Association of smokeless tobacco use and smoking in adolescents in the United States

Wiener, R. Constance

doi:10.14219/jada.archive.2013.0212

Cited by 16 publications

(6 citation statements)

References 25 publications

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“…Using published cut points for “positive screens” or values that would warrant further discussion, (Cella et al 2012; Coleman et al 2012; Kroenke et al 2009; Paxton et al 2011; Rohrer et al 2009; Smith et al 2009, 2010; Snowden et al 2011; Wiener 2013), we calculated the proportion of respondents who would qualify for primary care intervention for each health behavior and mental health measure. We calculated the frequency of each positive screen and total number of positive screens per patient for each practice and for subgroups of practices (FQHC vs. PBRN vs. VA).…”

Section: Methodsmentioning

confidence: 99%

Real-World Implementation and Outcomes of Health Behavior and Mental Health Assessment

Rodríguez

Glenn²,

Olmos

et al. 2014

The Journal of the American Board of Family Medicine

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Background Assessing patient-reported health behaviors is a critical first step to prioritizing prevention in primary care. We assessed the feasibility of point-of-care behavioral health assessment in nine diverse primary care practices, including four federally-qualified health centers (FQHCs), four Practice-based Research Network (PBRN) practices, and a Department of Veterans Affairs (VA) practice. Methods In this prospective mixed-methods study, practices were asked to integrate a standardized paper-based health behavior and mental health assessment into their workflow for 50 or more patients. We used three data sources to examine the implementation process: 1) patient responses to the health assessment, 2) patient feedback surveys about how assessments were used during encounters, and 3) post-implementation interviews. Results Most (71%) non-urgent patients visiting the participating practices during the implementation period completed the health assessment, but reach varied by practice (range: 59-88%). Unhealthy diet, sedentary lifestyle, and stress were the most common patient problems with similar frequencies observed across practices. The median number of “positive screens” per patient was similar across FQHCs (3.7-positives, SD=1.8), PBRN practices (3.8-positives, SD=1.9), and the VA clinic (4.1-positives, SD=2.0). Primary care clinicians discussed assessment results with patients about half of the time (54%), with considerable between practice variation (range: 13%-66% with lowest use among FQHC clinicians). Although clinicians were interested in routinely implementing assessments, many reported not feeling confident of having resources or support to address all patients’ behavioral health needs. Conclusions Primary care practices will need to revamp their patient-reported data collection processes in order to integrate routine health behavior assessments. Implementation support will be required if health assessments are to be actively used as part of routine primary care.

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Section: Methodsmentioning

confidence: 99%

Real-World Implementation and Outcomes of Health Behavior and Mental Health Assessment

Rodríguez

Glenn²,

Olmos

et al. 2014

The Journal of the American Board of Family Medicine

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“…This nding is not surprising given that the etiology of oral cancer is complex, and some potential confounders were not controlled for due to a lack of such information, including alcohol consumption and HPV infection. Previous studies have found that users of ST were more likely to be heavier alcohol drinkers [44,45]. Furthermore, the existing evidence points to a positive association between tobacco use and HPV [46].…”

Section: Discussionmentioning

confidence: 99%

Oral cancer risk among people who smoke, have quit smoking, use smokeless tobacco, or former smokers that use smokeless tobacco observed from state-based cancer registries

Noggle

Cheng

Sarkar

2023

Preprint

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Background Tobacco use has been identified as a risk factor for oral cancer worldwide. However, oral cancer risk among people who smoke cigarettes, use smokeless tobacco products (ST), have transitioned from cigarettes to ST (“switchers”) or quit both cigarettes and/or ST (“quitters”) has not been well studied. This study compared oral cancer incidence between 2014–2017 relative to never tobacco use.Methods We estimated incidence rates and incidence rate ratios using data from state-wide cancer registries (i.e., Colorado, Florida, North Carolina, and Texas) and population counts derived from national surveys. A random-effect meta-analysis approach was used to summarize estimates among these groups, based on multiple imputation-based incidence rate ratio estimates, by state and age groups while considering potential heterogeneity.Results A total of 19,536 oral cancer cases were identified among adult males 35 years and older in the study geographies and period. People who currently smoked cigarettes were 2.6 (95% CI = 2.0-3.3) times as likely to be diagnosed with oral cancer compared to individuals who currently used ST. The incidence rate ratio among people who currently smoke cigarettes was 3.6 (95% CI = 3.2–4.1) relative to never users, 2.4 (95% CI = 1.8–3.1) relative to switchers and 1.4 (95% CI = 1.0-2.1) among switchers relative to quitters. The incidence rate ratio of current users of ST relative to never-users was 1.4 (95% CI = 1.1–1.9).Conclusions Findings from this population-based study with a large number of oral cancer cases support lower risk of oral cancer among users of ST compared to cigarettes. Compared to those who continue to smoke, oral cancer risks can be reduced by switching to ST products or quitting all tobacco.

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“…Free nicotine (unionized and PH above 6.5) is readily absorbed into biological tissues, and well absorbed through the mouth and buccal membranes. The significance of the transfer of tobacco-related constituents and toxicants across oral mucosal membranes increases the potential for systemic diseases, oral diseases and many forms of cancer [18][19][20]. Constituents cross oral mucosal membranes, enter the bloodstream and subsequently the brain where is exerts the pharmacological effects that may lead to addiction [20].…”

Section: American Journal Of Biomedical Science and Researchmentioning

confidence: 99%

“…The significance of the transfer of tobacco-related constituents and toxicants across oral mucosal membranes increases the potential for systemic diseases, oral diseases and many forms of cancer [18][19][20]. Constituents cross oral mucosal membranes, enter the bloodstream and subsequently the brain where is exerts the pharmacological effects that may lead to addiction [20]. The results of two studies by Hatsukami.…”

Section: American Journal Of Biomedical Science and Researchmentioning

confidence: 99%

Approaches to Broaden Messaging about the Harms Tobacco Use

Warner

2021

AJBSR

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Dentist and other health professionals can have great influence to prevent and decrease the use tobacco products, through patient visits, direct messaging and social media. A brief part of the dental and medical visit can be used for providing current, state-of-the-art research and information on the harms of e-cigarette and cigarette use and the use of smokeless tobacco products. Many studies have shown that various tobacco products contain toxicants, constituents and harmful chemicals. Variations of different combinations of tobacco-related toxicants pass through the oral mucosal tissues, enter body fluids and systems causing severe health effects. During the assessment of findings and sharing of visual materials segment of the visit, the health professional can present the information so that the patient can better understand the physiological changes that may occur systemically, and the morbidity and mortality that may be associated with long-term tobacco use. Evidence-based research on the adverse health effects of tobacco use can be shared solely with the patient, and broadly through social media.

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Association of smokeless tobacco use and smoking in adolescents in the United States

Cited by 16 publications

References 25 publications

Real-World Implementation and Outcomes of Health Behavior and Mental Health Assessment

Real-World Implementation and Outcomes of Health Behavior and Mental Health Assessment

Oral cancer risk among people who smoke, have quit smoking, use smokeless tobacco, or former smokers that use smokeless tobacco observed from state-based cancer registries

Approaches to Broaden Messaging about the Harms Tobacco Use

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