Table 1

Questions asked in interviews with participants, based on Public Health Service (PHS) guideline and other factors

Interview Questions
[PHS Guideline Strategy 1] Let me start by asking about strategies for identifying patients who are tobacco users.
 1. Talk to me about any strategies the dental practice uses for identifying patients who use tobacco products.
  [Check off if you covered the following. Otherwise probe.]
  [1.1: Vital signs include tobacco use?]
  [1.2: Designated person who takes tobacco use vital sign?]
  [1.2a: Nonsmoking role models who are aware of importance of question?]
  [If necessary, probe:]
   a. Walk us through how a new patient would come to be flagged as using tobacco.
   b. Some dental practices record tobacco use as a “vital sign.” Tell me about any similar process used at your dental practice.
   c. Could you tell me more about the standard question asked to assess tobacco use? Is it more about smoking or any tobacco products?
     i. How about vaping or electronic cigarette use?
   d. Which staff member or members are responsible for asking patients about their tobacco use as part of the vital signs?
     i. Tell me about how you think they view the importance of this question.
     ii. What proportion of these staff members are non-smokers?
   e. About how often is a patient asked about his or her tobacco use?
[PHS Guideline Strategy 2] I’m now going to ask some questions about training opportunities.
 1. Tell me about the training opportunities for dental practice staff regarding tobacco cessation offered in the last year.
   a. Were there any incentives for participation such as continuing education credits? [If necessary, probe:] Tell me more about these incentives.
   b. [If there were training opportunities, probe:] Tell me more about who was conducting these trainings and who was trained.
   c. [If there were training opportunities, probe:] What types of training seemed to be most appreciated or work best?
 2. What can you tell me about any procedures in place for training newly hired staff about tobacco dependence?
 3. Talk to me about what resources for tobacco cessation are available in the dental practice. [If necessary, probe:]
   a. How often do you feel health care providers in the dental practice refer patients interested in quitting to the Quitline?
   b. Does the dental practice use a fax-to-Quitline referral service?
   c. What types of pamphlets or information sources about quitting, if any, are available in exam rooms or waiting rooms?
 4. What, if any, are some ways feedback is provided to health care providers in the dental practice about their work identifying, documenting, and treating tobacco dependence?
[PHS Guideline Strategy 3] I’m now going to ask some questions about coordination.
 1. Is there someone in charge of coordinating resources, training, and feedback relating to tobacco dependence?
   a. [If yes:] What is their job title?
   b. [If yes:] Tell me about their duties relating to coordinating tobacco dependence treatments.
[Other questions] We’ve reached the final section of questions. I’m now going to ask you about policies.
 1. What is your tobacco use policy for your building and grounds?
   a. How does the policy address electronic cigarettes or vaping?
 2. Do you have a policy against accepting funding from the tobacco industry?
 3. Tell me about any signage or displays about tobacco or vaping policies in waiting areas and entrances.
 4. Talk to me about some of the resources available in your dental practice to people who smoke who may wish to quit.
  [If needed, probe:] Do your providers prescribe pharmacotherapy, is there a support group, or what other resources are available?
 5. What type of tobacco cessation training did you yourself receive during dental school? [If necessary, probe:]
   a. How have tobacco cessation systems changed since you were in dental school?
   b. Did you feel you were properly trained to provide tobacco dependence treatment immediately after graduating from dental school?
   c. Is there anything you would now change about the tobacco cessation training you received during dental school?
 6. We’re trying to gauge where general dental practices are in thinking about tobacco dependence treatment. Can you give me a general idea of how you and the dental practice are thinking about tobacco dependence treatments?
   a. What barriers may be preventing other dentists from providing adequate amounts of tobacco dependence treatments?
 7. This is my last question. Is there anything else we should know?
  • Note: This table omits the contextual aspects of the interview including directions for the interviewer. The full telephone interview guide is available from the corresponding author. The PHS guideline is from Fiore MC, Jaen CR, Baker TB. Treating tobacco use and dependence: 2008 update. Rockville, MD: U.S. Department of Health and Human Services, 2008.