Upgrade to remove ads
Only $35.99/year

IPE - Tobacco Use and Outcomes for Oral Heath

Terms in this set (94)

The use of tobacco, smoking and vaping products is _______________: cigarettes, smokeless/chew, cigars, pipes, hookah, e-cig/vaporizer, bidis, kreteks, marijuana, secondhand smoke, thirdhand smoke

Tobacco/nicotine dependence is a powerful ______________

Nearly __________ of adults using tobacco are interested in quitting

The use of tobacco, smoking and vaping are all _________________

Professional organizations ______________ the active role of dental professionals in helping patients stop tobacco use

________________ is well-positioned to assess patients for the use of nicotine, alcohol, and other drugs to prevent and/or intervene with misuse of these substances, perhaps preventing a lifetime of addiction or even saving a life
Complex

Addiction

70%

Oral health issues

Support

Dentistry
Circa 1BC - __________________ begin smoking and using tobacco enemas

1492 - ________________ discovers tobacco smoking and takes it to Europe

1913 - _______________ birth of the "modern" cigarette

1939- USA first link between smoking and __________________

1964 - ___________________ determines that smoking causes lung cancer in men

1994: CEOs of cigarette companies testify before Congress that it is their opinion that nicotine is not ________________
Indigenous Americans

Cuba Columbus

USA

Lung cancer

Surgeon General's Report

Addictive
federal trade commission cigarette and smokeless tobacco reports for 2014: show that the top tobacco companies spent ______ marketing cigarettes and _______ marketing smokeless tobacco
$8.49 billion
$600 million
advertising for tobacco products targets
LGBTQ, African Americans, and youth

(dentists even recommended them)
Prevalence ofTobacco Product Use and Smoking:
-in 2019, _______ US adults aged 18 years or older (14%) currently smoked cigarettes
-14% of Americans is still ______ smokers
-in certain groups, there are much higher rates of use
-more than ________ live with a smoking-related disease
-~14 in every 100
-34.1 million
-16 million americans
Impact of Tobacco use:
-________ US adults smoke cigarettes
-________ of any tobacco product
34 million
50.6 of any tobacco product
Impact of Tobacco Use
E-cigarette use remains a _______________

Number of youth e-cig remains concerningly high: _______________

_____________ of high schoolers

_____________ of middles schoolers
Public health crisis

3.6 million

19.6%

4.7%
Current tobacco product use among high school students

Any product 2020: ___________________
23.6%
Current tobacco product use among middle school students

Any product 2020: _________________
6.7%
____________ billion people worldwide smoke tobacco
1.1 billlion
Toll of tobacco in Michigan
Metropolitan Detroit adult smoking

Oakland:
Macomb:
Washtenaw:
Wayne County:
12%
19%
12%
21%
Michigan's adult rate of smoking is:

A. Less than the national rate
B. More than the national rate
C. About equal to the national rate
B. More than the national rate
Tobacco product use among adults - United States

▪ Adults with disabilities: ()
▪ LGBTQ individuals: ()
▪ Mental Health Conditions:
-Among adults who experienced anxiety: mild (), moderate () or severe ()
▪ People divorced, separated, or widowed ()
▪ Non-Hispanic American Indian/Alaska Native ()
▪ Multiracial ()
▪ Black ()
▪ Insurance status: Medicaid , Uninsured ()
▪ Adults with disabilities: 26.9%
▪ LGBTQ individuals: 29.9%
▪ Mental Health Conditions
-Among adults who experienced anxiety: mild (30.4%), moderate (34.2%) or severe (45.3%)
▪ People divorced, separated, or widowed (23.5%)
▪ Non-Hispanic American Indian/Alaska Native (29.3%)
▪ Multiracial (28.1%)
▪ Black (20.7%)
▪ Insurance status: Medicaid 30%, Uninsured 30.2%
US adult rate
14%
Disparate Populations Adult Smoking in Michigan 2019 - Highest in:

Gender:
Racial and ethnic minorities:
Adults with lower educational attainment:
Lower income adults:
Men - 20.2%

American Indian/Alaska Native adults - 38.4%

Adults who did not graduate from high school -41.9%

Adults with an annual income of less than $25,000 - 35.2%
Smoking rates by industry
Which type of combination tobacco use best represents adult use (most common)?

