstinence)
  • Percent of trained dental professionals who report feeling confident and effective in assessing tobacco dependence and delivering evidence-based cessation support. (Assesses positive provider workforce outcomes related to successful implementation)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] Benjamin N, Choubey V, Bhasin M, Sushma B, Choudhary A, Thomas PA. Analysis of tobacco cessation programs in dental settings. J Pharm Bioall Sci 2024;16:S3290-2.
[2] Tomar SL. Dentistry’s role in tobacco control. J Am Dent Assoc 2001;132:30S 5S.
[3] Tvina, A., Tillis, B., Chen, M., MacBeth, M., Tsaih, S. W., & Palatnik, A. (2024). Effect of a best-practice alert on the rate of smoking cessation among pregnant women. American Journal of Perinatology, 41(S 01), e1901–e1907. https://doi.org/10.1055/a-2091-5643

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.