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Abstract
This study was conducted in 2001 with the aim of providing data on black South African secondary school students' tobacco use status, knowledge, and attitudes. The sample included 330 Grade 10 and 382 Grade 12 secondary school pupils chosen at random from six rural secondary schools in one of the regions in the Northern Province of South Africa. Results show a prevalence of 9.1% current smokers among boys and 5% among girls, and 8.4% current snuff users among girls and 3.9% among boys. The mean age of onset to take snuff was 12.5 years and that for smoking cigarettes 14.8 years. Adolescents who reported that some family member or their peers used tobacco were more likely to be users of tobacco. Two-thirds of the current snuff users believed that using snuff was safer than smoking cigarettes. Knowledge was found to be related to attitude but not with tobacco use behavior. Awareness of the adverse effects of such tobacco habits was poor and intervention programs to curb tobacco use is required.
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Affiliation(s)
- Karl Peltzer
- Department of Psychology, University of the North, Sovenga, South Africa.
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2
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Abstract
Cigarette smoking is a risk factor for several diseases, and recent evidence strongly suggests an adverse effect on periodontal health. Nevertheless, the nature of the relationship between smoking and periodontal disease is not clear. Smoking causes defects in neutrophil function, impairs inflammatory and immune responses to periodontal pathogens, and exerts both systemic and local effects. Smoking is associated with an increased rate of periodontal disease in terms of alveolar bone loss and attachment loss, as well as pocket formation. Nicotine, the major component of cigarette smoke, may weaken host defenses to the bacterial invasion induced by plaque.
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Affiliation(s)
- P Obeid
- Department of Periodontology, School of Dental Medicine and Stomatology, Catholic University of Louvain, Brussels, Belgium
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3
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Abstract
Behavioral science plays an integral, essential role in cancer control. This review examines that role in two broad areas: (1) in the development and implementation of cancer control technologies, and (2) in the emerging focus on the process of translating cancer research into clinical practice. In developing and implementing cancer control technologies, what we know of human processes as a result of behavioral science is identified as the common link in all stages of the cancer process (prevention, detection, treatment, rehabilitation, terminal care). The value of behavioral science is shown in conservative projections (incorporating likely rates of patient noncooperation) of the health benefits obtainable by the year 2000 if effective behavioral strategies in three key areas were broadly implemented. Smoking prevention and cessation programs could lead to 7.2 million fewer smokers; application of cancer screening programs might result in 45,000 additional 5-year cancer survivors each year; and behavioral programs could lead to improved quality of life in 150,000 patients per year who experience treatment side effects despite the use of antiemetics. Behavioral science also is shown to contribute to translational science by providing a pragmatic conceptual model for clinical practice and facilitating collaborative research between basic scientists and clinical researchers. As an example of behavioral science's contribution to translational research, behavioral issues in genetic screening for cancer risk are outlined based on the experience of several families with the BRCA1 genetic marker and patients with Huntington's disease.
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Affiliation(s)
- G R Morrow
- University of Rochester School of Medicine and Dentistry Cancer Center, Behavioral Medicine Unit, NY 14642
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4
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Abstract
BACKGROUND This research was undertaken to review the status of behavioral and psychosocial cancer research in the underserved. METHODS The author extensively reviewed the literature related to behavioral and psychosocial cancer research in the underserved for this article. The author's experience as the Principal Investigator for the only National Institutes of Health smoking cessation study targeting Asian-Americans also was used in analyzing the literature and developing an agenda for the future. RESULTS Two questions and accompanying agenda items were addressed. The underserved were defined, and the effect of being underserved was illustrated through their disproportionate and earlier (younger) presence in morbidity and mortality statistics. Initiating behavioral and psychosocial cancer research in the underserved begins with a proper attitude and making accommodations to culture. The agenda for research should be practical and assessed on the basis of prevalence and preventability of cancer related behaviors. Examples from underserved Asian-American populations were cited. CONCLUSIONS Behavioral and psychosocial cancer research needs to be done.
