1
|
M Jackson J, Weke A, Holliday R. Nicotine pouches: a review for the dental team. Br Dent J 2023; 235:643-646. [PMID: 37891304 PMCID: PMC10611559 DOI: 10.1038/s41415-023-6383-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/18/2023] [Accepted: 05/28/2023] [Indexed: 10/29/2023]
Abstract
Nicotine pouches are tobacco-free products that are becoming increasingly popular in the UK. They are held between the user's lip and gum to provide a source of nicotine. This article describes the composition of nicotine pouches, the legality surrounding their production and sale, patterns of use and explores possible oral and general health effects of their usage.
Collapse
Affiliation(s)
- Joshua M Jackson
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK; Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
| | - Anthony Weke
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Richard Holliday
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK; Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| |
Collapse
|
2
|
Mahyoub MA, Al-Qurmoti S, Rai AA, Abbas M, Jebril M, Alnaggar M, He S. Adverse physiological effects of smoking cessation on the gastrointestinal tract: A review. Medicine (Baltimore) 2023; 102:e35124. [PMID: 37747027 PMCID: PMC10519547 DOI: 10.1097/md.0000000000035124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 09/26/2023] Open
Abstract
Smoking cessation is known to have numerous health benefits, but it can also induce adverse physiological effects, including those affecting the gastrointestinal tract (GIT). Understanding the adverse physiological effects of smoking cessation on the GIT is critical for healthcare professionals and smokers attempting to quit, as it enables them to anticipate and manage potential challenges during the smoking cessation process. Although the detrimental effects of smoking on the GIT have been well established, there is a gap in the literature regarding the specific physiological reactions that may occur upon smoking cessation. This mini-review summarizes the current literature on the predisposing factors, pathophysiology, clinical presentation, and treatment options for adverse physiological effects of smoking cessation on the GIT. We aimed to raise awareness among busy clinical professionals about these adverse effects, empowering them to effectively support individuals striving to quit smoking and maintain their cessation. By consolidating the existing knowledge in this field, this review offers practical implications for smokers, healthcare providers, and policymakers to optimize smoking cessation interventions and support strategies to improve health outcomes.
Collapse
Affiliation(s)
- Mueataz A. Mahyoub
- Department of Gastroenterology, Faculty of Medicine and Health Sciences, Thamar University, Dhamar, Yemen
- Department of Gastroenterology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Clinical Medical Research Center for Digestive Diseases (Oncology) of Shaanxi Province, Xi’an, China
| | - Sarah Al-Qurmoti
- Department of Cleft Palate-Craniofacial Surgery, College of Stomatology, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | | | - Mustafa Abbas
- Department of Internal Medicine, Faculty of Medicine and Health Sciences, Thamar University, Dhamar, Yemen
| | - Majed Jebril
- College of Health Sciences, Department of Laboratory Medical Sciences, The Islamic University of Gaza, Gaza, Palestine
| | - Mohammed Alnaggar
- Department of Internal Medicine, Clinic Medical College, Hubei University of Science and Technology, Xianning, Hubei, China
- Department of Oncology, South Hubei Cancer Hospital, Xianning, Hubei, China
| | - Shuixiang He
- Department of Gastroenterology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Clinical Medical Research Center for Digestive Diseases (Oncology) of Shaanxi Province, Xi’an, China
| |
Collapse
|
3
|
Manoj MA, Jain A, Madtha SA, Cherian TM. Prevalence and risk factors of recurrent aphthous stomatitis among college students at Mangalore, India. PeerJ 2023; 11:e14998. [PMID: 37214085 PMCID: PMC10194064 DOI: 10.7717/peerj.14998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 02/13/2023] [Indexed: 05/24/2023] Open
Abstract
Background Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal diseases affecting an approximate 25% of the world's population. Some common etiological factors are genetics, nutritional deficiencies, stress and immune dysfunction. There is currently no specific medication to treat the condition but RAS tends to heal by itself within a week or two. We aimed to explore about the prevalence and related risk factors of recurrent aphthous ulcers among college students aged 18-30 years who had been affected within the preceding six months prior to the study duration. Methods A questionnaire survey was conducted among 681 students from four colleges in Mangalore, Karnataka, India after obtaining the approval for the same from the respective colleges. Consenting participants returned a survey containing various questions. The collected data was then analyzed using descriptive statistics. The study was approved by the Institutional Ethics Committee. Results Of the 681 participants, 322 (47.2%) were affected with RAS in the past six months which included 131 (40.6%) males and 191 (59.3%) females. Single mouth ulcers were the most common presentation seen among the study participants (74.2%). Factors showing statistically significant association were: family history of RAS (P < 0.001), known diabetics (P < 0.001), history of smoking (P < 0.001), oral trauma (P < 0.001), history of wearing braces/dentures (P < 0.001) as well as those using toothpastes containing sodium lauryl sulphate (P < 0.001), stress and lack of sleep (P < 0.001). The most common form of medication used were topical agents (43.1%) (P < 0.001). Conclusions There was a statistically significant association between the occurrence of RAS and family history of RAS, diabetes, smoking, history of braces/dentures, oral trauma, sodium lauryl sulphate toothpastes, lack of sleep, stress, menstruation, consumption of particular foods and beverages. Further research is needed in this field to truly understand the prevalence and risk factors of RAS and to help in discovering a treatment modality for this condition.
Collapse
Affiliation(s)
- Matthew Antony Manoj
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Animesh Jain
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Saanchia Andria Madtha
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Tina Mary Cherian
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| |
Collapse
|
4
|
Sivaramakrishnan G, Alsobaiei M, Sridharan K. Oral side effects of locally delivered nicotine replacement therapy: A meta-analysis of randomized controlled trials. Int J Dent Hyg 2023; 21:3-17. [PMID: 35485245 DOI: 10.1111/idh.12594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/11/2021] [Accepted: 04/26/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Nicotine replacement therapy is the first choice pharmacotherapy for smoking cessation. Oral side effects caused due to NRT lead to discontinuation of treatment. The objective of this meta-analysis was to look for the certainty of evidence on the number of patients that reported oral side effects due to the use of NRT. METHOD Eligible studies were selected and data extraction was carried out independently into a pre-tested data extraction form. Risk of bias was assessed using Cochrane Tool. The heterogeneity between the studies was assessed using Chi-square and I2 tests. Mean difference and Odds ratio at 95% confidence interval were the effect estimates. GRADE working group approach was used to assess the quality of evidence. RESULTS Twenty-eight studies were included with moderate to low risk of bias. The pooled estimates revealed a statistically significant number of patients developed mouth or throat irritation (2.54 [1.23, 5.25]), or oral soreness (2.22 [1.40, 3.55]) or gastric reflux or vomiting (1.97 [1.34, 2.90]) due to NRT. CONCLUSION It is important to understand that significant implications are caused due to NRT, on oral health. All patients on NRT must adhere to their regular dentist visits and must check their oral mucosa before initiating NRT.
