Open Access Open Access  Restricted Access Subscription Access

Applying a theory-based approach to identify determinants of dentists’ intention to adopt Canadian smoking cessation clinical guidelines in Quebec: A pilot study

Pascaline Kengne Talla, Aimée Dawson, Marie-Pierre Gagnon, Jordie Croteau


Introduction: Tobacco is a risk factor for many oral and systemic diseases and conditions. Many institutions recommend the use of clinical guidelines on smoking cessation to help people quit smoking. Yet, several studies also indicate that clinical guidelines are widely underutilized and study of this topic through a theoretical framework are scarce. The purpose of this study was to identify the underlying individual mechanisms which support dentists’ intention to adopt the Canadian smoking cessation clinical guidelines in Quebec, Canada.

Methods: A cross-sectional study was carried out on a sample of 59 dentists working in private practices between January and September 2016. The study was conducted using a validated and anonymous questionnaire based on a modified version of the Triandis’ Theory of Interpersonal Behaviour. The theoretical model was tested by multiple linear regression.

Results: The adapted theoretical model explained 63% of variance in dentists’ intention to adopt these guidelines in their practices. The mains predictors of dentists’ intention were professional norm (β=0.85; p≤ 0.0001) and control beliefs (β=0.3; p= 0.01).

Conclusions: Grounded in the theory, the results of this study give a first view of dentists’ individual determinants that could be targeted to develop successful ways of increasing the adoption of Canadian smoking cessation guidelines in dental settings. Further research is needed to confirm these results.


Clinical practice guidelines, dentistry, determinants, health professionals behaviours, intention, person-centered healthcare, psychosocial factors, psychosocial theory, Quebec, smoking cessation, theory based approaches, theory of interpersonal behaviour

Full Text:



Marteau, T.M. & Johnston, M. (1991). Health professionals: A source of variance in health outcomes. Psychology & Health 5 (1) 47-58.

CAN-ADAPTT. (2011). Lignes directrices canadiennes de pratique clinique sur le renoncement au tabagisme : énoncés sommaires. Toronto, Canada : Réseau d’action canadien pour l’avancement, la dissémination et l’adoption de pratiques en matière de traitement du tabagisme fondées sur l’expérience clinique, Centre de toxicomanie et de santé mentale.

Carr, A.B. & Ebbert, J. (2012). Interventions for tobacco cessation in the dental setting. Cochrane Database of Systematic Reviews 6:CD005084: 1-40.

Smith, D.R. & Leggat, P.A. (2006). A comparison of tobacco smoking among dentists in 15 countries. International Dental Journal 56 (5) 283-288.

Lala, R., Csikar, J., Douglas, G. & Muarry, J. (2017). Factors that influence delivery of tobacco cessation support in general dental practice: a narrative review. Journal of Public Health Dentistry 77 (1) 47-53.

Davis, R., Campbell, R., Hildon, Z., Hobbs, L. & Michie, S. (2015). Theories of behaviour and behaviour change across the social and behavioural sciences: a scoping review. Health Psychology Review 9 (3) 323-344.

Amemori, M. (2012). Developing assessment and promotion of tobacco counselling: A cluster-randomised community trial among oral health professionals. Helsinki: University of Helsinki, Finland.

Newlands, R., Duncan, E.M., Prior, M., Elouafkaoui, P., Elders, A., Young, L., Clarkson, J.E., Ramsay, C.R. & Translation Research in a Dental Setting (TRiaDS) Research Methodology Group. (2016). Barriers and facilitators of evidence-based management of patients with bacterial infections among general dental practitioners: a theory-informed interview study. Implementation Science 11 (1) 11.

Spallek, H., Song, M., Polk, D.E., Bekhuis, T., Frantsve-Hawley, J. & Aravamudhan, K. (2010). Barriers to Implementing Evidence-Based Clinical Guidelines: A Survey of Early Adopters. Journal of Evidence Based Dental Practice 10 (4) 195-206.

Kengne Talla, P., Gagnon, M-P. & Dawson, A. (2016). Environmental Factors Influencing Adoption of Canadian Guidelines on Smoking Cessation in Dental Healthcare Settings in Quebec: A Qualitative Study of Dentists’ Perspectives. Dentistry Journal 4 (4) 40.

Michie, S., Johnston, M., Abraham, C., Lawton, R., Parker, D., Walker, A. & "Psychological Theory" Group. (2005). Making psychological theory useful for implementing evidence based practice: a consensus approach. Quality & Safety Health Care 14 (1) 26-33.

