Longitudinal association of smoking-related attitude to oral health with adolescents' smoking onset

Objective: The negative oral health effects of smoking, such as stained teeth, gum infection, and bad breath may be more salient to adolescents, and therefore, more important expectancies for adolescent smokers and nonsmokers alike. Informed by the social cognitive theory, this prospective study sought to determine the role of smoking-related attitude to oral health on smoking onset among adolescents over a 12-month interval. Method: This prospective study involved a community sample of 422 nonsmoking eighth graders selected from three public schools in the capital city of South Africa. Data were collected through a questionnaire, which included a 5-point Likert-scale-type question on dental disease belief related to smoking (smoking causes plaque and bad breath) and an affective evaluation of this effect (bad breath causes peer rejection). The product of these two later variables was used to compute an attitude score. Higher scores represent a more favorable oral health attitude. Health-risk behaviors recorded included past month smoking and alcohol use. Results: The mean age of the participants was 13.9 years at baseline. At 1-year follow-up, 11.4 percent (n  =  48) of nonsmokers at baseline had initiated smoking. Compared to nonsmokers, current smokers were more likely to report frequent bleeding gums (51.2 versus 33.1 percent; P  =  0.02), but there was no significant difference in proportions brushing twice daily (64.4 versus 56.5 percent; P  =  0.30). In addition to the independent influence of peers and binge drinking, smoking-related attitude to oral health significantly influenced smoking onset. Conclusion: The study findings support the development of smoking prevention programs that include restructuring of cognitions about the oral health outcomes of smoking.     

Tooth mortality in smokers and nonsmokers in a selected population in Sana'a, Yemen

Background and Objective:  Tobacco smoking has been shown to be a major risk factor for tooth loss. The present study was designed to examine tooth mortality and the patterns of tooth loss in smokers and nonsmokers over a wide age range in a selected population from Sana'a, Yemen.
Material and Methods:  A total of 2506 persons between the ages of 15 and 64 years were examined, and every permanent tooth was assessed. Missing teeth included both extracted and missing teeth. Individuals currently smoking one or more boxes of cigarettes (20 cigarettes) a day for 5 years were considered as smokers, whereas individuals with no smoking history were considered as nonsmokers.
Results:  Smokers had a higher mean tooth loss than nonsmokers. The difference was statistically significant at p  < 0.001. Mean tooth loss was significantly higher in smokers across all age groups, except for those in the 45–54 years age group. Smokers had a significantly higher mean upper tooth loss than nonsmokers. Tooth loss decreased from the incisors to the canines and then increased, with peak loss in the first molars.
Conclusion:  Tooth loss among smokers is significantly higher than among nonsmokers. The central incisors, lateral incisors and first molars were the most commonly missing teeth in smokers, compared with nonsmokers.     