Collapse
Affiliation(s)
| | - Muneera Alsobaiei
- Dental Postgraduate Training Department, Ministry of Health, Manama, Bahrain
| | - Kannan Sridharan
- Department of Pharmacology and Therapeutics, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| |
Collapse
|
5
|
Cui ZY, Li YH, Liu Z, Li L, Nie XQ, Zhou XM, Cheng AQ, Li JX, Qin R, Wei XW, Zhao L, Ladmore D, Pesola F, Chung KF, Chen ZM, Hajek P, Xiao D, Wang C. The experience of tobacco withdrawal symptoms among current smokers and ex-smokers in the general population: Findings from nationwide China Health Literacy Survey during 2018-19. Front Psychiatry 2022; 13:1023756. [PMID: 36713929 PMCID: PMC9880314 DOI: 10.3389/fpsyt.2022.1023756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 12/28/2022] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To clarify the extent to which smokers in the general population experience tobacco withdrawal symptoms and whether such experience differs in those who continue to smoke and those who stopped smoking. METHODS We included relevant questions in the nationally-representative China Health Literacy Survey (CHLS) conducted in 2018-2019. Among 87,028 participants, there were 22,115 ever-smokers aged 20-69 years who provided information on their smoking history and their experience of tobacco withdrawal symptoms. Multivariate logistic regressions were conducted to explore the association between withdrawal symptoms and other variables. RESULTS Among ever-smokers, there were 19,643 (88.8%) current smokers and 2,472 (11.2%) ex-smokers. Among current smokers, 61.3% reported having tried to quit smoking in the past. Overall, 61.1% of current smokers reported experiencing withdrawal symptoms: 69.9% of those who tried to quit smoking in the past and 47.5% of those who did not. A lower proportion of ex-smokers experienced withdrawal symptoms (46.3%) and the difference remained significant after controlling for demographic characteristics (OR = 1.76, 95% CI 1.62-1.93, P < 0.001). The most commonly reported withdrawal symptoms in both current smokers and ex-smokers were craving, restlessness and anxiety. In the multivariable-adjusted analyses, those who experienced withdrawal symptoms when they tried to quit smoking (OR: 2.05, 95% CI: 1.86-2.27) were less likely to successfully quit. CONCLUSIONS The clinical picture of the tobacco withdrawal syndrome is the same in current smokers and in ex-smokers, but ex-smokers are less likely to have experienced it. The experience of discomfort when unable to smoke is common and seems likely to be a major factor contributing to maintaining smoking behavior not just among individuals seeking help with quitting smoking, but among smokers generally.
Collapse
Affiliation(s)
- Zi-Yang Cui
- Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Center for Respiratory Medicine, Beijing, China.,Graduate School of Peking Union Medical College, Beijing, China
| | - Ying-Hua Li
- China Health Education Center, Beijing, China
| | - Zhao Liu
- Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Center for Respiratory Medicine, Beijing, China
| | - Li Li
- China Health Education Center, Beijing, China
| | | | - Xin-Mei Zhou
- Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Center for Respiratory Medicine, Beijing, China
| | - An-Qi Cheng
- Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Center for Respiratory Medicine, Beijing, China
| | - Jin-Xuan Li
- Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Center for Respiratory Medicine, Beijing, China.,China-Japan Friendship School of Clinical Medicine, Capital Medical University, Beijing, China
| | - Rui Qin
- Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Center for Respiratory Medicine, Beijing, China.,Graduate School of Peking Union Medical College, Beijing, China
| | - Xiao-Wen Wei
- Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Center for Respiratory Medicine, Beijing, China.,China-Japan Friendship School of Clinical Medicine, Capital Medical University, Beijing, China
| | - Liang Zhao
- Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Center for Respiratory Medicine, Beijing, China
| | - Daniella Ladmore
- Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Francesca Pesola
- Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College London and Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Zheng-Ming Chen
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Peter Hajek
- Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Dan Xiao
- Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Center for Respiratory Medicine, Beijing, China.,Graduate School of Peking Union Medical College, Beijing, China
| | - Chen Wang
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Center for Respiratory Medicine, Beijing, China.,Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
6
|
Torgutalp M, Eroğlu DŞ, Sezer S, Yayla ME, Karataş G, Özel EM, Dinçer A, Yüksel ML, Gülöksüz E, Yılmaz R, Turgay TM, Kınıklı G, Ateş A. Patients characteristics in Behçet's Syndrome and their associations with major organ involvement: a single-centre experience of 2118 cases. Scand J Rheumatol 2021; 51:50-58. [PMID: 34121600 DOI: 10.1080/03009742.2021.1904622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Objectives: To evaluate the demographic and clinical characteristics of patients with Behçet's syndrome (BS), and to define their associations with the presence of major organ involvement (MOI).Method: Medical records of 2118 patients (964 males, 1154 females) were analysed retrospectively. MOI was defined as the presence of at least one of vascular, eye, nervous, or gastrointestinal system involvement. Univariable and multivariable binary and ordinal logistic regression analyses were applied to assess the factors that were potentially associated with MOI.Results: The mean ± sd age at diagnosis was 30.5 ± 9.4 years. Genital ulcer and joint involvement were more common in females (both p < 0.001), while MOI was more frequent in males (p < 0.001). Genital ulcer (p < 0.001) and vascular involvement (p = 0.006) were more common in patients with a younger age at diagnosis, while joint involvement was more common in older patients. A total of 1097 patients (51.8%) had at least one MOI, 322 (15.2%) at least two MOIs, and 48 (2.3%) at least three MOIs. Male gender, smoking history, and absence of genital ulcer were significantly associated with MOI in multivariable binary logistic regression. Multivariable ordinal regression analyses confirmed the association between MOI and male gender and smoking, but not the protective effect of genital ulcers. In both regression analyses, we found no significant effects of age, human leucocyte antigen-B51, skin involvement, or joint involvement on MOI.Conclusion: Male gender and positive smoking history have a significant influence on the presence of MOI in patients with BS.
