UNIVERSIDADE ESTADUAL PAULISTA
“JÚLIO DE MESQUITA FILHO”
Instituto de Ciência e Tecnologia
Campus de São José dos Campos
PERSPECTIVE ARTICLE DOI: https://doi.org/10.4322/bds.2025.e4530
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Braz Dent Sci 2025 Jan/Mar;28 (1): e4530
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.
Assessing Dentists’ knowledge and training needs in smoking
cessation and Electronic Nicotine Delivery Systems:
a cross-sectional study in Kosovo
Avaliação do conhecimento e das necessidades de treinamento de dentistas em cessação do tabagismo e Sistemas
Eletrônicos de Liberação de Nicotina: um estudo transversal em Kosovo
Zana Sllamniku DALIPI1 , Mirlinda Sopi KRASNIQI1 , Donika Bajrami SHABANI2 , Linda DULA3
1 - Department of Periodontology and Oral Medicine, University Dentistry Clinical Center of Kosovo, Medical Faculty, University of
Prishtina, Prishtina, Kosovo.
2 - Department of Endodontics, University Dentistry Clinical Center of Kosovo, Medical Faculty, University of Prishtina, Prishtina, Kosovo.
3 - Department of Prosthetic, University Dentistry Clinical Center of Kosovo, Medical Faculty, University of Prishtina, Prishtina, Kosovo.
How to cite: Dalipi ZS, Krasniqi MS, Shabani DB, Dula L. Assessing Dentists’ knowledge and training needs in smoking cessation and
Electronic Nicotine Delivery Systems: a cross-sectional study in Kosovo. Braz Dent Sci. 2025;28(1):e4530. https://doi.org/10.4322/
bds.2025.e4530
ABSTRACT
Background: Electronic cigarettes (e-cigarettes) vaporize a liquid solution containing nicotine and are marketed
as safer than traditional tobacco. However, they are linked to health issues, including cardiovascular, respiratory,
and oral problems. Dental professionals play a key role in educating patients and supporting smoking cessation.
Objective: This study evaluates dentists’ knowledge of smoking cessation methods in Kosovo and identies the
need for further training. Material and Methods: The study involved 189 licensed dentists in Kosovo, using an
18-question questionnaire to assess their discussions about e-cigarettes, smoking cessation knowledge, and training
participation. Data were analyzed using SPSS 22. Results: Among participants, 42.9% were male and 57.1%
female. Most (63.0%) felt condent discussing e-cigarettes’ harmful effects, while only 36.5% were knowledgeable
about advanced cessation methods, and 11.6% were familiar with structured intervention models like the 5As and
5Rs. Participation in training was low (27.0%). Dentists showed condence in discussing e-cigarettes but lacked
knowledge of advanced cessation methods. This gap highlights the need for standardized educational programs
to improve counseling effectiveness. Conclusion: While dentists in Kosovo recognize the risks of e-cigarettes,
there is a clear need for enhanced training in smoking cessation methods to better support patients.
KEYWORDS
Electronic nicotine delivery systems; Oral health; Professional education; Smoking; Tobacco use cessation.
RESUMO
Contexto: Os cigarros eletrônicos (VAPE) vaporizam uma solução líquida contendo nicotina e são vendidos como
mais seguros do que o cigarro convencional. No entanto, eles estão ligados a problemas de saúde, incluindo problemas
cardiovasculares, respiratórios e bucais. Os prossionais de odontologia desempenham um papel fundamental
na educação dos pacientes e no apoio à cessação do tabagismo. Objetivo: Este estudo avalia o conhecimento
dos dentistas sobre os métodos de cessação do tabagismo em Kosovo e identica a necessidade de treinamento
adicional. Material e Métodos: O estudo envolveu 189 dentistas habilitados em Kosovo, usando um questionário
de 18 perguntas para avaliar suas discussões sobre cigarros eletrônicos, conhecimento sobre cessação do tabagismo
e participação no treinamento. Os dados foram analisados usando o SPSS-22. Resultados: Entre os participantes,
42,9% eram homens e 57,1% mulheres. A maioria (63,0%) se sentiu conante em discutir os efeitos nocivos
dos cigarros eletrônicos, enquanto apenas 36,5% tinham conhecimento sobre métodos avançados de cessação,
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Dalipi ZS et al.
