Barriers to Tobacco Cessation Interventions in Dental Settings: A Narrative Review

Abstract

Background Tobacco use remains a significant global public health challenge, contributing to millions of deaths annually and imposing a substantial economic burden. Despite global tobacco control measures, smoking prevalence, particularly in low-and middle-income countries, remains high, with significant oral health implications. Dental professionals are in a unique position to aid in tobacco cessation, yet they face numerous barriers, including inadequate training, time constraints, and systemic challenges. While some of these barriers have been previously identified, there is a lack of comprehensive analysis in the existing literature on the full range of barriers affecting tobacco cessation delivery by oral health professionals. Aim This project aimed to comprehensively review and analyse existing evidence on the barriers impeding the successful delivery of tobacco cessation interventions by dental professionals within dental care settings. Methods A narrative literature review of quantitative and qualitative studies published between 2014 and 2024 on barriers to tobacco cessation was conducted. A literature search was conducted using the three online databases: Medline, Embase, and Emcare, which retrieved 231 studies. Twenty-five studies that matched the eligibility criteria were included for review. Key characteristics and barriers to tobacco cessation reported by each study were extracted and summarized in a narrative synthesis. Results The barriers identified from this research can be broadly classified into three categories based on common themes. Dental professional-related barriers included time constraints and workload, inadequate training, lack of confidence, smoking habits, and perceived role. Patient-related barriers included low motivation, resistance, misconceptions about tobacco use, sociocultural norms, and socioeconomic factors. Systemic barriers were those associated with limited resources, insufficient financial incentives, and a lack of institutional support. Significant regional and cultural differences were observed, with barriers such as sociocultural norms and misconceptions being more pronounced in certain low-and middle-income countries, where cultural stigma and economic challenges significantly influenced patient attitudes and dental professionals' engagement in cessation interventions. Conclusion Tobacco cessation interventions in the dental setting are strongly influenced by multifaceted barriers that dental professionals face. The findings underscore the need for a comprehensive, culturally sensitive approach that includes targeted interventions, robust training, policy reforms, and the promotion of healthy behaviours among dental professionals. Addressing these challenges can empower the dental profession to take a more proactive role in tobacco cessation, ultimately enhancing public health outcomes.