Collapse
Affiliation(s)
- M Torgutalp
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey.,Department of Gastroenterology, Infectious Diseases and Rheumatology, Charité-Universitätsmedizin, Berlin, Germany
| | - D Ş Eroğlu
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
| | - S Sezer
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
| | - M E Yayla
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
| | - G Karataş
- Faculty of Medicine, Department of Internal Medicine, Ankara University, Ankara, Turkey
| | - E M Özel
- Faculty of Medicine, Department of Internal Medicine, Ankara University, Ankara, Turkey
| | - Abk Dinçer
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
| | - M L Yüksel
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
| | - Ega Gülöksüz
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
| | - R Yılmaz
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
| | - T M Turgay
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
| | - G Kınıklı
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
| | - A Ateş
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
| |
Collapse
|
7
|
Holliday R, Hong B, McColl E, Livingstone-Banks J, Preshaw PM. Interventions for tobacco cessation delivered by dental professionals. Cochrane Database Syst Rev 2021; 2:CD005084. [PMID: 33605440 PMCID: PMC8095016 DOI: 10.1002/14651858.cd005084.pub4] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Dental professionals are well placed to help their patients stop using tobacco products. Large proportions of the population visit the dentist regularly. In addition, the adverse effects of tobacco use on oral health provide a context that dental professionals can use to motivate a quit attempt. OBJECTIVES To assess the effectiveness, adverse events and oral health effects of tobacco cessation interventions offered by dental professionals. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group's Specialised Register up to February 2020. SELECTION CRITERIA We included randomised and quasi-randomised clinical trials assessing tobacco cessation interventions conducted by dental professionals in the dental practice or community setting, with at least six months of follow-up. DATA COLLECTION AND ANALYSIS Two review authors independently reviewed abstracts for potential inclusion and extracted data from included trials. We resolved disagreements by consensus. The primary outcome was abstinence from all tobacco use (e.g. cigarettes, smokeless tobacco) at the longest follow-up, using the strictest definition of abstinence reported. Individual study effects and pooled effects were summarised as risk ratios (RR) and 95% confidence intervals (CI), using Mantel-Haenszel random-effects models to combine studies where appropriate. We assessed statistical heterogeneity with the I2 statistic. We summarised secondary outcomes narratively. MAIN RESULTS Twenty clinical trials involving 14,897 participants met the criteria for inclusion in this review. Sixteen studies assessed the effectiveness of interventions for tobacco-use cessation in dental clinics and four assessed this in community (school or college) settings. Five studies included only smokeless tobacco users, and the remaining studies included either smoked tobacco users only, or a combination of both smoked and smokeless tobacco users. All studies employed behavioural interventions, with four offering nicotine treatment (nicotine replacement therapy (NRT) or e-cigarettes) as part of the intervention. We judged three studies to be at low risk of bias, one to be at unclear risk of bias, and the remaining 16 studies to be at high risk of bias. Compared with usual care, brief advice, very brief advice, or less active treatment, we found very low-certainty evidence of benefit from behavioural support provided by dental professionals, comprising either one session (RR 1.86, 95% CI 1.01 to 3.41; I2 = 66%; four studies, n = 6328), or more than one session (RR 1.90, 95% CI 1.17 to 3.11; I2 = 61%; seven studies, n = 2639), on abstinence from tobacco use at least six months from baseline. We found moderate-certainty evidence of benefit from behavioural interventions provided by dental professionals combined with the provision of NRT or e-cigarettes, compared with no intervention, usual care, brief, or very brief advice only (RR 2.76, 95% CI 1.58 to 4.82; I2 = 0%; four studies, n = 1221). We did not detect a benefit from multiple-session behavioural support provided by dental professionals delivered in a high school or college, instead of a dental setting (RR 1.51, 95% CI 0.86 to 2.65; I2 = 83%; three studies, n = 1020; very low-certainty evidence). Only one study reported adverse events or oral health outcomes, making it difficult to draw any conclusions. AUTHORS' CONCLUSIONS There is very low-certainty evidence that quit rates increase when dental professionals offer behavioural support to promote tobacco cessation. There is moderate-certainty evidence that tobacco abstinence rates increase in cigarette smokers if dental professionals offer behavioural support combined with pharmacotherapy. Further evidence is required to be certain of the size of the benefit and whether adding pharmacological interventions is more effective than behavioural support alone. Future studies should use biochemical validation of abstinence so as to preclude the risk of detection bias. There is insufficient evidence on whether these interventions lead to adverse effects, but no reasons to suspect that these effects would be specific to interventions delivered by dental professionals. There was insufficient evidence that interventions affected oral health.
Collapse
Affiliation(s)
- Richard Holliday
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Bosun Hong
- Oral Surgery Department, Birmingham Dental Hospital, Birmingham, UK
| | - Elaine McColl
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Philip M Preshaw
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
8
|
Hajek P, Phillips-Waller A, Przulj D, Pesola F, Myers Smith K, Bisal N, Li J, Parrott S, Sasieni P, Dawkins L, Ross L, Goniewicz M, Wu Q, McRobbie HJ. A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy. N Engl J Med 2019; 380:629-637. [PMID: 30699054 DOI: 10.1056/nejmoa1808779] [Citation(s) in RCA: 872] [Impact Index Per Article: 174.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND E-cigarettes are commonly used in attempts to stop smoking, but evidence is limited regarding their effectiveness as compared with that of nicotine products approved as smoking-cessation treatments. METHODS We randomly assigned adults attending U.K. National Health Service stop-smoking services to either nicotine-replacement products of their choice, including product combinations, provided for up to 3 months, or an e-cigarette starter pack (a second-generation refillable e-cigarette with one bottle of nicotine e-liquid [18 mg per milliliter]), with a recommendation to purchase further e-liquids of the flavor and strength of their choice. Treatment included weekly behavioral support for at least 4 weeks. The primary outcome was sustained abstinence for 1 year, which was validated biochemically at the final visit. Participants who were lost to follow-up or did not provide biochemical validation were considered to not be abstinent. Secondary outcomes included participant-reported treatment usage and respiratory symptoms. RESULTS A total of 886 participants underwent randomization. The 1-year abstinence rate was 18.0% in the e-cigarette group, as compared with 9.9% in the nicotine-replacement group (relative risk, 1.83; 95% confidence interval [CI], 1.30 to 2.58; P<0.001). Among participants with 1-year abstinence, those in the e-cigarette group were more likely than those in the nicotine-replacement group to use their assigned product at 52 weeks (80% [63 of 79 participants] vs. 9% [4 of 44 participants]). Overall, throat or mouth irritation was reported more frequently in the e-cigarette group (65.3%, vs. 51.2% in the nicotine-replacement group) and nausea more frequently in the nicotine-replacement group (37.9%, vs. 31.3% in the e-cigarette group). The e-cigarette group reported greater declines in the incidence of cough and phlegm production from baseline to 52 weeks than did the nicotine-replacement group (relative risk for cough, 0.8; 95% CI, 0.6 to 0.9; relative risk for phlegm, 0.7; 95% CI, 0.6 to 0.9). There were no significant between-group differences in the incidence of wheezing or shortness of breath. CONCLUSIONS E-cigarettes were more effective for smoking cessation than nicotine-replacement therapy, when both products were accompanied by behavioral support. (Funded by the National Institute for Health Research and Cancer Research UK; Current Controlled Trials number, ISRCTN60477608 .).