Assessing Dentists’ knowledge and training needs in smoking cessation and Electronic Nicotine Delivery Systems: a cross-sectional study in Kosovo
Dalipi ZS et al. Assessing Dentists’ knowledge and training needs in smoking
cessation and Electronic Nicotine Delivery Systems: a cross-
sectional study in Kosovo
INTRODUCTION
The most common and significant
independent risk factor for periodontal disease
that can affect the host’s immune-inammatory
response is smoking [1]. Electronic cigarettes
(e-cigarettes) are battery-operated devices that
produce an aerosol by heating a liquid. They are
commonly known as vapes, vape pens, e-cigs, and
electronic nicotine delivery systems [2,3]. These
devices typically use e-liquids, which are solutions
made from glycerol and/or propylene glycol,
and vary in nicotine concentration [4]. Nicotine,
the primary addictive substance in traditional
tobacco products, is also a prominent ingredient in
e-cigarettes. Its presence in e-cigarettes contributes
to their addictive potential, similar to conventional
cigarettes, making it difcult for users to quit [5].
Originally designed as a less harmful
alternative to traditional tobacco smoking,
e-cigarettes have gained signicant popularity.
This increase is due to factors such as the wide
range of appealing avors, the absence of smoke
and its odors, their sleek and modern appearance,
and their ability to provide high nicotine levels [6].
The impact of electronic cigarettes
(e-cigarettes) on various clinical outcomes remains
unclear due to insufcient or missing evidence. This
includes conditions such as cancer, cardiovascular
diseases, respiratory disorders beyond lung
injury, mental health issues, developmental and
reproductive health concerns, sleep disturbances,
neurological conditions excluding seizures, and
various endocrine, olfactory, optical, allergic,
and hematological conditions. However, there is
substantial evidence indicating that e-cigarettes
contribute to indoor air pollution, generate waste,
and pose re hazards. Additionally, while direct
evidence is limited, there are indications that
e-cigarette use may adversely affect cardiovascular
health markers, including blood pressure and
heart rate, lung function, and adolescent brain
development and function [7,8].
In vitro studies have shown that aldehydes
and free radicals in e-cigarette aerosols cause
oxidative stress, alterations in cellular antioxidant
activity, and DNA damage—changes that are
expected to ultimately lead to periodontal
tissue destruction and alveolar bone loss, both
characteristic of periodontal diseases [9]. The
increased plaque accumulation and deeper
periodontal pockets observed in e-cigarette
users may be linked to the inammatory effects
of chemicals in e-cigarette aerosols, which can
disrupt oral health and promote the development
of periodontal disease [10].
Furthermore, clinical research indicates
that vaping negatively affects gum health, with
e-cigarette users demonstrating a less favorable
response to periodontal treatments compared to
non-smokers. The chemicals in e-cigarette vapor
can induce inflammation and gum damage,
increasing the risk of periodontal issues such
as gingivitis and periodontitis. Additionally, the
healing process after periodontal treatments may
be impaired in individuals who vape [11].
Dental healthcare professionals, including
dentists, play a crucial role in raising awareness
about the adverse effects of electronic cigarettes.
Beyond providing medical care, they are
instrumental in educating patients about the
potential health risks associated with e-cigarettes
and vaping. Their efforts include informing
patients about the impact of these products on
various aspects of health, such as cardiovascular,
respiratory, and oral health. By highlighting
these risks, healthcare professionals help patients
make informed decisions and take preventive
measures to protect their well-being [12-15].
However, effective smoking cessation strategies
e 11,6% estavam familiarizados com modelos de intervenção estruturados como os 5As e 5Rs. A participação no
treinamento foi baixa (27,0%). Os dentistas mostraram conança em discutir os cigarros eletrônicos, mas não
tinham conhecimento sobre métodos avançados de cessação. Essa lacuna destaca a necessidade de programas
educacionais padronizados para melhorar a ecácia do aconselhamento. Conclusão: Embora os dentistas em
Kosovo reconheçam os riscos dos cigarros eletrônicos, há uma necessidade clara de capacitação aprimorada em
métodos de cessação do tabagismo para fornecimento de melhor suporte aos pacientes.
PALAVRAS-CHAVE
Usos de cigarros eletrônicos; Saúde bucal; Educação Prossional em Saúde Pública; Tabagismo; Cessação tabagica.
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Dalipi ZS et al.