A. Cigarette and e-cigarettes
B. Cigarettes and cigars
C. Cigars and pipes
D. Cigarettes and smokeless tobacco.
E. None of the above
A. Cigarette and e-cigarettes
A social justice issue:

▪ Low ______________ backgrounds
▪ More likely to suffer a _________________
▪ Disproportionate burden of tobacco-related ____________
▪ Often lack access to __________________
▪ Are often _________________
▪ Spend money on cigarettes instead of _________________
Socioeconomic status

Mental illness

Morbidity

Medical services, smoking cessation programs and support

Stressed

Food, healthcare and other necessities
More likely to have tobacco retailers near ______________ than other neighborhoods
schools
In major cities like Washington DC, there are up to _____________ more tobacco advertisements in black neighborhoods than other neighborhoods
10x
Regarding rates of tobacco use and access to treatment, disparities exist in which of these groups?

A. Mental illness
B. Uninsured
C. Low educational level
D. LGBTQ
E. Hospitality industry worker
F. Adults with disabilities
G. American Indian/Alaskan native
ALL
Whats in a cigarette?

Over ____________ chemicals
Over ___________ toxins
_________ carcinogens
7000
2000
80
________________ produce many of the same toxins found in tobacco smoke, including tar and carbon monoxide
Herbal cigarettes
Menthol may increase _______________ potential

More ________________ smoke menthol than any other group

Menthol masks ___________ to allow deeper and more inhalations

___________ of African Americans smoke menthol cigarettes
Addictive

Teens and young adults

Harshness

>75%
1 cigarette = __________

One pack of cigarettes (20) = _______________

Carton of 200 cigarettes = _______________
11 min

3 hours and 40 min

1.5 days
Smokeless tobacco products:

Consumed without ________________

Can be used _____________ or ________________

One popular form is ____________

Increases risk of ______________ and _________________: remains in mouth for extended periods

More than ____________ in smokeless tobacco are linked to cancer: cancers of the mouth, esophagus and pancreas
Burning

Orally, nasally

"Snus"

Tooth decay, gum disease

30 chemicals
Cigars:

Not a ________ alternative to cigarettes

At least as toxic as __________________, if not more

Some contain as much nicotine as __________________
Safe

Cigarettes

1 pack of cigarettes
Hookah:

Concern about _________________ risk

Evidence suggests:
Infectious

Periodontal disease, oral lesions, larynx and voice effects
Dissolvable tobacco products:

Researchers are concerned that the products might cause ________________ or other ____________________

Ingredient precautions:
___________ is acutely toxic when delivered orally, _______________ is an oral irritant

______________, banned as a flavoring agent in food because of its link to a risk of liver damage
Oral cancer, oral health problems

Ethyl citrate, cinnamaldehyde

Coumarin
Clove cigarettes:

Mixture of _______________

Imported from _____________

Use is more prevalent among _____________

_____________ the tar and nicotine content of standard cigarettes
Tobacco and cloves

Indonesia

Young smokers

2x
Bidis:

Imported from ____________

Resemble _____________

Available in ____________

Deliver ___________ higher levels of carbon monoxide and nicotine and ___________ higher levels of tar when compared to standard cigarettes
India

Marijuana joints

Candy flavors

3-fold, 5-fold
Beetle Quid:

Originally found in __________________

300-600 million people worldwide are potentially addicted and at increased risk for _________________

Risk of __________________
India, Asia, and Pacific region

Oral disease and cancer

Precancerous and cancerous lesions
Dokha

Similar acute effects on ________________ and _______________ as other forms of smoking

Possible oral effects:
Blood pressure, respiratory rate

Palatal inflammation, tongue discoloration, candidiasis, and faint white patches on lower labial mucosa
When considering possible health consequences of use, which tobacco product would be safer to use?

