Differences and similarities in lying frequency, moral evaluations, and beliefs about lying among children with and without conduct problems.

The current study examined whether children (6-12 years old) with varying levels of conduct problems differ from those without conduct problems in three key areas: their perceptions of how often other people tell lies, their moral evaluations of truth- and lie-telling in different social contexts, and how often they tell antisocial and prosocial (i.e., "white") lies. Using a continuous measurement of conduct problems, we found that children with greater conduct problems believed that other people tell lies more often compared with children with fewer conduct problems. However, unexpectedly, children's moral evaluations of truth- and lie-telling in antisocial and prosocial contexts did not significantly differ based on conduct problems. Using parent-report methods, we found that children tell more antisocial lies with increasing severity of conduct problems, but they tell prosocial lies at a similar rate regardless of conduct problems. Finally, after grouping children based on level of conduct problems (none, low, or high), we found that children in the group with no conduct problems told more prosocial lies than antisocial lies, but the reverse was found for children in the group with high conduct problems. These findings highlight the importance of considering social context when examining the development of lying in children experiencing conduct problems.

The Alarming Rate of Major Disruptive Events in Primary Care Practices in Oklahoma.

PURPOSE: In primary care practices, sustainability of performance improvements and ability to deliver continuity of care to patients can be adversely affected by major disruptive events, such as relocations and changes in ownership, clinicians, and key staff. This study documented the rates of major disruptive events in a cohort of primary care practices in Oklahoma. METHODS: Practices were included if they had existed for 1 year before enrollment and remained in the project for at least 1 year after enrollment. Practice characteristics for 208 practices and major disruptive events during the preenrollment year were collected by survey. Postenrollment major disruptive events were prospectively collected by practice facilitators. We compiled frequency statistics and conducted bivariate analyses for each data set. RESULTS: Of 208 eligible practices, 81 (39%) were clinician owned, and 51 (25%) were health system owned. One hundred nine practices (52%) were in nonmetropolitan counties. One hundred seventy-five major disruptive events occurred in 120 (58%) practices during the preenrollment year, with 42 practices having experienced multiple events. During the first year of the project, 89 major disruptive events occurred in 67 (32%) practices, with 20 practices experiencing multiple events. The major disruptive events reported most often during both periods were loss of personnel and implementation of electronic health records and billing systems. Practice size was associated with occurrence of these events. CONCLUSIONS: During a 2-year period, major disruptive events occurred at an alarming rate, adversely affecting quality improvement efforts. Most reported events involved losses of clinicians and staff. More research is needed to identify and address the root causes of these events.

ST product characteristics and relationships with perceptions and behaviors among rural adolescent males: a qualitative study.

Although smoking declines in the United States, the prevalence of male adolescent smokeless tobacco (ST; moist snuff and chewing tobacco) use remains unchanged. ST product characteristics, such as flavoring, packaging, and branding, could influence adolescents' ST initiation and continued use. This qualitative study examines the potential role of product characteristics in shaping ST-related perceptions and behaviors among rural adolescent males. Semi-structured individual interviews were conducted at three California rural high schools. ST users were asked about their experiences and perceptions related to product characteristics. Interviews were transcribed, coded, and analyzed using a general inductive approach. Participants associated flavored ST with appealing non-tobacco products, such as chewing gum and alcohol. Availability of different varieties and flavors stimulated interest and curiosity in sampling or switching between ST products. Time-limited promotional flavors and packaging also enhanced product appeal. Adolescent ST users preferred certain brands based on perceived brand features and perceived nicotine content, associating higher-strength brands as better suited for experienced ST users. Brand preferences frequently reflected perceived ST brand popularity within peer groups. Based on these observations, potential ST regulation and health education campaigns to address misconceptions about ST characteristics could influence adolescents' ST-related perceptions and reduce ST use among this vulnerable population.

Smokeless Tobacco Decision-Making Among Rural Adolescent Males in California.