Assessing Dentists’ knowledge and training needs in smoking cessation and Electronic Nicotine Delivery Systems: a cross-sectional study in Kosovo
Dalipi ZS et al. Assessing Dentists’ knowledge and training needs in smoking
cessation and Electronic Nicotine Delivery Systems: a cross-
sectional study in Kosovo
require adequate knowledge and training. In this
context, structured models such as the 5As, 5Rs,
and STAR method have been developed to help
healthcare providers, including dentists, deliver
comprehensive and effective smoking cessation
interventions [16].
Despite their proven benefits, studies
suggest that smoking cessation education is
often underemphasized in dental training
programs. Dental professionals who receive
formal education in smoking cessation strategies
are significantly more effective in supporting
patients in quitting smoking compared to those
without such training.
The aim of this study is to evaluate dentists’
knowledge of smoking cessation methods
and the importance of training for dentists to
effectively provide patients with comprehensive
information and support regarding smoking
cessation strategies.
This study hypothesizes that although
dentists in Kosovo have a basic understanding
of smoking cessation techniques, there is a
signicant gap in their knowledge of structured
intervention models and advanced cessation
strategies, emphasizing the need for targeted
training programs.
MATERIAL AND METHODS
This cross-sectional study was conducted
from May-September 2024 and adhered to the
Strengthening the Reporting of Observational
Studies in Epidemiology (STROBE) guidelines.
The study aimed to assess dentists’ knowledge
and training needs in smoking cessation and
electronic nicotine delivery systems in Kosovo.
The 189 dentists were selected from those licensed
by the Kosovo Dental Chamber and working in
both public and private healthcare institutions
across Kosovo. Dentists were randomly selected
to participate in the study, with inclusion based
on their availability and willingness to engage
during the designated study period.
The participants were selected to provide a
comprehensive evaluation of their knowledge and
training concerning smoking cessation methods.
The sample size of 189 dentists was determined
based on a power analysis to achieve a condence
level of 95% and a margin of error of ±5%. The
nal number ensured representativeness of active
dental professionals in Kosovo.
The study employed an 18-question
questionnaire, divided into six sections. The rst
section included three descriptive questions about
dentists’ approach to discussing e-cigarettes with
patients based on gender. The second section
addressed how dentists approach discussing
e-cigarettes with patients based on their
professional education/training. The third section
focused on participants’ knowledge of smoking
cessation methods, categorized by gender. The
fourth section assessed the level of dentists’
knowledge on smoking cessation methods by
their education/professional training. The fth
section involved questions on participation in,
and the need for, smoking cessation training
among respondents based on gender. The sixth
section explored participation in, and the need for,
smoking cessation training among respondents
based on their education/professional training.
Eligibility criteria included dentists licensed by
the Kosovo Dental Chamber, actively practicing
in public or private clinics. Exclusion criteria
included retired professionals, administrative-
only roles, and those with incomplete survey
responses. Anonymity was ensured by making
the questionnaire anonymous, with no personal
identiers collected from the participants. This
means that respondents did not have to provide
their names or any other personal information
that could link their responses to their identities.
Participants received an 18-question self-
administered questionnaire at professional dental
meetings. The survey assessed knowledge of
smoking cessation methods, electronic cigarette
use, and participation in training. Responses were
collected anonymously and securely stored to
ensure condentiality.
The study received ethical approval from
the Kosovo Dental Chamber (Approval No:
48-1-30.05.2024.). Written informed consent
was obtained from all participants before survey
completion, ensuring voluntary participation and
condentiality in accordance with the Declaration
of Helsinki.
Data analysis was performed using SPSS
22. Chi-squared and Fisher’s exact tests were
used to analyze categorical variables, as they are
appropriate for assessing associations between
independent groups. Missing data were handled
using leastwise deletion to maintain data
accuracy, and signicance was set at P < 0.05.
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Dalipi ZS et al.
Assessing Dentists’ knowledge and training needs in smoking cessation and Electronic Nicotine Delivery Systems: a cross-sectional study in Kosovo
Dalipi ZS et al. Assessing Dentists’ knowledge and training needs in smoking
cessation and Electronic Nicotine Delivery Systems: a cross-
sectional study in Kosovo
RESULTS
Our study included 189 dentists from
Kosovo, all licensed by the Kosovo Dental
Chamber, of which 81 (42.9%) were male and
108 (57.1%) were female (Table I). In response
to the statement, “As professionals, we do not
need to discuss the harmful effects of e-cigarettes
with patients,” 39.7% of the dentists agreed.
