The changing tobacco landscape

Abstract

Background Recently, the range of tobacco products available in the United States and the patterns of tobacco product use have changed. While cigarette smoking prevalence has declined, dental professionals are likely to encounter many more users of new and alternative tobacco products among their patients. Approach This paper reviews conventional and new tobacco products currently available, their adverse oral and systemic health effects, and their prevalence of use in the US. Results Tobacco products other than cigarettes currently account for a substantial portion of tobacco use. For this reason, tobacco prevention and cessation counseling provided by dental professionals must address all tobacco products, including cigarettes, cigars, waterpipes (hookahs), and electronic cigarettes, as well as conventional and new smokeless tobacco products. Cigarette smoking and smokeless tobacco use are associated with immediate and long-term adverse health effects, including nicotine addiction, oral and systemic disease, and death. Novel products may attract new tobacco users, potentially leading to addiction that results in enduring tobacco product use and associated adverse health effects. Practical Implications Dental professionals regularly treat patients who use tobacco or who are at risk of initiating use. Therefore, it is essential that dental professionals are knowledgeable about tobacco products currently available and are able to answer patients' questions and to provide them with evidence-based tobacco-related counseling.

Evaluation of the prevalence of oral mucosal lesions in a population of eastern coast of South India

“…[ 18 ] The study also shows that smoking habit was more prevalent in men when compared to the other two habits [ Figure 1 ]. Socioeconomic status is found to have strong association with various adverse habits as participants with income <5000 had high prevalence of smoking and chewing tobacco, which was much similar to the United States study (2017)[ 19 ] wherein groups with economic or social disadvantage had higher prevalence of smoking (29.2%).…”

What should every dental health professional know about electronic cigarettes?

“…E‐cigarettes provide nicotine in an aerosol state without tobacco combustion and are thought to produce less toxins than cigarette smoke 2 . However, E‐cigarette aerosols can contain toxic compounds including: nicotine, tobacco‐specific nitrosamines, acetaldehyde, acrolein and toluene albeit at lesser quantities than conventional cigarettes 6,8 …”

“…E‐cigarettes come in many different designs and types and might be disposable or rechargeable. As E‐liquids are not directly produced from the tobacco leaf they are not universally classified as a tobacco product 6 …”

“…In Australia the trends appear to be different with 65% of 14–17 year‐olds and 39% of 18–24 year‐olds reporting they were a ‘never smoker’ the first time they tried an E‐cigarette 28 . Some data in the USA and UK show E‐cigarette users who ‘never smoked’ are more likely to try conventional cigarettes, resulting in possible increased nicotine dependence and dual use 6,33,37 . However, a causal link has not been established nor has a progression to conventional cigarettes 38…”

“…Dental professionals are in regular contact with their patient base, many of whom use tobacco or related products. Therefore it is important that dental professionals are up to date regarding the latest products available and are able to answer questions and provide evidence‐based counsel 6 . With the lack of consistent advice provided, this paper aims to summarize the current evidence and answer key questions regarding E‐cigarettes in a dental context.…”