378 Journal of Dental Education ■ Volume 79, Number 4 Allied Dental Education Tobacco Dependence Education in U.S. Dental Assisting Programs’ Curricula Emily Svetanoff, BS; Laura M. Romito, DDS, MS; Pamela T. Ford, CDA, MSW; Charles J. Palenik, MS, PhD, MBA; Joan M. Davis, RDH, PhD Abstract: The aim of this study was to assess the level of tobacco dependence education (TDE) in the curricula of U.S. dental assisting programs and to compare the indings to those from a similar assessment of dental hygiene curricula. In the 2012-13 academic year, a 51-item survey was sent to directors of all 298 accredited dental assisting programs. Assessed were curricular TDE content, time spent on each topic, expected levels of clinical competence, and resources used. Of the 298 potential partici- pants, 89 programs returned completed surveys, for a response rate of 30%. Of the 13 TDE-related content areas, those most often covered were oral disease related to tobacco use (100%) and general diseases related to tobacco use (93%); those least often covered were stages of (behavior) change (29%), how to develop a comprehensive tobacco intervention program in a private ofice setting (23%), and strategies for community-based tobacco control (22%). Responding program directors indicated the following levels of tobacco cessation intervention at which students should demonstrate competence: brief, 44%; moderate, 55%; intensive, 8%. Less than half of the reporting programs conducted a formal assessment of clinical competence in any TDE-related skills; however, skills in assessing patient tobacco use and associating head and neck indings to tobacco use were formally or informally assessed by 74% and 61%, respectively. Compared to dental hygiene programs, TDE appeared to play a smaller role in the curricula of dental assisting programs, and dental assisting programs were less likely to formally assess clinical competence in TDE. Ms. Svetanoff is a predental student and a graduate of Butler University; Dr. Romito is Associate Professor, Department of Oral Biology, Indiana University School of Dentistry; Prof. Ford is Clinical Assistant Professor and Director of Dental Assisting, Department of Periodontics and Allied Dental Programs, Indiana University School of Dentistry; Dr. Palenik is retired Professor, Indiana University School of Dentistry and currently associated with GC Infection Prevention and Control, Indianapolis, IN; and Dr. Davis is Professor, Dental Hygiene, School of Allied Health, Southern Illinois University Carbondale. Direct correspondence to Dr. Laura M. Romito, Indiana University School of Dentistry, 1121 W. Michigan St., Indianapolis, IN 46202; 317-278-6210; lromitoc@iu.edu. Keywords: tobacco dependence education, smoking cessation, dental assisting, dental assisting education, allied dental education, curriculum Submitted for publication 5/31/14; accepted 8/31/14 T he recently published report titled The Health Consequences of Smoking: 50 Years of Prog- ress, A Report of the Surgeon General reiter- ates the fact that tobacco use remains the nation’s leading preventable cause of morbidity and mortality and highlights a host of new diseases that are causally linked to smoking, including age-related macular de- generation and diabetes mellitus. 1 Moreover, tobacco use can adversely impact oral health by increasing a user’s risk of periodontitis, benign and malignant oral and maxillofacial conditions, tooth loss, and implant failure. 2-5 Tobacco use, in both smokeless and smoked forms, is a signiicant oral health problem; therefore, intervention by dental professionals is warranted. Additionally, with the growing body of evidence to support the link between oral and general health, tobacco dependence treatment by oral health providers reinforces the goals of integrated health promotion and holistic patient care. The U.S. Public Health Service Clinical Practice Guideline Treating Tobacco Use and De- pendence recommends that all health care providers deliver brief tobacco interventions and serves as an evidence-based resource to help clinicians address tobacco use and dependence in their patient popula- tions. 6 The guideline details pharmacological and behavioral approaches to tobacco dependence treat- ment including the “5As” brief intervention: asking patients about tobacco use, advising them to quit, assessing their willingness to quit, assisting in their quit attempt, and arranging for follow-up to evalu- ate progress. The guideline also describes the “5Rs,” which are used with individuals who are not ready to make a quit attempt and consist of the following: dis-