However, more than half (63.0%) felt condent
in discussing the harmful effects of e-cigarettes
with patients, and 61.4% regularly spent a few
minutes talking about the impact of e-cigarettes
on oral health with their patients. No signicant
differences based on gender were found in these
responses (P>0.05) (Table II).
Of the total respondents, 54.5% (103) were
dental specialists, while 45.5% (86) were general
dentists without specialization. When examining
the responses related to discussing e-cigarettes
with patients based on their level of professional
education, no statistically signicant differences
were identied (P>0.05) (Table III).
Only 36.5% of the dentists surveyed
had knowledge of the recommended non-
pharmacological and pharmacological methods
for smoking cessation. Additionally, just 11.6%
were aware of the structured models, such as the
5As and 5Rs, used to assist with brief smoking
cessation interventions, and only 10.1% were
familiar with the FDA-approved STAR method for
creating individualized smoking cessation plans.
The structured models “5As and 5Rs” indicate
a framework intended to facilitate medical
professionals in implementing smoking cessation
treatments. The 5As model comprises Ask, Advise,
Assess, Assist, and Arrange, providing doctors
Table I - General characteristics of the participants
Gender
Dentist Specialist Total
N%N%N%
F 53 51.5 55 64.0 108 57.1
M 50 48.5 31 36.0 81 42.9
Total 103 100.0 86 100.0 189 100.0
Chi test, P-value Chi=2.50, P=0.114
Table II - Dentists’ approach to discussing e-cigarettes with patients according to gender
Female Male Total
p-valueN % N % N %
Total N 108 100.0 81 100.0 189 100.0
% 57.1 - 42.9 - 100.0 -
As professionals, do we not need to discuss the harmful effects of e-cigarettes with patients?
Yes 41 38.0 34 42.0 75 39.7
p=0.748No 50 46.3 33 40.7 83 43.9
I don’t know 17 15.7 14 17.3 31 16.4
As a professional, do I feel prepared in my ability to discuss the harmful effects of e-cigarettes with patients?
Yes 68 63.0 51 63.0 119 63.0
p=0.663No 19 17.6 11 13.6 30 15.9
I don’t know 21 19.4 19 23.5 40 21.2
How much time do you spend discussing the impact of cigarettes on oral health with patients?
A few minutes 70 64.8 46 56.8 116 61.4
p=0.508I don’t discuss it 27 25.0 26 32.1 53 28.0
I don’t know 11 10.2 9 11.1 20 10.6
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Dalipi ZS et al.
Assessing Dentists’ knowledge and training needs in smoking cessation and Electronic Nicotine Delivery Systems: a cross-sectional study in Kosovo
Dalipi ZS et al. Assessing Dentists’ knowledge and training needs in smoking
cessation and Electronic Nicotine Delivery Systems: a cross-
sectional study in Kosovo
with an organized structure for supporting
patients in cessation of smoking. The 5Rs model
indicates Relevance, Risks, Rewards, Roadblocks,
and Repetition, with the objective of enhancing
patient motivation. The FDA-approved “STAR
method” is a systematic framework for creating
personalized smoking cessation strategies,
which includes setting a quit date, informing
family and friends, anticipating problems, and
removing tobacco items to improve adherence
to cessation initiatives. The questionnaire
incorporated these models to evaluate dentists’
awareness of evidence-based smoking cessation
techniques. Nevertheless, the data revealed a
limited awareness, underscoring the necessity for
enhanced educational initiatives. None of these
ndings showed signicant differences based on
gender (Table IV). When evaluating the level of
knowledge about smoking cessation methods by
education or professional training, no statistically
signicant differences were found in any of the
questions (Table V).
In response to the question “Have you
attended any training or educational programs
on smoking cessation methods as a healthcare
professional?”, 27.0% of the participants
answered “Yes.” Moreover, 69.3% reported
learning about the effects of smoking on oral
health through professional lectures, with no
signicant difference between genders (P>0.05).
When asked if ongoing professional education
through lectures and awareness programs on
the impact of e-cigarettes is essential for dental
professionals, 86.2% of respondents agreed,
again with no significant gender differences
(P>0.05) (Table VI). The questions concerning
participation in and the need for smoking
cessation training were also analyzed based on
professional background (dental specialists vs.
general dentists), and no signicant statistical
differences were found (P>0.05) (Table VII).