A. cigars
B. Herbal/natural cigarettes
C. Hookah
D. No safer product exists
D. No safer product exists
JUUL:

A single cartridge is roughly equal to a ________________ or ___________ puffs

The majority of youth e-cigarettes think that the last time they used a product they vaped only _____________, not nicotine
Pack of cigarettes, 200

Flavoring
Nicotine in e-cigarettes may have several negative health effects:

Chronic nicotine exposure may lead to insulin resistance and ___________

Inhaled nicotine increases _____________ and _______________

Evidence suggests that nicotine use during adolescence and young adulthood have long-term impacts on ________________
Type 2 diabetes

Heart rate and blood pressure

Brain development
_______ people worldwide smoke tobacco
1.1 billion
toll of tobacco use in Michigan: high school students who smoke
4.5% (23,500)
toll of tobacco use in Michigan: male high school students who smoke cigars (female use much lower)
7.2%
Michigan's adult rate of smoking is
-less than the national rate
-more than the national rate
-about equal to the national rate
more than the national rate
Disparate PopulationsAdult Smoking in Michigan 2019
GENDER:
Men (20.2 percent) (*17.2)
Women ___________-
(17.2 percent) (*13.6)
Disparate PopulationsAdult Smoking in Michigan 2019
Racial and ethnic minorities:
-American Indian/Alaska Native adults__________-
-More than one race (29.2 percent)
-Non-Hispanic black adults (21.9 percent)
-Non-Hispanic white adults (17.8 percent)
-Hispanic adults (24.7 percent)
-Asian adults (12.2 percent)
(38.4 percent)
Disparate PopulationsAdult Smoking in Michigan 2019
Adults with lower educational attainment:
-Adults who did not graduate from high school ________
-Adults who graduated from high school (25.6 percent)
-Adults who graduated from college (7.1 percent)
(41.9 percent)
MI adult rate
18.7%
more than a third or smokers have at least
3 dental health issues
Which type of combination tobacco use best represents adult use(most common)?
-Cigarettes and e-cigarettes
-Cigarettes and cigars
-Cigars and pipes
-Cigarettes and smokeless tobacco
-None of the above
cigarettes and e-cigarettes
Do low-income neighborhoods really have more tobacco retailers near schools?
More likely to have tobacco retailers near schools than other neighborhoods.
Do cigarette companies really advertise more in black neighborhoods?
In major cities like Washington D.C.,
there are up to 10X more tobacco advertisements in black neighborhoods than other neighborhoods.
smokeless tobacco products:
-increases ______: remains in the mouth for extended periods
-more than _______in smokeless tobacco are linked to cancer: cancer of the mouth, esophagus and pancreas
risk of tooth decay and gum disease

30 chemicals
hookah evidence suggests: (what oral manifestations)
Periodontal disease
Oral lesions
Larynx and voice effects
dissolvable tobacco products: Researchers are concerned that the products might cause
oral cancer or other oral health problems
blunts:
Cigar tobacco + marijuana: Increased dependence to both nicotine and cannabis
Khat: when chewed, leaves produce feelings of euphoria and stimulation

-oral effects including...
Oral effects including stomatitis, periodontal disease, dental caries, temporomandibular joint dysfunction and keratosis of buccal mucosa.

Oral cancers have been observed.
oral health risks of some abused substances: opiates, heroin:
Altered response to dental pain
oral health risks of some abused substances: cocaine
Cardiovascular risk with local anesthetics with vasoconstrictors (epinephrine)
oral health risks of some abused substances: methamphetamine
"Meth mouth"- cavities on buccal/cervical areas; secondary to poor oral care and acidic nature of inhaled drug
The sooner you quit the better, but quitting at any age reduces the risk of premature death
-People who quit between 25 to 34________ of life expectancy
-People who quit between 35 to 44___________
-People who quit between 45 to 59____________
regained almost all 10 years
regained 9 years
regained 4 to 6 years
People in addiction-treatment programs about 23x more likely to smoke than other people: Nearly ____ of those in treatment for drug and alcohol problems were smokers
85%
A Comparison of Cessation Counseling Received by Current Smokers at US Dentist and Physician Offices During 2010-2011:
-Results. Current adult smokers were significantly _________ Among physician patients who were advised to quit, 52.7% received at least 1 form of assistance beyond the simple advice to quit; 24.5% of dental patients received such assistance (P < .05). Approximately 9.4 million smokers who visited a dentist in 2010 to 2011 did not receive any cessation counseling.
-Conclusions. Our results indicate a ________
less likely to be advised to quit smoking during a visit to a dentist (31.2%) than to a physician (64.8%).