Smokeless tobacco (ST) use among US high school males living in rural areas exceeds national levels. Subgroups at heightened risk of ST use have been identified, but less is known regarding ST decision-making within high-risk groups. The study objective was to describe rural adolescent males' perceived ST acceptability, health risks, and social implications and how those perceptions differ between ST users and never-users. Semi-structured individual interviews were conducted with a purposeful sample of 55 male students (32 ST ever-users) at three rural California high schools. Interviews were audio recorded and professionally transcribed. Investigators collaboratively developed a codebook based on thematic content and then independently coded transcripts, reconvening frequently to achieve consensus. Coded text was systematically organized into themes following a general inductive approach. ST users and non-users shared multiple ST-related perceptions, including: that ST is a common, normative way of life in rural "country" culture among certain groups; that ST use conveys oral health risks; and that the decision to use (or not to use) is rooted in personal choice. ST users' and never-users' perceptions differed regarding the immediacy, severity, and inevitability of health risks, particularly relative to cigarette smoking. Other differences included perceived parental permissiveness and the expected social benefits of ST use, such as peer acceptance and conveying maturity. Within this population of rural male adolescents, ST users emphasized the social benefits of ST use, while acknowledging but discounting health risks. Differences and similarities in tobacco perceptions among adolescents living in similar environments may inform effective health communication.

Oral-systemic health during pregnancy: exploring prenatal and oral health providers' information, motivation and behavioral skills.

Pregnancy is identified as a sensitive period of increased risk for poor oral health among mothers and offspring. Subsequently, both medical and dental associations have re-endorsed consolidated, inter-professional guidelines promoting oral health during pregnancy. The objective was to explore prenatal and oral health providers' information, motivation and practice behaviors related to oral health during pregnancy. Twenty-two in-depth interviews were conducted with prenatal and oral health providers based on the Information-Motivation-Behavioral Skills Model. Data were analyzed using the constant comparative method in NVivo 10. Providers held variable knowledge with regards to identified oral-systemic connections and implications. Most providers were unaware of the guidelines; however, some oral health providers reported avoiding specific treatment behaviors during this period. Motivation to address oral-systemic health during pregnancy included: prevention; healthy pregnancy/birth outcomes; patient's complaint/question as cue to action; comprehensive, patient-centered, and family-centered care; ethical duty; and professional governing body. Oral health providers reported assessing, educating, and communicating with patients about oral health issues; whereas prenatal providers rarely addressed oral health but reported signing approval forms to receive such care. A few oral health providers highlighted lifecourse implications and the need for family-centered care when addressing poor oral health among pregnant patients. Findings suggest gaps in oral health prevention information and behaviors among prenatal and oral health providers. Future efforts should examine effective dissemination and implementation strategies that translate evidence-based guidelines into clinical practice, with the ultimate goal of improve oral-systemic health among women and their offspring across the lifecourse.

Oral health perceptions of paediatric palliative care nursing staff.

Systematic oral care reduces oral complications among children in paediatric palliative care (PPC), yet little is known about the oral health perceptions of PPC nursing staff. This qualitative cross-sectional study used semi-structured interviews based on phenomenography to explore PPC nursing staff's perceptions of oral health and the relationship of oral care to comfort and quality of life. A purposive sample of nine nursing staff employed at a California PPC facility participated. Five themes emerged from the analysis of the interviews: signs of oral health, reasons for oral care, adaptation of oral care on a case-by-case basis, barriers to providing oral care, and facilitators of improving oral care. The perceived importance of oral health was the underlining similarity between the themes. A need for further research in the area of oral PPC is indicated. Collaboration with dental professionals may be needed to create oral PPC guidelines that fit the complex needs of children with life-limiting illnesses.

Membrane technology for treating decanted oily wastewater from marine oil spill operations: Comparison between membrane filtration and membrane bioreactor.

Canadian oil spill response regulations require collection of all liquids from a response operation, this involves many vessels and frequent trips to shore to dispose of collected liquids, which mainly comprise of water. Onsite treatment of decanted oily seawater would benefit operations by addressing vessel storage and trip frequency issues. Membrane technology has proven effective at treating oily wastewater from various industries; therefore, is a good candidate for onsite treatment of wastewater generated from response operations. In this study, oily seawater treatment efficiency of a pilot-scale physical membrane filtration and a bench-scale membrane bioreactor (MBR) were compared. Three main parameters were considered, total petroleum hydrocarbon, petroleum hydrocarbon fractions, and polycyclic aromatic hydrocarbons. 99.1 % and 98.2 % TPH removal efficiency were achieved by MBR (93.1 ppm initial oil concentration) and membrane filtration (28.3 ppm initial oil concentration), respectively. The MBR showed more promise than membrane filtration for onsite treatment of decanted wastewater.

The linkage between childhood bullying behaviour and future offending.