Triandis, H.C. (1980). Values, attitudes and interpersonal behaviour. In: Nebraska Symposium on Motivation, 1979: Beliefs, attitudes and values. Page, M.M., (Ed.). Lincoln: University of Nebraska Press.

Triandis, H.C. (1989). The self and social behavior in differing cultural contexts. Psychological Review 96 (3) 506-520.

Gagnon, M-P., Légaré, F. & Godin, G. (2012). L'application des théories de prédiction pour les comportements associés aux pratiques cliniques des travailleurs de la santé. In: Les comportements dans le domaine de la santé: Comprendre pour mieux intervenir, Godin, I.G., (Ed.), pp. 209-227. Montréal, Québec: Les presses de l'Université de Montréal.

Godin, G., Belanger-Gravel, A., Eccles, M. & Grimshaw, J. (2008). Healthcare professionals' intentions and behaviours: A systematic review of studies based on social cognitive theories. Implementation Science 3 (1) 36.

Godin, G. (2012). Les comportements dans le domaine de la santé: Comprendre pour mieux intervenir. Montréal, Québec: Les presses de l'Université de Montréal.

Gagnon, M-P., Godin, G., Gagné, C., Fortin, J.P., Lamothe, L., Reinharz, D. & Cloutier, A. (2003). An adaptation of the Theory of Interpersonal Behaviour to the study of telemedicine adoption by physicians. International Journal of Medical Informatics 71 (2-3) 103-115.

Kengne Talla, P., Gagnon, M-P. & Dawson, A. (2017). Development and testing of a questionnaire exploring dentists’ intention to use clinical practice guidelines on smoking cessation in Quebec: A mixed methods study. International Journal of Dental and Health Sciences 4 (2) 1183-1188.

Brothwell, D.J. & Armstrong, K.A. (2004). Smoking cessation services provided by dental professionals in a rural Ontario health unit. Journal of the Canadian Dental Association 70 (2) 94-98.

Watt, R.G., Johnson, N.W. & Warnakulasuriya, K. (2000). Action on smoking - opportunities for the dental team. British Dental Journal 189 (7) 357-360.

Tremblay, M., Cournoyer, D. & O'Loughlin, J. (2007). Smoking cessation counselling-Result of a 2005 survey of Quebec dentists. Montréal, Québec : Direction du développement des individus et des communautés : Institut national de santé publique du Québec.

Freidson, E. (2001). Professionalism. The Third Logic. Cambridge: Polity Press.

Bøgh Andersen, L. (2009). Qu'est-ce qui détermine le comportement et la performance des professionnels de la santé? La motivation de service public, les normes professionnelles et/ou les incitants financiers. Revue Internationale des Sciences Administratives 75, 87-108.

Godin, G., NacCache, H., Brodeur, J-M. & Alary, M. (1999). Understanding the intention of dentists to provide dental care to HIV+ and AIDS patients. Community Dentistry and Oral Epidemiology 27 (3) 221-227.

Zijlstra-Shaw, S., Roberts, T.E. & Robinson, P.G. Perceptions of professionalism in dentistry - a qualitative study. British Dental Journal 215 (9) e18.

Antal, M., Forster, A., Zalai, Z., Barabas, K., Ramseier, C. & Nagy, K. (2012). Attitudes of Hungarian dental professionals to tobacco use and cessation. Central European Journal of Public Health 20 (1) 45-49.

Rikard-Bell, G. & Ward, J. (2001). Australian dentists' educational needs for smoking cessation counseling. Journal of Cancer Education 16 (2) 80-84.

Gagnon, M-P., Sánchez, E. & Pons, J.M.V. (2006). From recommendation to action: psychosocial factors influencing physician intention to use Health Technology Assessment (HTA) recommendations. Implementation Science 1 (1) 8.

Rikard-Bell, G. & Ward, J. (2000). Maximizing response rates to a survey of dentists: A randomized trial. Australian Dental Journal 45 (1) 46-48.

Babayan, A., Dubray, J., Haji, F. & Schwartz, R. (2012). Provision of Smoking Cessation by Ontario Dental Health Professionals. Ontario, Toronto: Ontario Tobacco Research Unit.

VanGeest, J.B., Johnson, T.P. & Welch, V.L. (2007). Methodologies for Improving Response Rates in Surveys of Physicians. Evaluation & the Health Professions 30 (4) 303-321.



  • There are currently no refbacks.