Tobacco smoking and periodontal health in a Saudi Arabian population

BACKGROUND & AIM: Tobacco smoking exerts a harmful effect on the periodontal tissues manifested by periodontal pockets, attachment loss and periodontal bone loss. Current evidences on the effects of tobacco on periodontal health mainly concern cigarette smoking. In view of the increasing popularity of water pipe smoking in Arabian countries and reports confirming that water pipe smoking has health effects similar to those of cigarette smoking, there is a need for a better understanding of the potential harm of this smoking habit. The present thesis was carried out in order to explore whether water pipe smoking is associated with periodontal health in a manner similar to cigarette smoking. MATERIAL & METHODS: Residents in Jeddah City, Saudi Arabia, were invited to participate in the study by means of announcements in two daily newspapers. 355 individuals, 100 women and 255 men (17-60 years) responded to a standardized questionnaire and digital panoramic dental radiographs were taken. The questionnaire included information about oral hygiene practices, dental care and smoking habits. Of these subjects, 262 (73%) also volunteered for clinical examination, including assessments of oral hygiene, gingival inflammation and probing depth. Subgingival microbial test was carried out in 198 individuals for the detection of 12 different bacterial species most commonly associated with periodontal disease using the checkerboard DNA-DNA hybridization technique. Participants were stratified into water pipe smokers 33%, cigarette smokers 20%, smokers of both water pipe and cigarettes (mixed smokers 19%) and non-smokers 28%. RESULTS: Tobacco smoking is associated with a suppression of the gingival bleeding response to plaque accumulation. A suppressive effect was observed in both cigarette and water pipe smokers compared to non-smokers (Study I). Both cigarette and water pipe smoking were associated with the presence of more than 10 pockets of > or = 5 mm probing depth. The relative risk for periodontal disease was 5.1-fold and 3.8-fold increased in water pipe and cigarette smokers, respectively, compared to non-smokers (p < 0.01). The relative risk associated with heavy smoking was about 8-fold elevated in water pipe smokers and 5-fold elevated in cigarette smokers, suggesting an exposure-response effect (Study II). Tobacco smoking was associated with a reduction of the periodontal bone height. The reduction was of similar magnitude in water pipe smokers and cigarette smokers. The relative risk of periodontal bone loss of more than 30% of the root length was 3.5-fold and 4.3-fold elevated in water pipe and cigarette smokers, respectively, compared to non-smokers (p < 0.01). The relative risk associated with heavy smoking was 7.5-fold elevated in water pipe smokers and 6.3-fold elevated cigarette smokers (Study III). Further more, cigarette smokers, water pipe smokers and non-smokers exhibited similar periodontal microflora (Study IV). CONCLUSION: Tobacco smoking is associated with inferior periodontal health. The impact of water pipe smoking is of largely the same magnitude as that of cigarette smoking. The association between tobacco smoking and an inferior periodontal health seems to be independent of the subgingival microflora. Water pipe smoking habit should be considered in periodontal health.     

Dental service use and the implications for oral cancer screening in a sample of Bangladeshi adult medical care users living in Tower Hamlets, UK.

AIM: To assess the use of dental services, barriers to uptake of dental care and attitudes to regular dental examinations and the prevalence of tobacco and paan chewing habits in a group of Bangladeshi medical care users. DESIGN: Multi-centre cross-sectional study. SETTING: Four general medical practices' waiting areas in Tower Hamlets. SUBJECTS: Bangladeshi adults aged 40 years and over. INTERVENTION: An interview schedule. MAIN OUTCOME MEASURES: The prevalence of tobacco smoking and paan chewing with or without the addition of tobacco. The use of dental services, barriers to the use of dental services and attitudes to regular dental examinations. RESULTS: Results were obtained from 158 subjects (response rate 85%). 25% of the whole sample had never visited a dentist. These were significantly (P < 0.05) more likely to be women, who also thought regular check-ups were of little value. In their use of health services 73% experienced language difficulties. 33% of the sample were tobacco smokers. Paan was chewed by 78% of the sample with significantly (P < 0.05) more females than males adding tobacco to their quid and chewing more frequently than males. CONCLUSION: There are considerable barriers to be overcome if dental practices are to be the site for oral cancer screening and oral health promotion in this population. There are sex differences in reported behaviour and attitudes about use of dental services and in tobacco and paan use in this Bangladeshi sample. Further research is needed to establish why this ethnic minority attend general medical practices but not general dental practices.     

Smoking habits and attitudes of oral and maxillofacial surgeons

A survey was done on the smoking behavior and attitudes of 1349 fellows and members of the American Association of Oral and Maxillofacial Surgeons. It was found that only 8% of this group currently smoke, 40% were former smokers, and 52% had never smoked; the nonsmokers were significantly younger than the smokers. The respondents generally did not permit smoking in the waiting room, and were active in advising patients against smoking and in follow-up on their use of tobacco. It was concluded that although there is still room for improvement, oral and maxillofacial surgeons are currently quite effective in controlling their own smoking habits and in helping their patients to do likewise.     

