Teens' Tobacco Use and Their Oral Health

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Teen smokeless tobacco users more likely to smoke cigarettes as well

August 22, 2013 / Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

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(dailyRx News) Some teens hoping to avoid the harmful effects of cigarette smoking may try smokeless tobacco products instead. But using these products also carries significant health risks like oral cancer.

A recent study found that teens who used smokeless tobacco were more likely to smoke cigarettes than teens who did not use smokeless tobacco.

Given the oral health risks associated with tobacco use, the study noted that dentists may be able to help educate teens about these risks.

"Talk to your dentist about the harmful effects of tobacco."

This study was done by R. Constance Wiener, MA, DMD, PhD, in the Department of Dental Practice and Rural Health, School of Dentistry at West Virginia University. She examined whether teens who smoked were more likely to also use smokeless tobacco than teens who did not smoke.

Smokeless tobacco comes in many forms, including chewing tobacco and snus (a dissolvable tobacco).

Dr. Wiener analyzed data from 9,655 high school participants (9th to 12th grade) in the 2011 national Youth Risk Behavior Surveillance System (YRBSS).

Smoking status was determined by asking participants how many days they had smoked cigarettes in the previous 30 days. Use of smokeless tobacco was also determined by asking participants whether they had used any smokeless tobacco products in the previous 30 days.

Several factors were taken into account when analyzing the data. These factors included sex, race/ethnicity, participation on a sports team, BMI (a measure used to determine if someone is a healthy weight), soda use, binge drinking, having ridden in a vehicle with a driver who had been drinking, marijuana use and having had sexual intercourse.

Dr. Wiener found that teens who used smokeless tobacco were about four times more likely to smoke cigarettes than teens who did not use smokeless tobacco.

Female smokeless tobacco users were over five times more likely to smoke cigarettes than females who did not use smokeless tobacco, while male smokeless tobacco users were more than 3.5 times more likely to smoke cigarettes than males who did not use smokeless tobacco.

It was also found that smokeless tobacco users were more likely to be white, male, have ridden with a driver that had been drinking alcohol and have engaged in binge drinking and sexual intercourse. 

Cigarette smoking among teens has decreased since 2002, but their use of other tobacco products has not, with some studies showing an increase. Dr. Wiener noted that dentists have a chance to educate teens on the risks of tobacco use and provide help with quitting during routine dental care.

"We are seeing a disturbing trend where more and more young people are using smokeless tobacco. Teens must be educated that using smokeless tobacco in place of cigarettes in  smoke free environments does not decrease their risk of lung cancer, as lung cancer risk is affected most by how long a person smokes," Dana Fort, DDS, a general dentist at Atlagic Dental, told dailyRx News.

"Rather, the use of smokeless tobacco puts them at additional risk of developing other oral and esophageal cancers as well as gum disease and tooth loss," said Dr. Fort.

This study was published on August 1 in the Journal of the American Dental Association.

The study author did not report any conflicts of interest.