AIM: To examine the linkage between bullying behaviour in early childhood and any subsequent contact with the criminal justice system. METHODS: A Canadian sample (570 boys and 379 girls) was derived from clients who participated in the evidenced-based programme, SNAP (STOP NOW AND PLAN), between 2001 and 2009. A court order was obtained to access any criminal record data on participants. The Early Assessment Risk Lists (EARL-20B and EARL-21G) and the Child Behavior Checklist (CBCL) were used to identify level of risk and bullying behaviour. Outcome variables included age the child first came in contact with the criminal justice system and frequency. RESULTS: Logistic and Cox regression analyses indicate that the risk of onset of criminal offence for bullies was significantly higher than for non-bullies. The hazard of criminal offence for bullies is 1.9 times (95% CI: 1.1-3.2) than that of non-bullies. This holds true even when adjusted for age, gender and other risk factors. CONCLUSION: We found a strong linkage between bullying behaviour during childhood and subsequent criminal offending after the age of 12. Criminal convictions for bullies were nearly twice as high for non-bullies up to the child's 18th birthday. EARLs were effective in differentiating risk associated with bullying.

Development of a bench-scale immersed ultrafiltration apparatus for coagulation pretreatment experiments.

The purpose of this paper is to present results of a project that focused on developing a standardized bench-scale apparatus and operating procedures for immersed ultrafiltration (UF) membrane systems to assess integrated process designs (e.g., coagulation-UF) under controlled laboratory conditions. The integrated test apparatus, termed Immersed Ultrafiltration Enhanced Coagulation (IUEC), was designed using a hollow-fiber, outside-in UF module immersed in a single compartment water preparation and filtration tank equipped with aeration mixing capabilities for coagulation and flocculation process evaluations. Bench-scale experiments were conducted with alum on a low turbidity surface water source to evaluate system performance of the integrated IUEC apparatus compared to a standard jar test unit. The experiments were evaluated by measuring the removal of natural organic matter and zeta-potential analysis from water collected from a conventional mechanically-mixed process with a manual transfer to a UF membrane system and comparing these results to the IUEC system. The results of this study demonstrated that using the single-compartment IUEC apparatus can provide water quality data that is congruent with those obtained through conventional methods that rely on use of standard jar tests.

Differential importance of nucleus accumbens Ox1Rs and AMPARs for female and male mouse binge alcohol drinking.

Alcohol use disorder exhausts substantial social and economic costs, with recent dramatic increases in female problem drinking. Thus, it is critically important to understand signaling differences underlying alcohol consumption across the sexes. Orexin-1 receptors (Ox1Rs) can strongly promote motivated behavior, and we previously identified Ox1Rs within nucleus accumbens shell (shell) as crucial for driving binge intake in higher-drinking male mice. Here, shell Ox1R inhibition did not alter female mouse alcohol drinking, unlike in males. Also, lower dose systemic Ox1R inhibition reduced compulsion-like alcohol intake in both sexes, indicating that female Ox1Rs can drive some aspects of pathological consumption, and higher doses of systemic Ox1R inhibition (which might have more off-target effects) reduced binge drinking in both sexes. In contrast to shell Ox1Rs, inhibiting shell calcium-permeable AMPA receptors (CP-AMPARs) strongly reduced alcohol drinking in both sexes, which was specific to alcohol since this did not reduce saccharin intake in either sex. Our results together suggest that the shell critically regulates binge drinking in both sexes, with shell CP-AMPARs supporting intake in both sexes, while shell Ox1Rs drove drinking only in males. Our findings provide important new information about sex-specific and -general mechanisms that promote binge alcohol intake and possible targeted therapeutic interventions.

The role of anterior insula-brainstem projections and alpha-1 noradrenergic receptors for compulsion-like and alcohol-only drinking.