Collapse
Affiliation(s)
- Peter Hajek
- From Queen Mary University of London (P.H., A.P.-W., D.P., K.M.S., N.B., H.J.M.), King's College London (F.P., P.S.), and London South Bank University (L.D.), London, the University of York, York (J.L., S.P., Q.W.), and Leicester City Council, Leicester (L.R.) - all in the United Kingdom; and Roswell Park Comprehensive Cancer Center, Buffalo, NY (M.G.)
| | - Anna Phillips-Waller
- From Queen Mary University of London (P.H., A.P.-W., D.P., K.M.S., N.B., H.J.M.), King's College London (F.P., P.S.), and London South Bank University (L.D.), London, the University of York, York (J.L., S.P., Q.W.), and Leicester City Council, Leicester (L.R.) - all in the United Kingdom; and Roswell Park Comprehensive Cancer Center, Buffalo, NY (M.G.)
| | - Dunja Przulj
- From Queen Mary University of London (P.H., A.P.-W., D.P., K.M.S., N.B., H.J.M.), King's College London (F.P., P.S.), and London South Bank University (L.D.), London, the University of York, York (J.L., S.P., Q.W.), and Leicester City Council, Leicester (L.R.) - all in the United Kingdom; and Roswell Park Comprehensive Cancer Center, Buffalo, NY (M.G.)
| | - Francesca Pesola
- From Queen Mary University of London (P.H., A.P.-W., D.P., K.M.S., N.B., H.J.M.), King's College London (F.P., P.S.), and London South Bank University (L.D.), London, the University of York, York (J.L., S.P., Q.W.), and Leicester City Council, Leicester (L.R.) - all in the United Kingdom; and Roswell Park Comprehensive Cancer Center, Buffalo, NY (M.G.)
| | - Katie Myers Smith
- From Queen Mary University of London (P.H., A.P.-W., D.P., K.M.S., N.B., H.J.M.), King's College London (F.P., P.S.), and London South Bank University (L.D.), London, the University of York, York (J.L., S.P., Q.W.), and Leicester City Council, Leicester (L.R.) - all in the United Kingdom; and Roswell Park Comprehensive Cancer Center, Buffalo, NY (M.G.)
| | - Natalie Bisal
- From Queen Mary University of London (P.H., A.P.-W., D.P., K.M.S., N.B., H.J.M.), King's College London (F.P., P.S.), and London South Bank University (L.D.), London, the University of York, York (J.L., S.P., Q.W.), and Leicester City Council, Leicester (L.R.) - all in the United Kingdom; and Roswell Park Comprehensive Cancer Center, Buffalo, NY (M.G.)
| | - Jinshuo Li
- From Queen Mary University of London (P.H., A.P.-W., D.P., K.M.S., N.B., H.J.M.), King's College London (F.P., P.S.), and London South Bank University (L.D.), London, the University of York, York (J.L., S.P., Q.W.), and Leicester City Council, Leicester (L.R.) - all in the United Kingdom; and Roswell Park Comprehensive Cancer Center, Buffalo, NY (M.G.)
| | - Steve Parrott
- From Queen Mary University of London (P.H., A.P.-W., D.P., K.M.S., N.B., H.J.M.), King's College London (F.P., P.S.), and London South Bank University (L.D.), London, the University of York, York (J.L., S.P., Q.W.), and Leicester City Council, Leicester (L.R.) - all in the United Kingdom; and Roswell Park Comprehensive Cancer Center, Buffalo, NY (M.G.)
| | - Peter Sasieni
- From Queen Mary University of London (P.H., A.P.-W., D.P., K.M.S., N.B., H.J.M.), King's College London (F.P., P.S.), and London South Bank University (L.D.), London, the University of York, York (J.L., S.P., Q.W.), and Leicester City Council, Leicester (L.R.) - all in the United Kingdom; and Roswell Park Comprehensive Cancer Center, Buffalo, NY (M.G.)
| | - Lynne Dawkins
- From Queen Mary University of London (P.H., A.P.-W., D.P., K.M.S., N.B., H.J.M.), King's College London (F.P., P.S.), and London South Bank University (L.D.), London, the University of York, York (J.L., S.P., Q.W.), and Leicester City Council, Leicester (L.R.) - all in the United Kingdom; and Roswell Park Comprehensive Cancer Center, Buffalo, NY (M.G.)
| | - Louise Ross
- From Queen Mary University of London (P.H., A.P.-W., D.P., K.M.S., N.B., H.J.M.), King's College London (F.P., P.S.), and London South Bank University (L.D.), London, the University of York, York (J.L., S.P., Q.W.), and Leicester City Council, Leicester (L.R.) - all in the United Kingdom; and Roswell Park Comprehensive Cancer Center, Buffalo, NY (M.G.)
| | - Maciej Goniewicz
- From Queen Mary University of London (P.H., A.P.-W., D.P., K.M.S., N.B., H.J.M.), King's College London (F.P., P.S.), and London South Bank University (L.D.), London, the University of York, York (J.L., S.P., Q.W.), and Leicester City Council, Leicester (L.R.) - all in the United Kingdom; and Roswell Park Comprehensive Cancer Center, Buffalo, NY (M.G.)
| | - Qi Wu
- From Queen Mary University of London (P.H., A.P.-W., D.P., K.M.S., N.B., H.J.M.), King's College London (F.P., P.S.), and London South Bank University (L.D.), London, the University of York, York (J.L., S.P., Q.W.), and Leicester City Council, Leicester (L.R.) - all in the United Kingdom; and Roswell Park Comprehensive Cancer Center, Buffalo, NY (M.G.)
| | - Hayden J McRobbie
- From Queen Mary University of London (P.H., A.P.-W., D.P., K.M.S., N.B., H.J.M.), King's College London (F.P., P.S.), and London South Bank University (L.D.), London, the University of York, York (J.L., S.P., Q.W.), and Leicester City Council, Leicester (L.R.) - all in the United Kingdom; and Roswell Park Comprehensive Cancer Center, Buffalo, NY (M.G.)
| |
Collapse
|
9
|
Malek Mahdavi A, Khabbazi A, Yaaghoobian B, Ghojazadeh M, Agamohammadi R, Kheyrollahiyan A, Rashtchizadeh N. Cigarette smoking and risk of Behcet’s disease: a propensity score matching analysis. Mod Rheumatol 2018; 29:633-639. [DOI: 10.1080/14397595.2018.1493065] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Aida Malek Mahdavi
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Khabbazi
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Barmak Yaaghoobian
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Morteza Ghojazadeh
- Research Development and Coordination Center (RDCC), Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ramin Agamohammadi
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Atefeh Kheyrollahiyan
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nadereh Rashtchizadeh
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
10
|
Keat RM, Fricain JC, Catros S, Monteiro L, Silva LMD, Freitas MD, Brandariz A, Lodi G, Pispero A, Warnakulasuriya S, Khan Z, Albuquerque R. The dentist's role in smoking cessation management — a literature review and recommendations: part 1. ACTA ACUST UNITED AC 2018. [DOI: 10.12968/denu.2018.45.3.197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Ross M Keat
- Birmingham Dental Hospital/School of Dentistry
| | | | | | | | | | | | - Angel Brandariz
- School of Medicine and Dentistry, University of Santiago de Compostela, Spain
| | - Giovanni Lodi
- Dipartimento di Scienze Biomediche Chirurgiche e Odontoiatriche
| | - Alberto Pispero
- Dipartimento di Scienze Biomediche Chirurgiche e Odontoiatriche, Milan 20142, Italy
| | - Saman Warnakulasuriya
- King's College London Dental Institute, Department of Oral Medicine and Pathology, London SE5 9RW
| | - Zahid Khan
- Birmingham Dental Hospital/School of Dentistry
| | - Rui Albuquerque
- Birmingham Dental Hospital/School of Dentistry, University of Birmingham, 5 Pebble Mill Road, Birmingham B5 7EG, UK
| |
Collapse
|
11
|
Everyday tactics in local moral worlds: E-cigarette practices in a working-class area of the UK. Soc Sci Med 2016; 170:106-113. [PMID: 27788410 PMCID: PMC5115649 DOI: 10.1016/j.socscimed.2016.10.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 10/11/2016] [Accepted: 10/14/2016] [Indexed: 02/04/2023]
Abstract
Research into e-cigarette use has largely focused on their health effects and efficacy for smoking cessation, with little attention given to their potential effect on health inequalities. Drawing on three years of ethnographic research between 2012 and 2015, I investigate the emerging e-cigarette practices of adult smokers and quitters in a working-class area of the UK. I first use de Certeau's notion of ‘tactics’ to describe the informal economy of local e-cigarette use. Low-priced products were purchased through personal networks and informal sources for financial reasons, but also as a solution to the moral problems of addiction and expenditure on the self, particularly for older smokers. E-cigarette practices were produced in local moral worlds where smoking and cessation had a complex status mediated through norms of age and gender. For younger men, smoking cessation conflicted with an ethic of working-class hedonism but e-cigarette use allowed cessation to be incorporated into male sociality. Continued addiction had moral implications which older men addressed by constructing e-cigarette use as functional rather than pleasurable, drawing on a narrative of family responsibility. The low priority which older women with a relational sense of identity gave to their own health led to a lower tolerance for e-cigarette unreliability. I draw on Kleinman's local moral worlds to make sense of these findings, arguing that smoking cessation can be a risk to moral identity in violating local norms of age and gender performance. I conclude that e-cigarettes did have some potential to overcome normative barriers to smoking cessation and therefore to reduce health inequalities, at least in relation to male smoking. Further research which attends to local meanings of cessation in relation to age and gender will establish whether e-cigarettes have similar potential elsewhere. Smokers and e-cigarette users bought cheap products for moral and financial reasons. Smoking cessation conflicted with an ethic of hedonism but e-cigarettes did not. Older men saw e-cigarette use as functional in a narrative of family responsibility. Older women gave their health low priority and found e-cigarettes too much trouble. E-cigarettes had potential to overcome some normative barriers to smoking cessation.