Oral melanin pigmentation related to smoking in a Turkish population

OBJECTIVE: Besides genetic factors, tobacco smoking has been found to be the major cause of oral melanin pigmentation. The purpose of the present study was to evaluate the frequency of oral melanin pigmentation in a Turkish population and to present its correlation with clinical parameters relevant to periodontal status in current smokers, non-smokers, former smokers. METHOD: A sample of 496 patients was randomly selected. The subjects were interviewed regarding their smoking habits. They were clinically examined by a single examiner for the presence of oral melanin pigmentation in different oral mucosal regions. The same examiner recorded the clinical parameters including GI (gingival index), PI (plaque index), BOP (bleeding on probing), PD (probing depth) and GR (gingival recession). Examiner 2 completed a questionnaire concerning skin color and smoking habits. RESULTS: In the study group, 41% were current smokers, 46% nonsmokers and 13% former smokers. The frequencies of pigmented areas were significantly higher in current smokers than in those without any smoking habits. The clinical parameters revealed similar findings for all groups. Low GI and BOP values were observed for current smokers when compared with non-smokers and former smokers, respectively. GI values were significantly associated with the pigmentations in gingiva. CONCLUSIONS: The results of our study show that smokers in a Turkish population had significantly more pigmented oral surfaces than nonsmokers.     

Smoking and Oral Health: a Population Survey in Finland

Objectives: A survey was conducted to study smokers' oral health behaviors and attitudes, and to determine if smokers were advised by their dentists to quit smoking. Methods : A random sample of 1,200 adults 15 to 64 years of age living in the province of North Karelia, Finland, was selected in each of two study years (1990 and 1991) and surveyed using a mail questionnaire. The 102-item questionnaire solicited information on smoking status, oral health behaviors, missing teeth, perceptions of tobacco's harmful effects on oral health, smoking status and quitting, and advice on smoking cessation provided by dentists. Variations in behaviors and opinions according to smoking status were analyzed. Results : Nonsmokers reported more frequent healthy oral health behaviors than did daily smokers, with the exception that no difference in toothbrushing frequencies existed among women. Daily smoking was associated with increased use of sugar in tea or coffee, and with more frequent alcohol consumption. Daily smoking was correlated with the number of missing teeth in bivariate analyses, but not in multivariate analyses. Fewer daily smokers than nonsmokers considered smoking to have harmful effects on oral health. The majority of daily smokers, however, wanted to quit. Eight percent of daily smokers reported that they had been advised by their dentist to quit. Conclusions : Dentists need to provide patients with counseling on tobacco use because of the desire of many smokers to quit. Counseling of smokers by the oral health team requires special attention and skills, because smokers' health behaviors and attitudes appear to be less favorable to oral health compared to nonsmokers.     

Attitudes of Italian dental and dental hygiene students toward tobacco-use cessation

Objective:  The aim of this study was to investigate the smoking habits of Italian dental and dental hygiene students and to assess their knowledge on the health effects of cigarette smoking and their attitudes toward tobacco-use cessation (TUC) in dental practice.
Materials and methods:  Data was collected from 220 students attending the Dental and Dental Hygiene Schools (DS and DHS, respectively) at the University of Palermo (Italy).
Results:  The percentage of smokers amongst DS and DHS students was similar (32.78% vs. 32.5%) with 67.77% of DS students and 77.5% of DHS agreeing that the damages to health caused by smoking were covered in their didactic course work. A high percentage of DS (63.33%) and DHS (67.5%) students reported the relationship between smoking and a number of associated health conditions. Both DS and DHS students showed poor knowledge of TUC interventions. Both DS and DHS students reported to be conscious of their own role as a counsellor, with DHS students feeling more comfortable in approaching counselling in clinical practice. Although DS and DHS students reported a positive attitude toward TUC interventions, almost half of the students had some concerns about the effectiveness of smoking cessation activities.
Discussion:  The introduction of a comprehensive tobacco education curriculum in DS and DHS programs could further improve students' perceptions and attitudes and provide knowledge and clinical experience which would lead to the incorporation of TUC into subsequent professional practice.     