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Affiliation(s)
- M S Chen
- Department of Preventive Medicine, Ohio State University, Columbus 43210
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5
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Little SJ, Stevens VJ, LaChance PA, Severson HH, Bartley MH, Lichtenstein E, Leben JR. Smokeless tobacco habits and oral mucosal lesions in dental patients. J Public Health Dent 1992; 52:269-76. [PMID: 1404072 DOI: 10.1111/j.1752-7325.1992.tb02288.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
As part of a smokeless tobacco (ST) intervention study, we collected data on tobacco use habits and oral health for 245 male ST users aged 15 to 77. The study sample was identified during routine dental office visits and represents a relatively diverse population of patients. Oral health data collection included grading the clinical appearance of oral mucosal lesions using Greer and Poulson's classification system, as well as identifying and recording the primary anatomic location of ST placement. Results show that 78.6 percent of ST users had observable oral lesions, 23.6 percent of which were in the most clinically advanced category (degree III). Of the lesions noted, 85 percent were in the same location the patient identified as his primary area of smokeless tobacco placement. In a comparison sample of 223 non-ST-users with the same age distribution, only 6.3 percent had observable lesions. A multiple logistic regression model for ST users showed that lesion presence and severity were most significantly related to current frequency of ST use.
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Affiliation(s)
- S J Little
- Kaiser Permanente Center for Health Research, Portland, OR 97227-1098
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6
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Abstract
Smoked and smokeless tobacco use produces profound effects on soft and hard tissues in and around the oral cavity. Because many of these changes are clinically observable, dentists, oral hygienists, and related health professionals are in ideal positions to give patients specific information concerning the oral ill effects of tobacco use. This article links tobacco use with a wide range of malignant, precancerous, and nonmalignant changes in the oral and perioral environment and addresses the documented benefits of quitting. Oral conditions less definitively linked to tobacco are also discussed.
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Affiliation(s)
- A G Christen
- Department of Preventive/Community Dentistry, Indiana University School of Dentistry, Indianapolis 46202
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7
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Telivuo M, Murtomaa H, Lahtinen A. Observations and concepts of the oral health consequences of tobacco use of Finnish periodontists and dentists. J Clin Periodontol 1992; 19:15-8. [PMID: 1732305 DOI: 10.1111/j.1600-051x.1992.tb01142.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The observations of Finnish periodontists and other dentists, and their concepts of the oral health consequences of tobacco use as well as their counseling on tobacco use, were surveyed from November 1987 to January 1988. A questionnaire was mailed to all 61 Finnish periodontists and to 535 other dentists; 37 periodontists (61%) and 432 of the other dentists (80%) responded. The periodontists enquired about and advised on smoking significantly more frequently than did the other dentists; 71% of the periodontists often or always enquired about, and 62% advised their patients on smoking. 31% of all dentists had patients who were users of smokeless tobacco, and 62% of those dentists had often or always advised the users to quit. Nearly all dentists had seen some tobacco-caused effects. Periodontists reported more frequently than the other dentists that they had observed more periodontitis, impaired healing of periodontitis and more changes in the oral mucosa in smokers compared with non-smokers. The majority of those who had seen users of smokeless tobacco had noticed changes in the oral mucosa and in the color of the gingiva. The majority of all dentists believed that heavy smoking may impair the host response in the periodontium, with periodontists believing in this more strongly than other dentists.
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Affiliation(s)
- M Telivuo
- Department of Cariology, University of Helsinki, Finland
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8
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Abstract
When the physician is confronted with an oral pathologic condition in a child, the adage "common things happen commonly" should be applied. Congenital lesions such as palatal and alveolar cysts occur in almost 50% of newborns. Developmental conditions such as Fordyce granules and retrocuspid papillae are found in most children. Localized soft-tissue enlargements commonly seen in young children include the parulis, mucocele, papilloma, and inflammatory gingival tumors. In addition, soft-tissue pathologies and discomfort associated with herpesvirus infections or recurrent aphthous ulcerations often present as a chief complaint. The physician's knowledge and treatment recommendations for common oral pathologies should be an integral component to the overall medical management of infants, children, and adolescents.