Collapse
|
12
|
Abstract
Persistent cigarette smokers usually have a nicotine addiction. This addiction has a chronic relapsing and sometimes remitting course and may persist lifelong. Remission can be facilitated by the use of medication as part of a comprehensive management strategy tailored to the individual patient. Nicotine replacement therapy is a first-line drug treatment. It is available in many formulations. Varenicline is also a first-line drug treatment. It should be started before the patient stops smoking. Bupropion is a second-line therapy. It may be associated with an increased risk of seizures and drug interactions. While there is some evidence that electronic cigarettes might facilitate smoking cessation, quit rates are not yet comparable with those of the drugs approved on the Pharmaceutical Benefits Scheme.
Collapse
|
13
|
Deen K, Curchin C, Wu J. Successful treatment of recurrent aphthous ulcers with nicotine lozenges in a lifelong non-smoker. Australas J Dermatol 2015; 56:143-4. [DOI: 10.1111/ajd.12261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Kristyn Deen
- Department of Dermatology; Princess Alexandra Hospital; Brisbane Queensland Australia
| | - Claudia Curchin
- Department of Dermatology; Princess Alexandra Hospital; Brisbane Queensland Australia
| | - Jason Wu
- Department of Dermatology; Princess Alexandra Hospital; Brisbane Queensland Australia
| |
Collapse
|
14
|
Mohamed S, Janakiram C. Recurrent aphthous ulcers among tobacco users- hospital based study. J Clin Diagn Res 2015; 8:ZC64-LC66. [PMID: 25584320 DOI: 10.7860/jcdr/2014/10368.5145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 08/05/2014] [Indexed: 11/24/2022]
Abstract
CONTEXT Current evidence shows ambiguous relationship between tobacco use and the occurrence of aphthous. OBJECTIVES We studied the relationship between the occurrence of recurrent aphthous ulcers and various forms of tobacco usage. MATERIALS AND METHODS A hospital based case control study was carried out in a dental teaching hospital in Cochin, India. One hundred and two outpatient subjects (Males 56.9%) were identified having aphthous ulceration using Natha's diagnostic criteria and were classified as cases. One hundred and eight subjects (Males, 70.4%) with no aphthous ulceration were selected randomly as controls. Exposure ascertainment of tobacco usage was done by structured interview. RESULTS The adjusted odd ratio was found to be 0.41 (95% CI 0.19-0.87) for tobacco usage and occurrence of aphthous ulceration compared to non tobacco users. The odds ratio of 0.41 for tobacco usage infers that subjects using tobacco were 59% less likely to have aphthous ulcerations compared to nontobacco users. CONCLUSION The tobacco consumers have less frequency of aphthous ulceration compared non users.
Collapse
Affiliation(s)
- Shamaz Mohamed
- Associate Professor, Department of Public Health Dentistry, Amrita University , Edapally, Cochin, Kerala, India
| | - Chandrashekar Janakiram
- Professor, Department of Public Health Dentistry, Amrita University , Edapally, Cochin, Kerala, India
| |
Collapse
|
15
|
Cleverson PATUSSI, Laurindo Moacir SASSI, Eduardo Ciliao MUNHOZ, Roberta Targa Stramandinoli ZANICOTTI, Juliana Lucena SCHUSSEL. Clinical assessment of oral mucositis and candidiasis compare to chemotherapic nadir in transplanted patients. Braz Oral Res 2014; 28:1-7. [DOI: 10.1590/1807-3107bor-2014.vol28.0050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 06/02/2014] [Indexed: 11/21/2022] Open
|
16
|
Abdullah MJ. Prevalence of recurrent aphthous ulceration experience in patients attending Piramird dental speciality in Sulaimani City. J Clin Exp Dent 2013; 5:e89-94. [PMID: 24455063 PMCID: PMC3892221 DOI: 10.4317/jced.51042] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 02/23/2013] [Indexed: 11/08/2022] Open
Abstract
Objective: The aim of this study is to report the prevalence and risk factors of recurrent aphthous ulceration (RAU) in patients attending Piramird dental speciality for seeking dental treatment.
Study design: A cross-sectional survey was carried out among patients (n=1100) who were visiting the department of oral medicine at Piramird dental speciality center in Sulaimani from December 2011-February 2012. The age range of the patients were between 10-79 years, with mean age of (34.27±14.14). 446 (44.6%) of participants were males and 554 (55.4%) were females, with male/female ratios of 0.80:1. All individuals had to answer specific questions including personal data (age, sex), level of education, occupation and smoking habit; etc. Additional questions were related to the risk factors that might be related to the condition. Chi Square test was used to analyze the data.
Result: The life time prevalence of RAU experience was 28.2% (n=282). It was highly significantly more common among females (31.76%) (p<0.004). The most commonly affected age group was 20-29 years (36.28%). The highest prevalence of RAU experience was seen among mere students (36.8%); Among non smokers there were highly significantly more patients with RAU experience (30%) than in heavy smoker patients (12.22%), (p=0.000). 34.4% of patients had family history of RAU. Lips and buccal mucosae were the commonest sites of ulcerations (73.10%), and the major risk factor was stress (43.3%).