Cancer Prevention in the Dental Practice: Oral Cancer Screening and Tobacco Cessation Advice

Objectives : In this paper we describe the proportion of US adults who report receiving oral cancer screening and tobacco cessation counseling and assistance from dentists and other health professionals. Methods : Data from the 1992 National Health Interview Survey (NHIS) Cancer Control Supplement, a nationally representative sample of 12,035 adults 18 years of age and older, are analyzed. Results : In 1992, less than 10 percent of adults reported oral cancer screening by a dentist or hygienist within the past three years. White adults (10.1%; 95% Cl=9.3,10.9) reported an oral cancer screening three times more frequently than black (3.2%; 95% Cl=1.9, 4.5) or Hispanic (3.4%; 95% Cl=2.1, 4.7) adults. About half of adult current smokers had seen a dentist within 12 months, and of those only 24.1 percent (95% Cl=21.7, 26.5) had been advised to quit smoking. Heavy smokers (two or more packs a day) were more likely to have been advised to quit than light (pack or less per day) or occasional smokers. A similar proportion (24.3%; 95% Cl=17.6, 31.0) of white adult men who reported using smokeless tobacco products had been told by a dentist to quit using tobacco. Conclusions : Results from this population-based survey indicate that cancer screening and tobacco cessation advice are underutilized in the dental practice. Increased patient awareness and implementation of screening and tobacco cessation interventions could improve oral cancer incidence and mortality and have a public health benefit for other tobacco-related morbidity and mortality as well.     

Smoking and health: opinions and awareness among general dentists in Jordan

AIM: To examine dentists' awareness on major health risks associated with smoking and their opinions on factors that influence tobacco use. DESIGN: A pre-tested postal questionnaire survey. PARTICIPANTS: A randomly selected sample of 849 licensed general dentists who were practicing dentistry in Jordan. RESULTS: A response rate of 72.2% (613/849) was obtained. The majority of respondents (91.8%) related lung cancer to smoking, however, associations with other cancers (cancer of oesophagus, pancreas and urinary bladder) were the least reported (33.6%). Only 39% agreed that smoking is the most important cause of premature death, non-smokers were significantly more likely to believe in this than current smokers. Most dentists associated tobacco use with staining of teeth (97.2%), whereas fewer dentists reported that smokers have increased risks of oral cancer (83.7%) and potentially malignant oral lesions (76.7%). Friends and stress were the most frequently implicated factors in the habit of smoking. CONCLUSION: This study revealed a significant lack of awareness among Jordanian dentists with respect to serious health consequences of smoking. An educational programme targeted towards general dentists in Jordan is needed, focusing attention on tobacco related morbidity and mortality.     

The Effect of Tobacco Smoking on Salivation

Aim

The purpose of this study was to examine the detrimental effect of smoking on the function of the salivary glands.

Material and Methods

The study was conducted on 60 patients who were divided into two groups: a test group which included smokers and control group represented by non-smokers. Each group included 30 patients. General information was collected from all the respondents via a questionnaire as well as the data on the duration of smoking and number of cigarettes smoked per day. Saliva was collected by spitting method in a graduated tube and the amount of unstimulated and stimulated saliva was measured and recorded in ml per minute. Stimulated saliva was collected immediately after rinsing the mouth with a 2% aqueous solution of citric acid which is carried salivary stimulation. The presence of pigmentation on the teeth and coated tongue were recorded during clinical examination. The degree of oral hygiene was determined by plaque index. All the obtained data were statistically analyzed with significance level p <0.05.

Results

The results showed no significant differences in the amount of saliva between smokers and non-smokers, however, the amount of saliva decreases significantly with the duration of smoking and increasing age of smokers. Also proven was the difference in the quality of saliva: smokers have thick saliva and nonsmokers predominantly serous. In addition, smokers have poorer oral hygiene status than non-smokers, and demonstrated a positive correlation between the level of oral hygiene and length of smoking tobacco.