Compulsion-like alcohol drinking (CLAD), where consumption continues despite negative consequences, is a major obstacle to treating alcohol use disorder. The locus coeruleus area in the brainstem and norepinephrine receptor (NER) signaling in forebrain cortical regions have been implicated in adaptive responding under stress, which is conceptually similar to compulsion-like responding (adaptive responding despite the presence of stress or conflict). Thus, we examined whether anterior insula (aINS)-to-brainstem connections and alpha-1 NERs regulated compulsion-like intake and alcohol-only drinking (AOD). Halorhodopsin inhibition of aINS-brainstem significantly reduced CLAD, with no effect on alcohol-only or saccharin intake, suggesting a specific aINS-brainstem role in aversion-resistant drinking. In contrast, prazosin inhibition of alpha-1 NERs systemically reduced both CLAD and AOD. Similar to systemic inhibition, intra-aINS alpha-1-NER antagonism reduced both CLAD and AOD. Global aINS inhibition with GABAR agonists also strongly reduced both CLAD and AOD, without impacting saccharin intake or locomotion, while aINS inhibition of calcium-permeable AMPARs (with NASPM) reduced CLAD without impacting AOD. Finally, prazosin inhibition of CLAD and AOD was not correlated with each other, systemically or within aINS, suggesting the possibility that different aINS pathways regulate CLAD versus AOD, which will require further study to definitively address. Together, our results provide important new information showing that some aINS pathways (aINS-brainstem and NASPM-sensitive) specifically regulate compulsion-like alcohol consumption, while aINS more generally may contain parallel pathways promoting CLAD versus AOD. These findings also support the importance of the adaptive stress response system for multiple forms of alcohol drinking.

Psychosocial Intervention for Youth With High Externalizing Behaviors and Aggression Is Associated With Improvement in Impulsivity and Brain Gray Matter Volume Changes.

Background: Stop, Now And Plan (SNAP) is a cognitive behavioral-based psychosocial intervention that has a strong evidence base for treating youth with high aggression and externalizing behaviors, many of whom have disruptive behavior disorders. In a pre-post design, we tested whether SNAP could improve externalizing behaviors, assessed by the parent-rated Child Behavior Checklist (CBCL) and also improve behavioral measures of impulsivity in children with high aggression and impulsivity. We then investigated whether any improvement in externalizing behavior or impulsivity was associated with gray matter volume (GMV) changes assessed using structural magnetic resonance imaging (sMRI). We also recruited typically developing youth who were assessed twice without undergoing the SNAP intervention. Methods: Ten children who were participating in SNAP treatment completed the entire study protocol. CBCL measures, behavioral measures of impulsivity, and sMRI scanning was conducted pre-SNAP and then 13 weeks later post-SNAP. Twelve healthy controls also completed the study; they were rated on the CBCL, performed the same behavioral measure of impulsivity, and underwent sMRI twice, separated by 13 weeks. They did not receive the SNAP intervention. Result: At baseline, SNAP participants had higher CBCL scores and performed worse on the impulsivity task compared with the healthy controls. At the second visit, SNAP participants still had higher scores on the CBCL compared with normally-developing controls, but their performance on the impulsivity task had improved to the point where their results were indistinguishable from the healthy controls. Structural magnetic resonance imaging in the SNAP participants further revealed that improvements in impulsivity were associated with GMV changes in the frontotemporal region. Conclusion: These results suggest that SNAP led to improvement in behavioral measures of impulsivity in a cohort of boys with high externalizing behavior. Improvement in impulsivity was also associated with increased GMV changes. The mechanism behind these brain changes is unknown but could relate to cognitive behavioral therapy and contingency management interventions, important components of SNAP, that target frontotemporal brain regions. Clinically, this study offers new evidence for the potential targeting of brain regions by non-invasive modalities, such as repetitive transcranial magnetic stimulation, to improve externalizing behavior and impulsivity.

Smokeless tobacco cessation cluster randomized trial with rural high school males: intervention interaction with baseline smoking.

INTRODUCTION: Adolescent males in rural areas use smokeless tobacco (ST). We assessed the efficacy of a school-based nurse-directed ST intervention among rural high school males. METHODS: Study high schools were randomly selected from a public high school list of California rural counties. Consenting high schools were stratified by school size and randomly assigned within strata to intervention or no-intervention groups. After gaining parental consent, male students completed baseline and 1-year follow-up questionnaires. The intervention included peer-led educational sessions and an oral exam by the school nurse who also provided brief tobacco cessation counseling. We used binary generalized estimating equation (GEE) models accounting for clustering within schools to test no difference between groups after adjusting for year in high school using both completers only and multiple imputation for those lost to follow-up. Subgroup analyses assessed Baseline Factor x Group interaction in GEE models. RESULTS: Twenty-one rural counties (72%), 41 randomly selected high schools (56%), and 4,731 male students (50%) participated with 65% retention. Nonsmoking ST users in the intervention group were significantly more likely to stop using ST at follow-up than those in the no-intervention group; there was no intervention effect among baseline ST users who also smoked. A higher percentage of baseline nonsmoking ST users reported smoking at follow-up than baseline non-ST-using smokers who reported using ST. DISCUSSION: A school-based nurse-directed ST cessation program was efficacious among rural nonsmoking ST-using high school males. The potential program reach holds significant public health value. Baseline ST use facilitated smoking at follow-up.

