Tobacco cessation training for undergraduate dental students: a systematic review.
Abstract
INTRODUCTION Tobacco use causes substantial morbidity and mortality, including oral consequences such as periodontitis, impaired healing, and oral cancer. Dentists are well positioned to provide cessation advice, but many students report limited knowledge, confidence, preparedness, and counseling skills. This review assessed students' baseline knowledge, attitudes, confidence, and preparedness and evaluated structured training.
Methods
Following PRISMA guidelines, Ovid MEDLINE, Embase, and Cochrane Central were searched for studies published between January 2016 and July 2025 enrolling dental undergraduates. Baseline status was captured from any quantitative design; interventional studies evaluated structured cessation training. Findings were narratively synthesized.
Results
From 995 records, 13 studies met inclusion: seven cross-sectional and six interventional. At baseline (n ≈ 2851), knowledge was modest (37%-52%; median ≈49%), attitudes were positive (83%-99%; median ≈93%), preparedness was low (26%-44%), and confidence was inconsistently reported, but one study found that 62% felt cessation counseling would be difficult. Formal training exposure was limited (~12%), although most wanted more teaching (83%-91%). Structured training (~2-12 hours) was associated with short-term improvements: knowledge increased by +24-57 percentage points, counseling skills by +25-30 percentage points, attitudes by +8-15 percentage points, and confidence increased where reported, including +26.7 percentage points in one study. Certainty of evidence was low to very low.
Conclusion
Despite positive attitudes, students had limited readiness for cessation support. Low to very low certainty evidence suggests that short, structured, skills-based modules may improve knowledge, attitudes, confidence, and counseling skills in the short term. Undergraduate curricula should consider early, clinically reinforced, and assessed cessation training. IMPLICATIONS This review focuses exclusively on undergraduate dental students from 2016 to 2025, synthesizing baseline preparedness and structured cessation training outcomes. Students generally held positive attitudes toward tobacco cessation counseling but had modest knowledge, low confidence, and limited preparedness at baseline. Low to very low certainty evidence suggests that structured, skills-based approaches, including role-play, simulation, and objective structured clinical examination (OSCE)-based assessment, may improve knowledge, practical counseling skills, attitudes, and confidence in the short term. Findings support consideration of early brief advice training, standardized outcomes and assessments, and alignment with WHO FCTC Article 14. Stronger evaluations are needed to confirm durability and real-world impact.