Conclusion: This study has provided information about the epidemiologic aspects of recurrent aphthous ulceration, Based on the finding of this study, RAU is a common, recurrent painful oral ulceration. This study point to the importance of a thorough history taking to identify the patient’s main risk factors to get preventive measures, therefore treatment will be tailored for each patient accordingly. And the author concluded that stress was the major risk factor, thus, stress-management interventions suggested to be beneficial in reducing RAU recurrence episodes.
Key words:Recurrent aphthous ulceration, prevalence, stress.
Collapse
Affiliation(s)
- Mustafa J Abdullah
- B.D.S., M.Sc.Oral Medicine, Assistant lecturer in the Oral Medicine Clinic of the school of dentistry, University of Sulaimani, Kurdistan region, Iraq
| |
Collapse
|
17
|
Hanioka T, Ojima M, Kawaguchi Y, Hirata Y, Ogawa H, Mochizuki Y. Tobacco interventions by dentists and dental hygienists. JAPANESE DENTAL SCIENCE REVIEW 2013. [DOI: 10.1016/j.jdsr.2012.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
18
|
Etter JF, Ussher M, Hughes JR. A test of proposed new tobacco withdrawal symptoms. Addiction 2013; 108:50-9. [PMID: 22702228 DOI: 10.1111/j.1360-0443.2012.03981.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Revised: 03/12/2012] [Accepted: 06/11/2012] [Indexed: 11/30/2022]
Abstract
AIMS Recent studies suggest that smoking cessation may cause more withdrawal symptoms than thought previously. The widely used Minnesota Withdrawal Scale (MWS-R) was revised recently to include some of these newly described symptoms. We assessed the validity of MWS-R and other proposed self-reported measures of tobacco withdrawal symptoms. DESIGN AND SETTING An internet survey of daily and former smokers with repeated measurements, followed by a randomized trial among the daily smokers. PARTICIPANTS Daily smokers (n = 1126) and former smokers (n = 3239). MEASUREMENTS Participants answered the original MWS (nine items), the eight additional symptoms in the MWS-R and 23 other questions on tobacco withdrawal symptoms. Daily smokers were assigned randomly to either continue to smoke for 2 weeks or to stop smoking, and they answered follow-up surveys 1, 3 and 7 days after their target quit date. FINDINGS Among the 31 proposed new symptoms tested by comparing recent quitters with continuing smokers, the only withdrawal-like symptom observed was worsening of mood swings. Post-cessation change in mood swings remained statistically significant after adjustment for baseline depression, irritability, impatience, restlessness, stress or anxiety/nervousness. Also, abstinence improved sense of smell, sense of taste and sore throat. Post-cessation change in symptoms intensities did not predict relapse. CONCLUSIONS Moods swings are a symptom of tobacco withdrawal that can be validly measured and are unpleasant. In contrast, smoking cessation also has positive, immediate effects, including improved sense of smell and taste and reduced sore throat.
Collapse
Affiliation(s)
- Jean-François Etter
- Institute of Social and Preventive Medicine, University of Geneva, Switzerland.
| | | | | |
Collapse
|
19
|
Subramanyam RV. Occurrence of recurrent aphthous stomatitis only on lining mucosa and its relationship to smoking--a possible hypothesis. Med Hypotheses 2011; 77:185-7. [PMID: 21546167 DOI: 10.1016/j.mehy.2011.04.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Revised: 04/04/2011] [Accepted: 04/06/2011] [Indexed: 01/26/2023]
Abstract
Recurrent aphthous stomatitis (RAS) is one of the most common ulcers affecting the oral cavity. Though it is known that RAS affects only the lining (non-keratinized) mucosa sparing the masticatory (keratinized) mucosa and is unlikely to be seen in smokers, no concrete explanations have been put forward. A hypothesis is proposed that the keratin layer blocks the ingress of antigens and prevents the occurrence of RAS on masticatory mucosa. Similarly, combustible products of smoking are known to cause keratinization and therefore have a similar effect on the lining mucosa and inhibit its occurrence. In addition, nicotine or its metabolites can result in decrease of pro-inflammatory cytokines like tumor necrosis factor-α, interleukins 1 and 6, and increase of anti-inflammatory cytokine interleukin-10. Consequently, there is reduced susceptibility to RAS due to immunosuppression and/or reduction in inflammatory response.
Collapse
Affiliation(s)
- R V Subramanyam
- Dept. of Oral Pathology & Microbiology, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Chinoutpally, Gannavaram, Andhra Pradesh 521286, India.
| |
Collapse
|
20
|
Hays JT, Ebbert JO. Adverse Effects and Tolerability of Medications for the Treatment of Tobacco Use and Dependence. Drugs 2010; 70:2357-72. [DOI: 10.2165/11538190-000000000-00000] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
21
|
Abstract
PURPOSE To study the effect of smoking on the prevalence of recurrent aphthous stomatitis (RAS) and to examine whether intensity and duration of smoking influence RAS lesions. SUBJECTS AND METHODS A cross-sectional survey was conducted on a random sample of 1000 students of The University of Jordan, Amman, between May and September 2008. Sociodemographic factors and details about smoking habits and RAS in last 12 months were collected. RESULTS Annual prevalence (AP) of RAS was 37.1%. Tobacco use was common among students: 30.2% were current smokers and 2.8% were exsmokers. AP was not significantly influenced by students' age, gender, marital status, college, and household income but was significantly affected by place of living (P = 0.02) and presence of chronic diseases (P = 0.03). No significant difference in AP of RAS was found between smokers and nonsmokers. Cigarette smokers who smoked heavily and for a longer period of time had significantly less AP of RAS when compared to moderate smokers and those who smoked for a shorter period of time. The protective effect of smoking was only noticed when there was heavy cigarette smoking (>20 cigarettes/day) (P = 0.021) or smoking for long periods of time (>5 years) (P = 0.009). Nevertheless, no significant associations were found between intensity or duration of smoking and clinical severity of RAS lesions. CONCLUSION The "protective effect" of smoking on RAS was dose- and time-dependent. When lesions are present, smoking had no effect on RAS severity.