Conclusion

This study has proven that smoking adversely affects salivation: long-term smoking reduces the secretion of saliva and changes its quality.Key words: Smoking, Tobacco Use Disorder, Saliva, Salivation, Xerostomia     

Smokeless tobacco use among men in the United States, 2000 and 2005

Background:  Compared with smoking, there is much less information about smokeless tobacco (ST) use in the United States. The purpose of this study is to characterize and compare ST use among American men in 2000 and 2005.
Methods:  We used US National Health Interview Surveys from 2000 and 2005 to estimate the prevalence of ST use, describe the demographic and socioeconomic profile of ST users and evaluate ST use according to product type and with respect to smoking.
Results:  The prevalence of ST use among American men was 4.4% in 2000 and 4.3% in 2005. Almost all ST users were white, about half were 25–44 years old and 80% lived in the South or Midwest, commonly in small metropolitan and rural areas. Educational and income levels of ST users were lower than those of never users of tobacco. One-third of ST users also smoked; cigarette consumption was lower among dual users than among exclusive smokers. In 2005, 1.3 million current ST users were former smokers but 3.2 million smokers were former ST users. ST users were evenly distributed between snuff (43%) and chewing tobacco (44%) in 2000 and 13% used both products. By 2005 snuff use was clearly dominant.
Conclusions:  The prevalence of ST use among men is low but stable; dual use of cigarettes and ST is common, and snuff has become the dominant ST product.     

Cigarette smoking, alcohol drinking, and oral and pharyngeal cancer mortality in Japan

Objectives:  To prospectively examine the association of cigarette smoking and alcohol drinking with oral and pharyngeal carcinogenesis, we analyzed data from a nation-wide large-scale cohort study in Japan.
Methods:  A total of 34 136 men and 43 711 women aged 40–79 years were included in the study. The Cox proportional hazard model was used to estimate the relative risk (RR) and 95% confidence interval (95% CI) of oral and pharyngeal cancer for smoking and drinking by sex, while adjusting for age, consumption of green tea, preference for salty foods, and consumption of green yellow vegetables.
Results:  Current smokers were found to have a higher risk of death caused by oral and pharyngeal cancer compared with non-smokers in both sexes: the RR was 2.6 (95% CI: 1.0–6.7) in men and 8.2 (95% CI: 2.1–32.1) in women. Men who drank more than 46 g ethanol per day had an approximately threefold increased risk of oral and pharyngeal cancer. Simultaneous exposure to both factors was significantly associated with an elevated risk of oral and pharyngeal cancer (RR: 3.3, 95% CI: 1.1–9.6).
Conclusions:  The result supports the carcinogenic effect of cigarette smoking and alcohol drinking on the oral cavity and pharynx.     

Knowledge of oral cancer and screening practices of primary care providers at Federally Qualified Health Centers

OBJECTIVES: Primary care providers (PCPs) who worked in Federally-Qualified Health Centers (FQHC) in Michigan were surveyed to assess their knowledge level and practices related to screening and preventing oral cancer. METHODS: A questionnaire was developed with the assistance of dental and medical experts, and revised through focus groups. The questionnaire included one case scenario describing a suspicious oral lesion in a 55-year old female patient, followed by questions assessing PCPs' knowledge level, attitude, opinion, and screening practices for oral cancer. This mail survey was conducted in 2003. RESULTS: Survey response rate was 56.4%. Over 70% of the respondents reported that they screen patients for oral cancer during a routine physical examination. Forty-four percent of PCPs had high knowledge level, based on the scenario questions. Those who had high knowledge level were more likely to be physicians, males, and more likely to perform screening for oral cancer than those with low knowledge level. There was no difference in age and race/ethnicity between high and low knowledge groups. Perceived barriers included (1) lack of education; (2) lack of specialists to refer patients; and (3) lack of reimbursement. CONCLUSIONS: The majority of PCPs in this survey had positive attitudes about performing screening for oral cancer. To involve PCPs in screening for oral cancer, oral health programs should focus on providing up-to-date education, setting up a referral system, and providing proper reimbursement.     