DISCUSSION
Smoking has a well-documented adverse
impact on oral health, including increased
risks for periodontal disease, oral cancers, and
delayed healing. Given this, dentists are in a
unique position to play a pivotal role in smoking
cessation efforts.
Our study revealed significant gaps in
dentists’ knowledge regarding the latest smoking
cessation methods. While most dentists were
familiar with basic cessation techniques, advanced
methods such as pharmacological aids and
behavioral counseling were less well understood.
Table III - Dentists’ approach to discussing e-cigarettes with patients, based on professional preparation/education
Dentist Specialist
p-value
N%N%
Total N 103 100.0 86 100.0
% 54.5 - 45.5 -
As professionals, is it not necessary for us to talk about the harmful effects of e-cigarettes with patients?
Yes 40 38.8 35 40.7
p=0.862
No 47 45.6 36 41.9
I don’t know 16 15.5 15 17.4
As a professional, do I feel well-prepared to address the harmful effects of e-cigarettes with patients?
Yes 64 62.1 55 64.0
p=0.911No 16 15.5 14 16.3
I don’t know 23 22.3 17 19.8
How much time do you dedicate to discussing the impact of cigarettes on oral health with patients?
A few minutes 64 62.1 52 60.5
p=0.959I don’t discuss it 28 27.2 25 29.1
I don’t know 11 10.7 9 10.5
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Assessing Dentists’ knowledge and training needs in smoking cessation and Electronic Nicotine Delivery Systems: a cross-sectional study in Kosovo
Dalipi ZS et al. Assessing Dentists’ knowledge and training needs in smoking
cessation and Electronic Nicotine Delivery Systems: a cross-
sectional study in Kosovo
Table IV - Knowledge level of participants on smoking cessation methods, categorized by gender
Femal Male Total
p-value
N%N%N%
Total 108 100.0 81 100.0 189 100.0
Are you knowledgeable about the recommended non-pharmacological and pharmacological
methods for quitting smoking?
Yes 40 37.0 29 35.8 69 36.5
p=0.213No 41 38.0 23 28.4 64 33.9
I don’t know 27 25.0 29 35.8 56 29.6
Do you have information on structured models available to support the implementation
of brief interventions for smoking cessation (such as the 5As and 5Rs)?
Yes 14 13.0 8 9.9 22 11.6
p=0.779No 56 51.9 42 51.9 98 51.9
I don’t know 38 35.2 31 38.3 69 36.5
Do you know about the STAR method for developing a personalized smoking cessation plan,
which has been approved by the FDA?
Yes 10 9.3 9 11.1 19 10.1
p=0.894No 61 56.5 46 56.8 107 56.6
I don’t know 37 34.3 26 32.1 63 33.3
Table V - Level of dentist knowledge on smoking cessation methods by education/Professional training
Dentist Specialist
p-valueN % N %
Total 103 100.0 86 100.0
Do you have information on the recommended non-pharmacological and pharmacological
methods for smoking cessation?
Yes 38 36.9 31 36.0
p=0.963No 34 33.0 30 34.9
I don’t know 31 30.1 25 29.1
Do you have information on structured models available to assist with the implementation of brief interventions
for smoking cessation (such as the 5As and 5Rs)?
Yes 87.8 14 16.3
p=0.191No 56 54.4 42 48.8
I don’t know 39 37.9 30 34.9
Are you familiar with the STAR method for developing an individualized smoking cessation plan,
which is approved by the FDA?
Yes 7 6.8 12 14.0
p=0.138No 64 62.1 43 50.0
I don’t know 32 31.1 31 36.0
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Dalipi ZS et al.
Assessing Dentists’ knowledge and training needs in smoking cessation and Electronic Nicotine Delivery Systems: a cross-sectional study in Kosovo
Dalipi ZS et al. Assessing Dentists’ knowledge and training needs in smoking
cessation and Electronic Nicotine Delivery Systems: a cross-
sectional study in Kosovo
Furthermore, the training programs currently
available were often insufcient in equipping
dentists with practical skills for effective smoking
cessation interventions. Effective smoking
cessation programs incorporate behavioral
counseling, pharmacotherapy, and continuous
patient monitoring. Motivational interviewing
and structured therapies such as the 5As and
5Rs enhance the personalization of the cessation
process. Pharmacological interventions, such
Table VI - Participation in and need for smoking cessation training among researchers by gender
Female Male Total
P-value
N%N%N%
Total 108 100.0 81 100.0 189 100.0
Have you participated in any training or educational programs on smoking cessation
methods as a healthcare professional?