need for intensified efforts to increase dentist involvement in cessation counseling. System-level changes, coupled with regular training, may enhance self-efficacy of dentists in engaging patients in tobacco cessation counseling.
oral health risks of some abused substances: cannabis
Dental erosion, leukoplakia, oral carcinomas
oral health risks of some abused substances: alcohol, illicit drugs:
-Periodontal disease (poor oral hygiene; secondary effects from malnutrition);
-Xerostomia (dry mouth) leading to increased dental caries
-Biofilm(dentalplaque)accumulation
-Generalized dental caries
-______________________ to suspect substance use when they see clinical signs of advanced dental or periodontal disease that are inconsistent with the age of the patient.
-Substance use should be _____________ in the same way that patients are asked about allergies, medications, smoking and alcohol consumption.
-Consideration should also be given to _________ when patients are intoxicated, as well as the reduced efficacy of opioid analgesics in these patients
-Dentists should be aware that they may be _________behavior
-Dentists may be the first clinicians
-part of a standard history
-issues around treatment and consent
-the target of opioid-seeking
Kratom: supplement/herb that acts in the brain like an opiate, The chemicals in the herb interact with different types of receptors in the brain —
some that respond to opioids, and others to stimulants.
clove cigarettes (AKA Kreteks):
Mixture of tobacco and cloves
Imported from Indonesia
Use is more prevalent among young smokers
Two times the tar and nicotine content of standard cigarettes
use of E-cigarettes to quit smoking cigarettes: Actively recommending e-cigarettes to our smoking patients in a therapeutic encounter (at the least) exposes the clinician
to a potentially litigious hairball
advising our dental patients about vaping:
here's what we do know about electronic cigarettes:
-nicotine exposure in the developing brains of babies, children, and young people has ______
-the potential harm ________ whether nicotine is delivered by smoking, dip/chew, hookah or e-cigarettes
-there are likely ________ from inhaling secondhand vapors

here's what we don't know about electronic cigarettes. because there are no manufacturing guidelines or regulation of the chemical contents of electronic cigarettes we have no way of knowing
-if e-cigarettes are ______ for their intended use
-if they help people quit using ____
-what types and concentrations of possible harmful chemicals are in them (emphasize that there is likely a ______ between what's advertised as being in them and whats actually in them)
-the amount of nicotine inhaled when you use them (emphasize that theres no standardization of _____)
lifelong harmful effects
does not change
harmful effects

