This Article Free Full Text (Free PDF) Free References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Tomar, S.L. Articles by Kleinman, D.V. Search for Related Content PubMed PubMed Citation Articles by Tomar, S.L. Articles by Kleinman, D.V. Social Bookmarking                         What's this?

Oral Mucosal Smokeless Tobacco Lesions among Adolescents in the United States

'Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop K-50, Atlanta, Georgia 30341-3724

D.M. Winn

National Institute of Dental Research, National Institutes of Health, Bethesda, Maryland

P.A. Swango

National Institute of Dental Research, National Institutes of Health, Bethesda, Maryland

G.A. Giovino

'Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop K-50, Atlanta, Georgia 30341-3724

D.V. Kleinman

National Institute of Dental Research, National Institutes of Health, Bethesda, Maryland

The presence of oral smokeless tobacco lesions among adolescents may be an early indicator of increased risk for oral cancers. Data from the 1986-1987 National Survey of Oral Health in US School Children were used to examine the cross-sectional relationship between the use of tobacco and alcohol and the presence of white or whitish oral soft-tissue lesions. The sample included 17,027 schoolchildren (aged 12 to 17 years) who provided information on the use of snuff, chewing tobacco, cigarettes, and alcohol and who received oral clinical examinations. Smokeless tobacco lesions were detected in 1.5% of students (projects to about 300,000 nationally), including 2.9% of males and 0.1% of females. These lesions were more prevalent among whites (2.0%) than among African-Americans (0.2%) or Hispanics (0.8%). Modeling with multivariate logistic regression revealed that, among white males, current snuff use was the strongest correlate of lesions [odds ratio (OR) = 18.4; 95% confidence interval (CI) = 8.5-39.8], followed by current chewing tobacco use [OR = 2.5; 95% CI = 1.3-5.0]. Lesions were strongly associated with duration, monthly frequency, and daily minutes of use of snuff and chewing tobacco. These data suggest that snuff may be a stronger risk factor than chewing tobacco for smokeless tobacco lesions, but the use of either of these forms of oral tobacco exhibits a dose-response relationship with the occurrence of lesions. We found little evidence that the use of alcohol or cigarettes may increase the risk of smokeless tobacco lesions. Preventing smokeless tobacco lesions and their possible malignant transformation may be best accomplished among adolescents by preventing the use of snuff and chewing tobacco.

Key Words: smokeless tobacco • oral leukoplakia • mouth mucosa • adolescents • epidemiology.

Journal of Dental Research, Vol. 76, No. 6, 1277-1286 (1997)
DOI: 10.1177/00220345970760060701


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				M. M. Walsh and J. A. Ellison Treatment of Tobacco Use and Dependence: The Role of the Dental Professional J Dent Educ., May 1, 2005; 69(5): 521 - 537. [Abstract] [Full Text] [PDF]

				R. J. Billings, R. J. Berkowitz, and G. Watson Teeth Pediatrics, April 1, 2004; 113(4/S1): 1120 - 1127. [Abstract] [Full Text] [PDF]

				S. L. TOMAR Dentistry's role in tobacco control J Am Dent Assoc, November 1, 2001; 132(suppl_1): 30S - 35S. [Abstract] [Full Text] [PDF]

				B. Trock Out of the Mouths of Babes: Oral Premalignant Lesions and Use of Alternative Tobacco Products Cancer Epidemiol. Biomarkers Prev., July 1, 2000; 9(7): 637 - 638. [Full Text]

				R. V Fant, J. E Henningfield, R. A Nelson, and W. B Pickworth Pharmacokinetics and pharmacodynamics of moist snuff in humans Tob. Control, December 1, 1999; 8(4): 387 - 392. [Abstract] [Full Text]