Yes 25 23.1 26 32.1 51 27.0
P=0.315No 76 70.4 52 64.2 128 67.7
I don’t know 7 6.5 3 3.7 10 5.3
Are you familiar with the effects of smoking on oral health through professional lectures?
Yes 76 70.4 55 67.9 131 69.3
P=0.884
No 26 24.1 22 27.2 48 25.4
I don’t know 6 5.6 4 4.9 10 5.3
Is it essential for dental professionals to receive continuing education through lectures
and awareness programs on the effects of e-cigarettes?
Yes 96 88.9 67 82.7 163 86.2
P=0.466No 3 2.8 4 4.9 7 3.7
I don’t know 9 8.3 10 12.3 19 10.1
Table VII - Participation in and need for smoking cessation training among researchers by education/Professional training
Dentist Specialist
p-valueN % N %
Total 103 100.0 86 100.0
Have you participated in any training or educational programs on smoking cessation methods as a healthcare pro-
fessional?
Yes 27 26.2 24 27.9
p=0.246No 73 70.9 55 64.0
I don’t know 3 2.9 7 8.1
Are you familiar with the effects of smoking on oral health through professional lectures?
Yes 68 66.0 63 73.3
p=0.433No 30 29.1 18 20.9
I don’t know 5 4.9 5 5.8
Are you aware of the effects of smoking on oral health through professional lectures?
Yes 88 85.4 75 87.2
p=0.614No 3 2.9 4 4.7
I don’t know 12 11.7 7 8.1
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Assessing Dentists’ knowledge and training needs in smoking cessation and Electronic Nicotine Delivery Systems: a cross-sectional study in Kosovo
Dalipi ZS et al. Assessing Dentists’ knowledge and training needs in smoking
cessation and Electronic Nicotine Delivery Systems: a cross-
sectional study in Kosovo
as nicotine replacement therapy (NRT) and
prescription medications are crucial for enhancing
cessation rates. Our data indicate that many
dentists utilize these structured intervention
methods, emphasizing the need for specialized
continuing education programs that incorporate
behavioral and pharmacological therapies.
More than half (63.0%) felt confident in
discussing the harmful effects of e-cigarettes
with patients, Unlike the research of Parkar et al,
where most of the dentists strongly believed that
it is their responsibility to educate the patients
regarding tobacco cessation counselling, but the
lack of proper training was found to be the major
barrier for tobacco cessation counselling [17].
Only 36.5% of the dentists surveyed
had knowledge of the recommended non-
pharmacological and pharmacological methods for
smoking cessation. Additionally, just 11.6% were
aware of the structured models, such as the 5As
and 5Rs, and only 10.1% were familiar with the
FDA-approved STAR method. A study conducted
by Surrati et al, found that 60% of physicians
demonstrated a solid understanding of smoking
cessation counseling, with satisfactory practice
reported in certain areas [18]. The discrepancy
between dentists’ and physicians’ knowledge
levels in smoking cessation counseling could be
attributed to differences in medical and dental
education. Physicians often receive formal training
in patient lifestyle interventions, whereas dental
curricula focus primarily on clinical procedures
rather than behavioral counseling. Additionally,
medical professionals may have greater exposure
to smoking cessation programs as part of primary
healthcare services, whereas dental professionals
typically focus on oral health without the same
level of preventive care training.
A study conducted in the Netherlands
compared 14 groups of healthcare providers
and found that dentists had the lowest rates of
giving advice and making referrals, compared
with the other groups [19]. This highlights
the need to address barriers and enhance
smoking cessation practices within dental care,
as oral health professionals play a crucial role
in disease prevention. In our study, only 27.0%
of participants reported attending any training
or educational programs on smoking cessation
techniques. This suggests that professional
lectures and ongoing education are essential to
raise awareness about the dangers of smoking
and the benefits of quitting. Dentists should,
therefore, be more actively involved in counseling
patients to stop smoking.
Among respondents, 61.4% routinely spent a
few minutes discussing the effects of e-cigarettes
on oral health with their patients. There were
no signicant gender-based differences in these
responses (P>0.05). In contrast, the study by
B.W. Chaffee et al. found that dental professionals
in California frequently asked about smoking but
were less consistent in offering cessation support
and asking about non-cigarette products [20].