Bridging the gender gap: interventions with aggressive girls and their parents.

In response to a gap in gender-sensitive programming for young aggressive girls (5-11) and their families, the SNAP Girls Connection (GC) was developed in 1996. This multi-systemic intervention is built on a developmental model of risk and protective factors within the girl and her relationships. We evaluated the SNAP(R) GC using a prospective quasi-experimental design, randomly assigning 80 girls to treatment (N = 45) and waiting-list groups (N = 35) over 2 years. Fifty-five parents completed measures at assessment periods 1, 2 and 3. Results showed significant positive changes on girls' problem behavior and parenting skills for the treatment versus the waiting-list groups, as well as maintenance of treatment gains. Implications of the findings on treatment effectiveness of this gender-sensitive intervention are discussed.

Dentists' attitudes and practices related to diabetes in the dental setting.

OBJECTIVE: The objective of this study was to determine general dentists' attitudes and practices related to patients with diabetes, a major public health issue with oral complications. METHODS: This study was a cross-sectional survey of 265 randomly selected general dentists who were Delta Dental providers in California, West Virginia, and Pennsylvania. RESULTS: Sixty-one percent of respondents believed that addressing diabetes was important to their role as a dentist, 86 percent advised patients with diabetes about periodontal risks, 18 percent provided diabetic-related services, 47 percent reported they knew how to assess for diabetes, and 42 percent felt well prepared to intervene with patients with diabetes. Adjusting for number of patients with diabetes and adult patients seen in the past month, dentists' formal training in diabetes assessment and management [odds ratio (OR) = 4.0, P = 0.000, confidence interval (CI) = 1.9, 8.5], and belief in the importance of their role as a dentist to intervene with patients with diabetes (OR = 1.6, P = 0.011, CI = 1.1,2.3) were both significant factors in providing services for patients with diabetes. Similarly, dentists' formal training (OR = 3.0, P = 0.02, CI = 1.2, 7.3) and belief in the importance of their role (OR = 1.9, P = 0.00, CI = 1.3, 2.6) were both significant factors in advising patients with diabetes about periodontal risk associated with diabetes. CONCLUSIONS: Formal training and personal beliefs are important factors related to dentists' behavior toward patients with diabetes in the dental setting.

Patterns and correlates of spit tobacco use among high school males in rural California.

OBJECTIVE: To assess patterns and correlates of spit [smokeless tobacco (ST)] use among high school males in rural California. METHODS: An 18-item, self-administered questionnaire was used to assess ST use among young males in 41 randomly selected high schools in 21 rural counties in California. To ensure confidentiality, students were instructed to seal their completed questionnaire in an attached envelope prior to returning it to the questionnaire administrator. RESULTS: Overall prevalence of ST use was 9.8 percent, significantly increasing with year in school from 5 percent among freshmen to 15 percent among seniors. ST use was highest among rodeo athletes at 42 percent compared with <6 percent among nonathletes; ST use was significantly higher among smokers (32 percent) who were 2.5-30 times more likely to use ST compared with nonsmokers, depending on race/ethnicity as a result of a significant race/ethnicity x smoking interaction of degree/magnitude. In addition, students who believed there was no, or slight risk of, harm from ST use were significantly more likely to use ST than students perceiving moderate or great risk, depending on race/ethnicity (odds ratios 3.6-13). Among all ST users, 40 percent used ST on at least 5 days in the previous week, 80 percent of those reporting a brand used the brand Copenhagen, and 41 percent (189) used ST within 30 minutes of waking. CONCLUSION: Dental public health practitioners, scholars, and policy-makers need to promote dental health through organized community efforts targeting high school male subgroups in rural areas that are at risk for ST-associated adverse health effects.

Tobacco control in pediatric dental practices: a survey of practitioners.