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Affiliation(s)
- D C Dilley
- Department of Pediatric Dentistry, University of North Carolina, Chapel Hill
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9
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Abstract
This study surveyed a proportionate random sample of licensed dental hygienists in five states and the District of Columbia, to assess their antitobacco use behaviors and attitudes. The response rate was 79.4 percent. Descriptive data as well as chi-square, analysis of variance (ANOVA), and Duncan's multiple range test statistical results were reported. Only 6.9 percent of the hygienists sampled currently smoked. These hygienists appeared to exhibit significantly different aggregate attitudes and select clinical practice behaviors than their nonsmoking counterparts. Years of employment and geographic location showed no significant relationship to aggregate clinical practice behaviors or attitudes, although each was related to individual behaviors and attitudes. Overall, dental hygienists appeared committed to involvement in both individualized and community-based antitobacco-use efforts. Measures to coordinate hygienists' involvement at both of these levels need to be enhanced.
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Affiliation(s)
- J L Fried
- Department of Dental Hygiene, Baltimore College of Dental Surgery Dental School, University of Maryland 21201
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10
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Abstract
Literally, Public Law 99-252 (otherwise known as the Comprehensive Smokeless Tobacco Health Education Act of 1986) includes provisions that are informational in nature. Implicitly, however, this law is considered part of the federal effort in disease prevention and health promotion. This paper reviews the societal and legislative context of that act and presents a plan to evaluate the impact of this law on decreasing smokeless tobacco use. The uniqueness of this plan is its incorporation of nine disciplinary perspectives in the derivation of indicators to measure process, impact, and outcome measures for decreasing smokeless tobacco use. A basic prevention strategy is suggested by this interdisciplinary approach. In addition, specific lessons could be applied from the history of successes in public health to decreasing smokeless tobacco use.
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Affiliation(s)
- M S Chen
- Health Education Section, Ohio State University, Columbus 43210
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11
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Abstract
This paper is one of a series attempting to determine the impact of Public Law 99-252, the Comprehensive Smokeless Tobacco Health Education Act of 1986, on decreasing smokeless tobacco use. Potential indicators are discussed that could be used by the dental profession to determine the efficacy of the profession's involvement in existing and future prevention and cessation efforts relative to this law. In this review, six major areas are considered for measuring declines in smokeless tobacco use relative to the role of the dental health practitioner. These areas encompass the following: (1) the dental profession's knowledge of smokeless tobacco health hazards, (2) dental practitioners' involvement in measuring changes in use patterns, (3) the influence dentists have with their patients and community in decreasing smokeless tobacco use, (4) the general attitude and intention to quit on the part of dental patients, (5) active governmental involvement efforts, and (6) health effects of smokeless tobacco that might be used for identifying decreasing smokeless tobacco use. Within each of these six broad categories, more specific indicators for measuring the impact of P.L. 99-252 relative to the dental profession were considered.
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Affiliation(s)
- K L Schroeder
- Section of Oral Biology, Ohio State University, College of Dentistry, Columbus 43210
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12
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Chen MS, Schroeder KL. An epilogue to evaluating the impact of P.L. 99-252 on decreasing smokeless tobacco use. J Public Health Dent 1990; 50:101-4. [PMID: 2295996 DOI: 10.1111/j.1752-7325.1990.tb03566.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In a previous paper, "Evaluating the Impact of P.L. 99-252 on Decreasing Smokeless Tobacco Use," the context of this law and the theoretical framework for an evaluation plan for measuring its impact were described. In this paper, the methodology and selected findings from this project as well as their implications are discussed. This discussion includes the identification of the six indicators considered to be the most relevant, valid, reliable, accessible, and practical for measuring the impact of this law on decreasing smokeless tobacco use, as well as a report on the feasibility analysis of three of these indicators. Pilot data on two indicators--pounds of smokeless tobacco sold and incidence rates of tobacco-induced leukoplakia--are presented and analyzed.
