Objective:
We examined how dental hygienists support smoking cessation in their routine regular check-up sessions. In Japan, where primary medical care is provided by universal health insurance (UHI), smoking cessation support is not included in dental care under UHI. However, the smoking habit is the greatest risk factor for periodontal disease and risk factors for various oral mucosal diseases; hence regardless of lack of financial incentives for the clinics, many dental hygienists take the initiative in smoking cessation support.

Methods:
A web survey on smoking cessation support (Survey Monkey, using servers by Advantage Service) was conducted for dental hygienists who were a member of the Japan Health Care Dental Association, and responses were received from 182 people. The release period of the URL was from July 12, 2018 to September 15.

Results:
Those who suggested smoking cessation to their patients: 91.2%; recommended smoking cessation to 6 or more patients in the last year: 40.0%. In this survey included was a question, “Under what circumstances would you not suggest smoking cessation?” The answer was, "Anyone who absolutely refuses to quit smoking: 64%; they (DH) feel that the patients do not want to quit smoking or any intervention related to smoking cessation: 52%; when a patient refuses initial treatment: 38%."

Conclusions:
The project of “Capacity Development: Dental Hygienists as Supporters and Collaborators of Smoking Cessation” develops seminars and workshops to learn how to support smoking cessation in every day clinical practice, sharing the experiences of each other through group work and role-play based on the narratives of smokers. Through these activities emerging is a way of collaborative approach (in contrast to instructive approach) toward smoking cessation. In regular professional dental care, lifelong continuous care with so many teachable moments, smoking cessation support is both important and effective.