Beyond Asking and Advising: Smoking Cessation Practices and Motivation Among Dentists in Germany.

INTRODUCTION AND AIMS: Dental professionals are well placed to support smoking cessation, but the extent to which smoking-related communication is translated into structured cessation support remains unclear. This study assessed smoking cessation-related practices among participating dentists in Germany and examined factors associated with motivation to provide regular smoking cessation counselling. METHODS: An anonymous cross-sectional online survey was conducted among practicing dentists in Germany. The sample was predominantly affiliated with the dental chamber of Lower Saxony. Completed questionnaires were analysed descriptively, and reported practices were mapped to the 5As framework. High motivation was defined as a score of 4-5 on a 5-point scale. Associations with high motivation were examined using multivariable logistic regression, with ordinal sensitivity analysis. RESULTS: A total of 252 completed questionnaires were included. Smoking was addressed or assessed by 245 respondents (97.2%), and advice about smoking-related harms or cessation was reported by 221 (87.7%). More structured components were less frequent: personalized counselling or goal-setting (48/252, 19.0%), recall-based follow-up (51/252, 20.2%), active assistance (73/252, 29.0%) and referral to other services (98/252, 38.9%). High motivation was reported by 47 respondents (18.7%) and high perceived preparedness by 58 (23.0%). Nearly 4 out of 5 respondents (200/252, 79.4%) reported that they had not received undergraduate education or training related to smoking cessation. In the multivariable model, high motivation was associated with high perceived preparedness (adjusted OR: 2.79, 95% CI, 1.33-5.80), clear professional role perception (adjusted OR: 2.72, 95% CI, 1.26-5.81) and belief in dentists' influence on patients' smoking behaviour (adjusted OR: 2.68, 95% CI, 1.21-6.42). CONCLUSION: Smoking was frequently addressed by participating dentists, whereas structured cessation support beyond asking and advising was less consistently implemented. Most respondents reported no undergraduate education or training related to smoking cessation. High motivation for regular smoking cessation counselling was associated with preparedness, professional role perception and perceived influence. CLINICAL RELEVANCE: Training, referral pathways and workflow-integrated tools may help dentists provide smoking cessation support beyond asking and advising.