Anticipatory anxiety in children visiting the dentist: lack of effect of preparatory information

Aim.  This study sought to explore whether viewing a leaflet explaining the benefits of dental treatment would have a significant impact on children's anticipatory anxiety.
Method.  Fifty children aged 8–12, attending the paediatric dental clinic of King's College Hospital, London, took part in this triple-masked, randomized control study. The participants were randomly allocated to one of two groups and either shown an intervention leaflet containing child-friendly dental information (the experimental group) or a leaflet with child-friendly information on the benefits of healthy eating (the control group). Using the Facial Image Scale, anxiety was measured when the children arrived for their dental appointment, once before reading the leaflet and again after reading the leaflet.
Results.  There was no statistically significant effect of the experimental leaflet on self-reported anxiety levels in this study, although anxiety levels did drop slightly in both groups after reading a leaflet.
Conclusions.  Providing paediatric patients with preparatory information about what to expect from a visit to the dentist had no effect on anticipatory anxiety in comparison to reading a leaflet about healthy eating. We speculate that reading, or cognitive processing, may have some beneficial effect. Future work should investigate this possibility.     

Policies and practices of European dental schools in relation to smoking; a ten-year follow-up

OBJECTIVE: To investigate the policies and practices of European dental schools in relation to smoking as a ten-year follow-up. DESIGN: A postal survey questionnaire. SETTING: European dental schools in 2003. MATERIALS AND METHODS: Two hundred and one European dental schools were identified from the DentEd database. A postal questionnaire was sent to each with up to three follow-up letters to non-responders. MAIN OUTCOME MEASURES: Results were tabulated and compared with the previous study (1993). RESULTS: The effective response rate (allowing for errors in the database) was 149 of 199 schools (72%). Eighty schools (59%) had written tobacco policies, 132 (92%) banned smoking in clinical areas, 127 (89%) in non-clinical areas and 122 (85%) in public access areas. One hundred and seven (76%) expected students to take tobacco histories from all patients, while 79 (69%) and 100 (70%) respectively taught students anti-smoking advice and expected them to give such advice. The number of schools teaching the role of tobacco in oral cancer aetiology was 133 (93%), in periodontal disease was 135 (94%) and in osseointegrated implant failure was 127 (91%). There was considerable regional variation between northern, southern and eastern Europe.Direct comparison of the responses of the 78 schools that replied in both 1993 and 2003 showed some improvements in most of their policies and practices. However, there was some deterioration in the practices of southern European schools. CONCLUSIONS: While improvements were seen in the practices of most schools, comparison with recent US data suggests that European schools lag behind. However, self-selection of respondents may have introduced bias into the results.     

School-based education to improve oral cleanliness and gingival health in adolescents in Tehran, Iran

Background.  Schools can be an important setting for health education programmes, controlling the growing burden of oral diseases and promoting oral health.
Aim.  The aim of this study was to evaluate the short-term effect of school-based educational intervention on oral cleanliness and gingival health of 15-year-olds in Tehran, Iran.
Design.  The present cluster randomized trial was based on exposing students ( n  = 287; control, n  = 130) at public schools to oral health knowledge through a leaflet or a videotape. The outcome was evaluated after 12 weeks. A positive outcome was defined as at minimum a 50% reduction in numbers of teeth with dental plaque or gingival bleeding compared to baseline. Evaluation included percentage changes, number needed to treat (NNT), and students' self-assessment.
Results.  At baseline, all students had dental plaque, and 93% had gingival bleeding on at least one index tooth. Positive outcome for oral cleanliness was 58% ( P  < 0.001) of the students in the leaflet group, 37% ( P  < 0.001) in the videotape group, and 10% of controls. Corresponding figures for gingival health were 72% ( P  < 0.001), 64% ( P  < 0.001), and 30%. For oral cleanliness, NNT was 2 in the leaflet and 3 in the videotape group; for gingival bleeding, NNT in both groups was 3. More than two-thirds of the students assessed their oral health behaviours as having improved moderately.
Conclusion.  An easy-to-organize and inexpensive school-based intervention can in the short term be effective in improving oral cleanliness and gingival health among adolescents; in particular, in countries with a developing oral health system.     