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Affiliation(s)
- M S Chen
- Ohio State University, Columbus 43210
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13
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Abstract
One hundred eight patients with a histologically confirmed diagnosis of epithelial dysplasia of the oral cavity and a prior history of smokeless tobacco (ST) usage were identified. The mean age at time of diagnosis for female patients was almost a decade later than for male patients (63.6 versus 51.2 years). In addition, women were more likely (P = 0.02) to have moderate or severe epithelial dysplasia than men. The two most common locations (buccal mucosa/vestibule and alveolar ridge/gingiva) accounted for 82.4% of all cases. In the 44 cases which specified both ST placement and biopsy site, 90.9% demonstrated epithelial dysplasia at the location used by the patient for holding the ST. When evaluating the histologic severity of epithelial dysplasia, a trend (P = 0.02) toward focal mild or mild was noted among ST users as compared to nonusers. No difference was found in the histologic grade of the lesions associated with either snuff or chewing tobacco.
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Affiliation(s)
- G E Kaugars
- Department of Oral Pathology, Medical College of Virginia, Richmond 23298
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14
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Curtis MR. How many oral cancers have you found--or missed--lately? Postgrad Med 1989; 86:279, 282. [PMID: 2678068 DOI: 10.1080/00325481.1989.11704452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Oral cancers too often advance farther than they should before being diagnosed, because neither the patient's physician nor dentist has performed a thorough examination of the oral cavity. Only greater attention to this important area by both disciplines can improve the survival and quality of life of patients with a malignant oral lesion.
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Wisniewski JF, Bartolucci AA. Comparative patterns of smokeless tobacco usage among major league baseball personnel. J Oral Pathol Med 1989; 18:322-6. [PMID: 2810130 DOI: 10.1111/j.1600-0714.1989.tb01560.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The purpose of this study was to survey major league baseball personnel in order to determine the prevalence, cultural distribution and factors influential in, and the level of knowledge of individuals regarding the harmful effects of smokeless tobacco usage. During the 1987 preseason/season, 25 of 26 baseball teams in the American and National Leagues participated in the survey. The players (46%) "dipped" or "chewed" more than the managers/coaches (35%) followed by the trainers (30%). Current usage of smokeless tobacco was highest among Caucasian athletes (50%) followed by Hispanic athletes (33%) and then Black athletes (30%). Among the baseball players surveyed who currently use smokeless tobacco, 58% started during the ages 18 to 22. This study indicates that although baseball personnel are fully aware of the harmful effects of smokeless tobacco usage, current use of smokeless tobacco in major league baseball is high. Additionally, baseball personnel start "dipping" or "chewing" smokeless tobacco at an early age and continue this practice for long periods.
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Affiliation(s)
- J F Wisniewski
- Department of Restorative Dentistry, University of Alabama, Birmingham
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16
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Greer RO, Schroeder KL, Crosby L. Morphologic and immunohistochemical evidence of human papillomavirus capsid antigen in smokeless tobacco keratoses from juveniles and adults. J Oral Maxillofac Surg 1988; 46:919-29. [PMID: 2846804 DOI: 10.1016/0278-2391(88)90327-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Seventy-seven tissue samples from patients with either degree I, II, or III smokeless tobacco keratoses were examined. The tissues were evaluated for the presence of human papillomavirus (HPV) antigen by immunocytochemical staining. Capsid antigen could be identified in sixteen cases (20.78%). This investigation further supports the concept that smokeless tobacco-associated leukoplakias can be correlated with HPV infection.
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Affiliation(s)
- R O Greer
- Division of Oral Pathology and Oncology, University of Colorado School of Dentistry, Denver 80262
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