safe
tobacco
difference
dosage
Potential health consequences of vaping include:
Explosions
Nicotine poisoning
Brain development
DNA damage
Long term health consequences are less than use of combustible tobacco
All of the items above
all of the items above
Bidis:
-imported from india
-resemble marijuana joints
-available in candy flavors
-deliver _________ when compared to standard cigarettes
3-fold higher levels of carbon monoxide and nicotine and 5-fold higher levels of tar
Beetle Quid:
-Originally found in India, Asia, Pacific region
-300 to 600 million people worldwide are potentially addicted and at ______
-Risk of precancerous and cancerous lesions
increased risk for oral disease and cancer
nicotine in e-cigarettes may have several negative health effects:
-Chronic nicotine exposure may lead to insulin resistance and type 2 diabetes
-Inhaled nicotine increases heart rate and blood pressure.
-Evidence suggests that nicotine use during adolescence and young adulthood have______
long-term impacts on brain development
what is JUUL?
-in just over _______ on the market, amassed over 75% of the e-cigarette market share
-JUUL devices heat up a cartridge containing oils to create vapor, which quickly dissolves into the air
-Proven to appeal to young people and facilitate initiation of tobacco product use
-A single JUUL cartridge is roughly equal to ______ cigarettes, or ____ cigarette puffs
-the majority of youth e-cigarette users think that the last time they used a product they vaped only ______ according to the University of Michigan's 2016 Monitoring the Future study
-Nicotine salts allow for absorption of nicotine.
2 years
a pack, 200
flavoring, not nicotine
Dokha:
-Similar acute effects on blood pressure and respiratory rate as other forms of smoking.
-Possible oral effects: _____
palatal inflammation, tongue discoloration, candidiasis and faint white patches on the lower labial mucosa
When considering possible health consequences of use, which tobacco product would be safer to use?
-Cigars
-Herbal/natural cigarettes
-Hookah
-No safer product exists
no safer product exists
hookah multiple of average cigarette smoke value
Tar: 72x
cigarettes: menthol
-menthol may _________
-more _______ smoke menthol than any other group
-menthol masks ____ harshness to allow deeper and more inhalations
-____ of African Americans smoke menthol cigarettes (due to targeting by tobacco companies)
-INCREASE ADDICTIVE POTENTIAL
-teens and young adults
-harshness
->75%
Regarding rates of tobacco use and access to treatment, disparities exist in which of these groups?
-Mental illness
-Uninsured
-Low educational level
-LGBTQ
-Hospitality industry worker
-Adults with disabilities
-American Indian/Alaskan Native
all of the above
Cigarettes: "additive-free" and/or "natural", "light"
Herbal cigarettes produce many of the same toxins found in tobacco smoke, including tar and carbon monoxide
groups with higher rates of smoking
a social justice issue:
-_______ SES backgrounds
-more likely to suffer a _____
-disproportionate burden of tobacco-related ______
-often ___________ to medical services, smoking cessation programs, and support
-are often _____
-spend money on cigarettes instead of _______
-low
-mental illness
-morbidity
-lack of access
-stressed
-food, healthcare, and other necessities
Disparate PopulationsAdult Smoking in Michigan 2019
Lower income adults:
-Adults with an annual income of less than $25,000 _______
-Adults making between $25,000 and $49,999 (22.2 percent)
-Adults making between $50,000 and $74,999 (16.0 percent)
-Adults making more than $75,000 (10.7 percent)
(35.2 percent)
Tobacco Product Use Among Adults —United States, Disparate Populations
-adults with disabilities:
-LGBTQ individuals:
-mental health conditions: among adults who experienced anxiety:
-people divorced, separated, or widowed:
-non-hispanic American Indian/alaska native:
-multiracial
-black
-insurance status:
-26.9%
-29.9%
-mild (30.4%), moderate (34.2%), severe (45.3%)
-23.5%
-29.3%
-28.1%
-20.7%
-medicaid 30%, uninsured 30.2%
Tobacco Product Use Among Adults —United States, Disparate Populations
-US adult rate:
14%
toll of tobacco use in Michigan: high school students who use e-cigarettes
20.8%
toll of tobacco use in Michigan: kids (under 18) who become new daily smokers each year
3,200
toll of tobacco use in Michigan: adults in Michigan who smoke
18.7% (1,466,800)
toll of tobacco use in Michigan: proportion of cancer deaths in Michigan attributable to smoking
29.8%
In 2018, current smoking ranged from nearly 9 of every 100 adults in ________(9%) to 25 of every 100 adults in ________ (25.2%).
utah

West Virginia
E-cigarette use remains a ________
public health crisis
(3.6 million users from high school and middle school)
14% of Americans still smoke cigarettes, which is still ___________________ smokers

More than ____________ Americans live with a smoking-related disease
34.1 million

16 million
Youth E-cigarette Epidemic
Federal trade commission cigarette and smoking reports for 2014: Show that the top tobacco companies spent _________________ marketing cigarettes and __________________ million marketing smokeless tobacco
8.49 billion

600 million
Tobacco use is a pediatric disease

_____________ of adults who have ever smoked daily report that they first smoked before the age of 18, and ____________ report that they smoked by the age of 26

More than _____________ of adults who have ever smoked report they tried their first cigarette by the age of 14

_______________ of adult smokers who are nicotine-dependent report that they started smoking before they were 18-years old
88%, 99%

1/3

80%
Sets found in the same folder