A study by Alsiwat and Alayadi [21], highlights
the importance of revising the undergraduate
curriculum to incorporate smoking cessation
counseling. The study also emphasizes the value of
continuing education in enhancing dental hygiene
practitioners’ knowledge in this area. Despite a
positive attitude, dentists lacked confidence in
providing tobacco cessation counseling. Similarly,
in our study, when participants were asked if
ongoing professional education through lectures and
awareness programs on the effects of e-cigarettes
is crucial for dental professionals, 86.2% agreed,
with no significant differences observed based
on gender (P>0.05). Also, dentists believe that
creating a curriculum focused on interdisciplinary
collaboration and coordinating scientic activities
with medical associations will be crucial for raising
awareness about oral-systemic health [22].
While the study offers important insights
into assessing dentists’ understanding of smoking
cessation techniques and underscores the
need for training to effectively assist patients,
additional research may be warranted. This could
involve simulating training sessions for dentists in
collaboration with the Kosovar Dental Chamber.
Future studies should evaluate the impact of
structured smoking cessation training programs
within dental education. A key strategy could
involve pilot studies implementing structured
training modules—such as role-playing, patient
simulations, or online courses—followed
by assessments of knowledge retention and
application in clinical practice. Collaborations
with dental associations and public health
organizations could further strengthen these
initiatives by ensuring that smoking cessation
training is standardized and accessible to all dental
professionals. This research assessed the level of
dentists’ knowledge regarding smoking cessation
techniques and identied their requirements for
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Assessing Dentists’ knowledge and training needs in smoking cessation and Electronic Nicotine Delivery Systems: a cross-sectional study in Kosovo
Dalipi ZS et al. Assessing Dentists’ knowledge and training needs in smoking
cessation and Electronic Nicotine Delivery Systems: a cross-
sectional study in Kosovo
additional training, with a particular emphasis on
structured intervention models. While 63.0% of
participants expressed condence in their ability
to discuss the harmful effects of e-cigarettes, only
36.5% exhibited knowledge of evidence-based
smoking cessation strategies, and merely 11.6%
were acquainted with structured intervention
frameworks, including the 5As and 5Rs. The
ndings underscore a signicant deciency in
smoking cessation education within the dental
profession, emphasizing the importance for the
development of specialized training programs
focused on improving practitioners’ ability to
support patients in quitting smoking.
Numerous limitations must be addressed.
The reliance on self-reported data heightens the
possibility of recall bias, while the utilization
of convenience sampling may have introduced
selection bias by disproportionately representing
dentists with a prior interest in smoking cessation.
The study’s cross-sectional design restricts
the capacity to determine causal correlations
between training participation and knowledge
levels. Future study utilizing randomized or
stratified sampling methods may provide a
more thorough evaluation of these knowledge
deciencies. Deciencies in smoking cessation
education have been documented, underscoring
the need for further research on the integration
of structured cessation training within dental
curricula and continuing education programs
across diverse healthcare systems in Kosovo.
Comparative studies could offer valuable insights
into optimizing the role of dental professionals
in tobacco cessation counseling.
CONCLUSIONS
This study indicates that while a signicant
proportion of dentists in Kosovo are condent in
discussing the risks associated with e-cigarette use,
there is a notable deciency in their knowledge
of advanced smoking cessation techniques
and structured intervention models. Dentists
generally exhibit a positive attitude toward
tobacco cessation counseling; however, a lack of
formal training signicantly impedes their ability
to effectively implement such interventions.
Acknowledgements
We would like to express our sincere
gratitude to the Kosovar Dental Chamber for
their invaluable cooperation in facilitating the
inclusion of dentists in our survey. Their support
was crucial in ensuring the successful completion
of this study and we deeply appreciate their
collaboration and dedication to advancing
research in dental care.
Author’s Contributions
ZSD: Conceptualization, Formal Analysis,
Writing – Original Draft Preparation. MSK:
Data Curation, Investigation, Writing – Review
& Editing. DSH: Methodology, Supervision,
Writing – Review & Editing. LD: Data Curation,
Project Administration, Writing – Original Draft
Preparation.
Conict of Interest
None
Funding
None
Regulatory Statement
This study protocol was reviewed and
approved by the Ethics Committee of the Kosovo
Dental Chamber (Approval No: 48-1-30.05.2024).
The study adhered to ethical guidelines, ensuring
voluntary participation, anonymity, and informed
consent. Participants signed informed consent
forms before completing the questionnaire,
following ethical principles outlined in the
Declaration of Helsinki.
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