Collapse
Affiliation(s)
- Faleh A Sawair
- Faculty of Dentistry, University of Jordan, Amman, Jordan.
| |
Collapse
|
22
|
Mills EJ, Wu P, Lockhart I, Wilson K, Ebbert JO. Adverse events associated with nicotine replacement therapy (NRT) for smoking cessation. A systematic review and meta-analysis of one hundred and twenty studies involving 177,390 individuals. Tob Induc Dis 2010; 8:8. [PMID: 20626883 PMCID: PMC2917405 DOI: 10.1186/1617-9625-8-8] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Accepted: 07/13/2010] [Indexed: 11/10/2022] Open
Abstract
Background Nicotine replacement therapy (NRT) is the most common form of smoking cessation pharmacotherapy and has proven efficacy for the treatment of tobacco dependence. Although expectations of mild adverse effects have been observed to be independent predictors of reduced motivation to use NRT, adverse effects associated with NRT have not been precisely quantified. Objective A systematic review and meta-analysis aimed to identify all randomized clinical trials (RCTs) of NRT versus inert controls and all observational studies to determine the magnitude of reported adverse effects with NRT. Methods Searches of 10 electronic databases from inception to November 2009 were conducted. Study selection and data extraction were carried out independently in duplicate. RCTs were pooled using a random effects method with Odds Ratio [OR] as the effect measure, while proportions were pooled from observational studies. A meta-regression analysis was applied to examine whether the nicotine patch is associated with different adverse effects from those common to orally administered NRT. Results Ninety-two RCTs involving 32,185 participants and 28 observational studies involving 145, 205 participants were identified. Pooled RCT evidence of varying NRT formulations found an increased risk of heart palpitations and chest pains (OR 2.06, 95% Confidence Interval [CI] 1.51-2.82, P < 0.001); nausea and vomiting (OR 1.67, 95% CI 1.37-2.04, P < 0.001); gastrointestinal complaints (OR 1.54, 95% CI, 1.25-1.89, P < 0.001); and insomnia (OR 1.42, 95% CI, 1.21-1.66, P < 0.001). Pooled evidence specific to the NRT patch found an increase in skin irritations (OR 2.80, 95% CO, 2.28-3.24, P < 0.001). Orally administered NRT was associated with mouth and throat soreness (OR 1.87, 95% CI, 1.36-2.57, P < 0.001); mouth ulcers (OR 1.49, 95% CI, 1.05-2.20, P < 0.001); hiccoughs (OR 7.68, 95% CI, 4.59-12.85, P < 0.001) and coughing (OR 2.89, 95% CI, 1.92-4.33, P < 0.001). There was no statistically significant increase in anxiety or depressive symptoms associated with NRT use. Non-comparative observational studies demonstrated the prevalence of these events in a broad population. Conclusion The use of NRT is associated with a variety of side effects. In addition to counseling and medical monitoring, clinicians should inform patients of potential side effects which are associated with the use of NRT for the treatment of tobacco dependence.
Collapse
Affiliation(s)
- Edward J Mills
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.
| | | | | | | | | |
Collapse
|
23
|
Abstract
INTRODUCTION Smoking is an independent risk factor for periodontal disease and tooth loss. STATE OF THE ART Smoking impairs inflammatory and immune responses to periodontal pathogens, and exerts both systemic and local effects. Periodontal disease is increased both in prevalence and severity in smokers. Smoking is a predisposing factor to acute necrotizing ulcerative gingivitis and is associated with an increased rate of periodontal disease in terms of pocket formation and attachment loss, as well as alveolar bone loss. Cigar, pipe, water-pipe and cannabis smoking have similar adverse effects on periodontal health as cigarette smoking. Passive smoking is also an independent periodontal disease risk factor. Smokeless tobacco is associated with localized periodontal disease. Smokers respond less favourably to both non-surgical and surgical treatments and have higher failure rates and complications following dental implantation. Smoking cessation may halt the disease progression and improve the outcome of periodontal treatment. CONCLUSION Smoking cessation counselling should be an integral part of periodontal therapy and prevention.
Collapse
Affiliation(s)
- M Underner
- Unité de Tabacologie, Service de Pneumologie, Pavillon René Beauchant, CHU la Milétrie, BP 577, 86021 Poitiers cedex.
| | | | | | | |
Collapse
|
24
|
Muñoz-Corcuera M, Esparza-Gómez G, González-Moles MA, Bascones-Martínez A. Oral ulcers: clinical aspects. A tool for dermatologists. Part I. Acute ulcers. Clin Exp Dermatol 2009; 34:289-94. [PMID: 19309371 DOI: 10.1111/j.1365-2230.2009.03220.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Oral ulcers are generally painful lesions that are related to various conditions developing within the oral cavity. They can be classified as acute or chronic according to their presentation and progression. Acute oral ulcers are be associated with conditions such as trauma, recurrent aphthous stomatitis, Behçet's disease, bacterial and viral infections, allergic reactions or adverse drug reactions. Chronic oral ulcers are associated with conditions such as oral lichen planus, pemphigus vulgaris, mucosal pemphigoid, lupus erythematosus, mycosis and some bacterial and parasitic diseases. The correct differential diagnosis is necessary to establish the appropriate treatment, taking into account all the possible causes of ulcers in the oral cavity. In the first part of this two-part review, acute oral ulcers are reviewed.
Collapse
Affiliation(s)
- M Muñoz-Corcuera
- Stomatology Department, Dental School, Complutense University of Madrid, Spain
| | | | | | | |
Collapse
|
25
|
Abstract
BACKGROUND Tobacco smoking is a major risk factor for cardiovascular disease, respiratory disease and cancer and, for current smokers, smoking cessation is one of the most effective therapeutic interventions for reducing the risk of all-cause morbidity and mortality. However, smoking cessation causes nicotine withdrawal syndrome, a condition with symptoms that overlap those of major depression and anxiety disorders. SCOPE The objective of this review was to examine the evidence that smoking cessation may be associated with new onset of psychiatric illness, particularly in individuals with no history of psychiatric disease, and to provide recommendations for the management of emergent psychiatric symptoms in smokers attempting cessation. Relevant articles were obtained from a MEDLINE search (articles indexed up to, and including, October 2008, with no historical date limit), and citation review of selected primary and review articles. FINDINGS There is evidence that smoking cessation can result in new onset of major depressive disorder, even in individuals with no history of depression. It has also been suggested that nicotine may be used as a form of self-medication for depression, and that smoking cessation can reveal a previously undiagnosed condition. There is little evidence of an association between smoking cessation and increased risk for other types of psychiatric illness. The management of emergent psychiatric symptoms in smokers attempting abstinence is discussed. CONCLUSION The overall health benefits of quitting smoking undoubtedly outweigh any potential side-effects associated with nicotine withdrawal. However, a well-managed quit attempt must plan for the emergence of nicotine withdrawal, monitor for symptoms of depression and psychiatric disease, and manage these conditions appropriately should they present.
Collapse
Affiliation(s)
- Henri-Jean Aubin
- Hôpital Emile Roux, Assistance Publique-Hôpitaux de Paris, Limeil-Brévannes, France.
| |
Collapse
|
26
|
Abstract
BACKGROUND Smoking cessation is associated with substantial reductions in tobacco-related morbidity and mortality. Based on the current literature, the beneficial effects of quitting are particularly evident on pulmonary and cardiovascular function, but the negative physiological effects of cessation are less well documented. SCOPE The objective of this article was to review systematically data on the physiological effects of smoking cessation. Articles based upon clinical trials, randomised controlled trials and meta-analyses were selected from titles and abstracts obtained via a MEDLINE search (May 2003-May 2008). Additional studies were identified from the bibliographies of reviewed literature. FINDINGS Smoking cessation is associated with improved lung function and a reduction in the presence and severity of respiratory symptoms. These changes, apparent within months of quitting, are sustained with long-term abstinence. The underlying pathophysiologies of smoking-induced airway inflammation and endothelial dysfunction are partially reversed following cessation in healthy ex-smokers, but not in those with chronic obstructive pulmonary disease. Smoking cessation is also associated with substantially improved cardiovascular function and reduced risk of primary and secondary cardiovascular morbidity and mortality. Although the overall long-term health benefits are unquestionable, smoking cessation is also associated with other possible undesirable short-term physiological effects such as weight gain, hypertension, constipation and mouth ulcers; and altered activity of the enzyme cytochrome P450 1A2 (CYP1A2), which metabolises many commonly used drugs. CONCLUSION The negative physiological effects of smoking cessation may adversely affect a smoker's attempt to quit, and physicians should provide their smoking patients with motivation and regular encouragement and support when attempting to quit, whilst educating them on the health benefits of abstinence. Additionally, since cigarette smoke is a potent inducer of CYP1A2, patients attempting to quit smoking should have their dosages of drugs metabolised by this enzyme closely monitored.
