Smoking cessation counseling in primary care settings: Cross-sectional views from patients and dentists as key stakeholders

BACKGROUND: Despite attitudes' central role in shaping health behaviors, little is known about the attitudes of dentists and patients, key stakeholders, toward smoking cessation counselling by dentists (SCCD), particularly within Iran's primary care system. This study provides a side-by-side comparison of SCCD attitudes among these key stakeholder groups and examines their individual-level determinants. MATERIALS AND METHODS: This two-phase cross-sectional study, incorporating both descriptive and analytical elements, recruited dentists from all comprehensive healthcare centers (CHCs) in Tehran province via census (March-June 2019) and patients from three randomly selected CHCs in Tehran city (July-August 2020). Both groups completed questionnaires on SCCD attitudes and individual-level factors, with patient attitudes further analyzed across three dimensions: dentist competence, SCCD effectiveness, and oral symptoms as motivators. Statistical analyses included independent t-tests, multiple logistic regression, and simple and multiple linear regression. RESULTS: Of 380 patients (68.9% response rate), 51.6% were female, with a mean age of 38.8 years (SD = 7.1). Among 180 dentists (93% response rate), 81.6% were female, with a mean age of 34 years (SD = 10.0). Among dentists, non-smokers (B = 5.99, p = 0.005) and those working in Tehran city (B = -3.24, p = 0.024) were more likely to show positive SCCD attitudes. Among patients, non-smokers (OR = 1.52, p = 0.049) and those with a smoking family member (OR = 0.61, p = 0.021) were more likely to deem SCCD effective. Employed patients saw oral symptoms as stronger quitting motivators (OR = 0.46, p = 0.001), and employed smoking patients were more willing to quit using SCCD (OR = 0.43, p = 0.010). CONCLUSIONS: Enhancing SCCD attitudes in Iranian primary care settings may be achieved through mentorship for smoking dentists, virtual or remote education for rural dentists, workplace-based SCCD for employed patients, and engagement in family and community advocacy for non-smoking patients.