PURPOSE: The study purpose was to determine tobacco-related knowledge, attitudes, and practice behaviors of American Academy of Pediatric Dentistry (AAPD) members. METHODS: A 26-item survey was distributed to a national, random sample of 1,700 AAPD members. Frequencies, odds ratios and 95% confidence intervals assessed factors related to tobacco control behaviors. RESULTS: Of 1,700 questionnaires, 1,292 (82%) were returned and usable. Over 75% of respondents agreed that it is a pediatric dentist's responsibility to help patients who wish to stop using tobacco; only 142 (11%) had prior tobacco prevention/cessation training. Of those untrained, 905 (70%) were willing to be trained. Not knowing where to send patients for counseling and feeling ineffective with helping patients to stop their tobacco use were significant barriers reported by nearly half the respondents. Two hundred forty-five (19%) reported always/often asking their adolescent patients about tobacco use; 491 (38%) reported always/often advising known tobacco users to quit; and 284 (22%) reported always/often assisting with stopping tobacco use. Feeling well prepared to ask about tobacco was significantly associated with assisting tobacco users (odds ratio=8.9; 95% confidence interval=6.6-12). CONCLUSION: Continuing education programs are needed to enhance the knowledge and skills of pediatric dentists to promote tobacco control behaviors.

Conducting evaluation research with children exposed to violence: How technological innovations in methodologies and data collection may enhance the process.

Research and program evaluation processes that engage children and youth are becoming much more common due to influences from children's rights and the acknowledgement that children have the capacity to contribute to research, both as participants and co-researchers (Roberts, 2017). Recent technological advances in the form of tablet and internet-based applications have provided researchers with additional methodological tools to better capture the voices and experiences of children and their caregivers (Livingstone & Blum-Ross, 2017). However, little has been written on the ways in which these new technological advances can improve research experiences for children who have been exposed to intimate partner and family violence, as well as other forms of traumatic experiences. This paper provides a review of current literature and a case study example of how one children's mental health agency has implemented tablet-based data collection procedures.

Nursing Administrators' Views on Oral Health in Long-Term Care Facilities: An exploratory study.

Purpose: To explore the knowledge, attitudes, and practices of supervising nurse administrators (SNAs) regarding the oral care provided to long-term care facility (LTCF) residents and the role of dental professionals in those facilities.Methods: The investigators of this study partnered with the National Association of Nursing Administrators to send this cross-sectional study consisting of a 35-item electronic survey to its members whose email addresses were in their database. Online software tabulated responses and calculated frequencies (percentages) of responses for each survey item.Results: Of the 2,359 potential participants, 171 (n=171) completed the survey for a 7% response rate. Only 25% of the respondents were familiar with the expertise of dental hygienists (DHs), however once informed, the majority were interested in having DHs perform oral health staff trainings, oral screenings, and dental referrals and initiate fluoride varnish programs. Most respondents correctly answered the oral health-related knowledge items, understood that oral health is important to general health, but reported that the LTCF residents' oral health was only "good" or "fair." Fewer than half, (48%) of the SNAs were "very satisfied" with the quality of oral care provided to the residents. While more than half reported that they had no dentist on staff or on-site dental equipment, 77% reported that they would consider on-site mobile oral care services. Oral health training for staff was provided primarily by registered nurses, however only 32% reported including identification of dental caries as part of the in-service training.Conclusion: This exploratory study lays the foundation for more extensive research investigating various strategies to improve the oral health of LTCF residents, including increased collaboration between DHs and SNAs.

Patterns and correlates of tobacco control behavior among american association of pediatric dentistry members: a cross-sectional national study.

BACKGROUND: To determine the tobacco-related knowledge, attitudes, and practice behaviors among US pediatric dentists. METHODS: A survey was conducted in 1998 among a national, random sample of 1500 American Academy of Pediatric Dentistry members. Chi-square tests and logistic regression with odds ratios (ORs) and 95% confidence intervals assessed factors related to pediatric dentists' tobacco control behaviors. RESULTS: Response was 65% for the survey. Only 12% of respondents had prior tobacco prevention/cessation training. Of those untrained, 70% were willing to be trained. Less than two-thirds correctly answered any of four tobacco-related knowledge items. Over one-half agreed pediatric dentists should engage in tobacco control behaviors, but identified patient resistance as a barrier. About 24% of respondents reported always/often asking their adolescent patients about tobacco use; 73% reported always/often advising known tobacco users to quit; and 37% of respondents always/often assisting with stopping tobacco use. Feeling prepared to perform tobacco control behaviors (ORs = 1.9-2.8), a more positive attitude score (4 points) from 11 tobacco-related items (ORs = 1.5-1.8), and a higher statewide tobacco use prevalence significantly predicted performance of tobacco control behaviors. CONCLUSION: Findings suggest thatraining programs on tobacco use and dependence treatment in the pediatric dental setting may be needed to promote tobacco control behaviors for adolescent patients.