Smoking Cessation Counseling in Primary Care Settings: Cross-sectional Perspectives from Patients and Dentists

Background In lower-middle income primary care settings, little is known about how dentists’ and patients’ attitudes view smoking cessation counseling by dentists (SCCD). This gap is particularly evident in Iran. Therefore, this study explored SCCD attitudes and their associations with individual-level factors among Iranian primary care patients and dentists. Materials and methods This two-phase cross-sectional study in Iran recruited dentists from all CHCs in Tehran province via census (March–June 2019) and patients from three randomly selected CHCs in Tehran city via convenience sampling (July–August 2020). Both groups completed questionnaires on SCCD attitudes and individual-level factors, with patient attitudes further analyzed across three dimensions: dentist competence, SCCD effectiveness, and oral symptoms as motivators. Statistical analyses included independent t-tests and multiple logistic regression for patients and simple and multiple linear regression for dentists. Results Of 380 patients (68.9% response rate), 51.6% were female, with a mean age of 38.8 years (SD = 7.1). Among 180 dentists (93% response rate), 81.6% were female, with a mean age of 34 years (SD = 10.0). Among dentists, non-smokers (B = 5.99, p = 0.005) and those working in Tehran city (B = -3.24, p = 0.024) were more likely to show positive SCCD attitudes. Among patients, non-smokers (OR = 1.52, p = 0.049) and those with a smoking family member (OR = 0.61, p = 0.021) were more likely to view SCCD as effective. Employed patients saw oral symptoms as stronger quitting motivators (OR = 0.46, p = 0.001), and employed smokers were more willing to quit using SCCD (OR = 0.41, p = 0.003). Conclusions Enhancing SCCD attitudes in primary care requires continuing professional education, SCCD piloting, programs, public education campaigns, peer mentorship for smoking and rural dentists, workplace SCCD programs, and community advocacy of non-smoking patients.