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New Study Connects Smoke-Free Laws, Dentists’ Advice to Quit

February 13, 2014

Smoke-free laws may help encourage dentists to recommend that their patients kick the smoking habit, according to new research co-authored by UC Merced Professor Mariaelena Gonzalez.

The paper, published in the American Journal of Public Health, suggests the societal change manifested by smoke-free laws can contribute to an atmosphere in which dentists pay more attention to patients’ smoking habits.

“Smoke-free laws can have strong effects – and not just on stopping individual-level behavior,” said Gonzalez, whose research focuses on tobacco control. “These laws can influence other behavior and attitudes, as our study shows with dentists. They can have a huge effect on people’s preferences, such as a preference for clean indoor air. Even smokers like clean indoor air.”

Gonzalez co-authored the study “Association of Strong Smoke-Free Laws with Dentists’ Advice to Quit Smoking, 2006-2007,” with Stanton A. Glantz, a professor of medicine at UCSF, and Ashley Sanders-Jackson, a post-doctoral fellow at Stanford University. All three have been associated with the UCSF-based Center for Tobacco Control Research and Education, where Glantz is the director.

For the study, the team linked data from the national 2006-2007 Tobacco Use Supplement to the Current Population Survey with the American Nonsmokers’ Rights Foundation’s Local Ordinance Database of smoke-free laws. Researchers looked at the effect of 100 percent smoke-free laws or laws prohibiting smoking in private workplaces, restaurants and bars, and whether dentists implemented the 2A’s + R (ask, advise, refer to a quit line) model of intervention with smokers who were examined in the past year.

The study examined the responses of smokers in larger counties, where information about smoke-free laws was available. Of that group, about 48 percent said they had visited the dentist within the past 12 months and 35 percent of those said they were advised to quit smoking. Only 16 percent of those given that advice also were referred to a quit line.

Interventions are needed with dentists to increase patient referrals to quit-smoking telephone coaching lines or other cessation programs, the study concludes.

“This work shows one more way in which smoke-free laws change social norms, in this case motivating dentists to ask their patients about smoking,” Glantz said. “The professionals still need to move to the next step and actually help their smoking patients quit.”

“That dentists are advising patients to stop smoking is a step forward,” Gonzalez said, noting that smoking can cause oral disease and other problems.

Gonzalez said even people who have smoked for many years can realize health benefits by stopping.

“It’s never too late to quit smoking,” she said.

In California, smoking is on the decline. Rates have fallen due to strong state tobacco-control policies such as banning smoking in restaurants, bars and inside public buildings.

Gonzalez, who holds a Ph.D. in sociology from Stanford University, joined the UC Merced faculty last fall after completing post-doctoral work at the Center for Tobacco Control Research and Education. She earned a master’s in religions of the world from Harvard University and bachelor’s degrees in mathematics and religious studies from Santa Clara University.

UC Merced is a kind of homecoming for Gonzalez, who graduated from Bret Harte High School in Angels Camp. Once the opening of the UC Merced was announced, she immediately thought about working at the system’s 10th and newest campus.

“UC Merced is a really good thing for the region,” Gonzalez said. “I wanted to be part of that.”

Gonzalez teaches classes in public health on campus and is a member of the Health Sciences Research Institute. Much of her research is focused on tobacco control and the effects of the environment on behavior. Both undergraduate and graduate students are involved in various aspects of her research.

Using newer and more detailed data, Gonzalez now is working on a follow-up to the recently released study. She believes the new research should offer additional insight into dentists’ treatment of patients who smoke.