Periodontal health, oral health behaviours, and chronic obstructive pulmonary disease

Aim: To evaluate the associations of periodontal health status and oral health behaviours with chronic obstructive pulmonary disease (COPD).
Materials and Methods: We conducted a case–control study of 306 COPD patients and 328 controls with normal pulmonary function. Their periodontal status and respiratory function were clinically examined and information on oral health behaviours was obtained using a validated questionnaire.
Results: Patients with COPD had fewer teeth and a higher plaque index than the controls. Univariate analysis showed that tooth brushing times and method, experience of dental floss use, dental visit and regular supra-gingival scaling, and oral health knowledge were significantly related to the risk of COPD. After adjusting for age, sex, and body mass index and stratifying by smoking status, inappropriate tooth brushing method ( p =0.025 among non-smokers), lower regular supra-gingival scaling ( p =0.027 among non-smokers and p <0.0001 among former smokers), and poorer oral health knowledge ( p <0.0001 among non-smokers and p =0.019 among former smokers and p =0.044 among current smokers) remained significantly associated with COPD.
Conclusions: Poor periodontal health, dental care, and oral health knowledge were significantly associated with an increased risk of COPD. Our findings indicate the importance of promoting dental care and oral health knowledge that can be integrated into the prevention and treatment of COPD.     

Smoking cessation counseling in dentistry: attitudes of Nigerian dentists and dental students

The study was aimed at assessing the awareness, attitude, practices, willingness, and perceived barriers of dental students and dentists in Lagos University Teaching Hospital, Lagos, Nigeria, in relation to smoking cessation in the dental care setting. An anonymous self-administered questionnaire that contained questions relating to attitudes, views, and perceived barriers to smoking cessation activities in the dental clinic was hand-delivered to all dentists and clinical dental students in 2007. One hundred and thirty-six respondents took part in the study (response rate=81.9 percent). Although 95 percent of the respondents believed that smoking affects the dental management of the patient, only 65 percent always ask their patients about their smoking habits, and only 30 percent have heard about smoking cessation programs. A significantly higher proportion of students always ask patients about their smoking habits compared with dentists (p=0.0017). Also, a significantly higher proportion of dentists (97 percent) advised their patients against tobacco use compared with 77 percent of students (p=0.0000). Only 2 percent and 3 percent agreed that it is their professional responsibility to educate or encourage patients to quit smoking, respectively. Also, 98 percent strongly disagreed that it is within the scope of dental practice to ask about tobacco use, and 86 percent disagreed that tobacco counseling can be effective in helping patients quit tobacco use. Perceived barriers reported were lack of time (88 percent), lack of necessary materials (81 percent), and lack of knowledge of smoking cessation (74 percent). However, 81 percent of the respondents said they are willing to undergo training in tobacco use cessation. Since most of the dentists and dental students had poor attitudes and negative perceptions of smoking cessation activities, possibly due to lack of training and resources to carry it out in the clinics, there is need to include smoking cessation training in the dental curriculum in Nigeria.     

Smoking behavior and views of Jordanian dentists: A pilot survey

OBJECTIVE: The purpose of this study was to examine tobacco use among Jordanian dentists and their views on smoking. STUDY DESIGN: In July 1999, a self-reported questionnaire survey was mailed to a representative sample of 849 of 1693 licensed general dentists. The data were analyzed by using the Statistical Package for the Social Sciences (Chicago, Ill), and the statistical significance was determined by means of the chi(2) test. RESULTS: A response rate of 72.2% (613) was obtained. Overall, two thirds of the respondents were men younger than 40 years of age who worked in the private sector. Current tobacco users made up 35% (215/613), the majority of whom smoked cigarettes, with 83% being daily smokers. One fifth of daily smokers said that they smoke 20 or more cigarettes per day. Of respondents, 86.8% agreed that dentists should be a nonsmoking role model, and 77% believed that they should be involved in tobacco cessation counseling. Only 38.3% thought that they could convince patients who smoke to quit. Nonsmokers were significantly more likely to respond positively to these questions. Most respondents (92.2%) reported that the harmful effect of tobacco on health is a good reason to motivate smokers to quit. Unfortunately, almost half of the respondents (46.7%) thought that dental treatment is more important than providing tobacco counseling, and those were significantly more likely to be from private practices. CONCLUSIONS: Despite the high proportion of general dentists who were current smokers, many hold positive views on the tobacco issue. An education program targeted at dentists in Jordan is needed to discourage them from using tobacco and to teach them tobacco-cessation techniques and behaviors to reduce use among their patients.