Collapse
Affiliation(s)
- Christina Gratziou
- Athens University Medical School and Evgenidio Hospital, Athens, Greece.
| |
Collapse
|
27
|
Miyamoto Jr NT, Borra RC, Abreu M, Weckx LLM, Franco M. Immune-expression of HSP27 and IL-10 in recurrent aphthous ulceration. J Oral Pathol Med 2008; 37:462-7. [DOI: 10.1111/j.1600-0714.2008.00665.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
28
|
|
29
|
|
30
|
Marakoğlu K, Sezer RE, Toker HC, Marakoğlu I. The recurrent aphthous stomatitis frequency in the smoking cessation people. Clin Oral Investig 2007; 11:149-53. [PMID: 17273857 DOI: 10.1007/s00784-007-0102-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2006] [Accepted: 01/16/2007] [Indexed: 10/23/2022]
Abstract
This study was aimed to evaluate the frequency of recurrent aphthous stomatitis (RAS) within the 6-week period after quitting smoking. The study group consisted of 90 subjects. Oral, medical findings and tobacco habits were recorded for all subjects. Nicotine replacement therapy (NRT) and behavioral treatment were applied to some of the subjects by a family physician. All subjects were evaluated for their RAS and periodontal measurements on baseline, 1, 3, 6 weeks by a periodontist. While the subjects were in this smoking cessation programme, 64 of the 90 smokers successfully quit smoking within the 6 weeks and 26 smokers dropped out during the third week of the study. Point prevalence of RAS among the subjects on the first day of the quitting period and at the end of the first, third and sixth week after smoking cessation was 3.3% (3/90), 18.9% (17/90), 21.1% (19/90) and 17.1 (11/64), respectively. In the following weeks, aphthous ulcer point prevalence was significantly higher than the quitting level (p < 0.05). As the time after quitting increased, the incidence of aphthous ulcer decreased. Of 64 patients, 35 (54.6%) completed the 6 weeks using NRT and 29 (45.4%) of them did not use any medication. The aphthous ulcer frequency observed in the patients taking NRT [11.4% (4/35)] was lower when compared with the subjects taking no NRT [24.1% (7/29)] (p > 0.05). The results of this study confirm that RAS is a complication of quitting smoking. Further studies are needed to identify the effects of NRT on RAS.
Collapse
Affiliation(s)
- Kamile Marakoğlu
- Meram Medical Faculty, Department of Family Medicine, Selçuk University, Aile Hekimliği AD, Konya, Turkey.
| | | | | | | |
Collapse
|
31
|
Abstract
AIMS To describe the prevalence and intensity of different symptoms in relation to tobacco abstinence. To explore latent dimensions between symptoms in smokers trying to quit. DESIGN A cross sectional study using a questionnaire to retrospectively assess symptoms over a period of 12 months. SETTING Swedish telephone quitline, a nationwide free of charge service. PARTICIPANTS All 741 individuals who had called the quitline and signed up for smoking cessation treatment between February 2000 to November 2001 and reported to have been smoke free for at least 24 hours during the previous 12 month period from first contact. MEASUREMENTS Assessments were made by self-report, and abstinence was defined as "not a single puff of smoke during the last week". A factor analysis approach where individual items aggregate into factors was used to explore the relationship between the different symptoms. FINDINGS High intensity of symptoms related to unsuccessful quitting attempts and included craving, irritability, apprehension/anxiety, difficulties concentrating, restlessness, depression/depressed mood, and insomnia. The factor loadings of all 17 symptoms resulted in three factors with factor 1, psychological being the most important. High scores on this factor relates to unsuccessful quitting attempts. Using Nicotine Replacement Therapy (NRT) for 5 weeks or longer, reduced symptoms included in factor 1. The other two factors were factor 2 physiological and factor 3 neurological. CONCLUSION Symptoms that are psychological and/or neurological in nature are interrelated and appear to be the most significant obstacles for successful quitting attempts in a population-based setting. These symptoms may be successfully treated with NRT.
Collapse
Affiliation(s)
- Tanja Tomson
- Centre for Public Health, Stockholm County Council & Department of Public Health Sciences, Karolinska Institutet, Sweden
| | | | | | | |
Collapse
|
32
|
Abstract
AIMS To compare the psychometric properties of three cigarette withdrawal scales. DESIGN An internet cohort study. PARTICIPANTS Each of 4,644 current (44%), former (49%) and never smokers (7%) completed the three scales via the internet. A subsample completed the scales again after 14 days (n=1309), and indicated their smoking status after 42 days (n=1431). MEASUREMENTS The Cigarette Withdrawal Scale (CWS), the Wisconsin Withdrawal Scale (WWS) and the Minnesota Withdrawal Form (MWF). FINDINGS All three scales covered the main elements in the Diagnostic and Statistical Manual version IV (DSM-IV) and the International Classification of Diseases version 10 (ICD-10) definitions of tobacco withdrawal, but WWS did not cover weight gain. Factor analyses indicated that only six factors were present in WWS, instead of the expected seven factors. Cronbach's alpha coefficients (0.76-0.93) were high for all scales. Test-retest coefficients were in the range of 0.66-0.86 for CWS and WWS, but were somewhat lower for some MWF items (range 0.52-0.80). In 324 ex-smokers who had quit smoking 31 days or less before baseline, craving predicted relapse at 14-day follow-up (CWS: odds ratio=1.53 per point, P=0.003; WWS: odds ratio=1.40, P=0.04; MWF: odds ratio=1.49, P=0.002). In 34 baseline smokers who had quit smoking by 14-day retest, an increase in craving (WWS and MWF), depressed mood (MWF) and difficulty concentrating (WWS) between baseline and retest predicted relapse at 42-day follow-up. In terms of construct validity, scales performed similarly, but performance on some key tests (e.g. withdrawal will increase post-cessation) were inadequate, due perhaps to methodological limitations. CONCLUSIONS No scale showed a decisive advantage over the others. MWF has the advantage of brevity.
Collapse
Affiliation(s)
- Jean-François Etter
- Institute of Social and Preventive Medicine, University of Geneva, Switzerland.
| | | |
Collapse
|
33
|
McRobbie H, Whittaker R, Bullen C. Using Nicotine Replacement Therapy to Assist in Reducing Cigarette Consumption before Quitting. ACTA ACUST UNITED AC 2006. [DOI: 10.2165/00115677-200614060-00003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|