Effects of active non-smoking programmes on smoking behaviour in oral precancer patients.
ABSTRACT Smoking is the commonest risk factor for oral cancer and precancer. The objective of this study was to characterize smoking behaviour and attitude in a cohort of oral precancer patients in Newcastle upon Tyne, UK, and to determine changes in behaviour during diagnosis, treatment and follow-up. Twenty-seven consecutive, smoking patients with dysplastic oral lesions were recruited to the study and a detailed smoking history obtained, quantifying types and numbers of cigarettes smoked, length of smoking history, and changes in smoking behaviour during treatment episodes and long-term follow-up. All patients underwent an interventional management protocol comprising risk-factor education, histopathological diagnosis by incisional biopsy and laser excision of lesions. Patients were followed up for 5 years. Whilst there was a significant decrease in the number of cigarettes smoked at patients' most recent follow-up compared with initial presentation (p<0.001), 74% continued to smoke. Patients received advice from a smoking cessation adviser on support available to them from the local NHS (National Health Service) Stop Smoking services. Six out of 10 patients who set a 'quit date' and attended a programme had quit at the 4-week follow-up but only 5 remained non-smokers. Smoking remains a considerable problem in oral precancer patients even after interventional treatment, with the risk of further precancerous lesions and malignant transformation.
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ABSTRACT: The present study assessed possible clinicopathologic differences between oral leukoplakia in current smokers and never-smokers. Retrospective study of 52 patients with oral leukoplakia. Clinical and pathologic data (age, sex, lesion size, lesion location, and presence/absence of dysplasia) were compared between 41 current-smoking patients and 11 never-smoking patients. The mean age of the smoking patients was 49 yrs, significantly lower than the never-smoking patients (59 yrs) (P < .05). The proportion of women was markedly and significantly higher in the never-smoker group than in the smoker group (82% vs. 22%). The odds ratio for lesions on the tongue (0.80, 95% CI 0.01-0.37) was statistically significant at the 5% level (i.e., 95% CI). Dysplastic lesions were observed most frequently in the never-smoking patients, and this difference was statistically significant (P = .026). The results of the present study indicate that nonsmoking-related oral leukoplakia lesions are more frequent among women than among men, are more likely to be located on the tongue than smoking-related lesions, and show epithelial dysplasia more frequently than smoking-related lesions.Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 08/2006; 102(2):199-203. · 1.50 Impact Factor
Article: Tobacco use and oral disease.[show abstract] [hide abstract]
ABSTRACT: Tobacco use is a risk factor for oral cancer, oral mucosal lesions, periodontal disease and impaired healing after periodontal treatment, gingival recession, and coronal and root caries. Available evidence suggests that the risks of oral diseases increase with greater use of tobacco and that quitting smoking can result in decreased risk. The magnitude of the effect of tobacco on the occurrence of oral diseases is high, with users having many times the risk of non-users. There is a clear benefit to quitting tobacco use. The risks of oral cancer and periodontal disease decline as time from cessation increases, and some oral mucosal lesions may resolve with cessation of smokeless tobacco use. Smoking accounts for half of periodontal disease and three-fourths of oral cancers in the United States. Because tobacco accounts for such a high proportion of these diseases, comprehensive tobacco control policies are required to make progress in reducing the burden of tobacco-related oral diseases. Effective treatments to prevent tobacco use and increase cessation are available and need greater implementation. Dental practices may provide a uniquely effective setting for tobacco prevention and cessation.Journal of dental education 05/2001; 65(4):306-12. · 0.99 Impact Factor
Article: Tobacco use and oral leukoplakia.[show abstract] [hide abstract]
ABSTRACT: The increase in cancer mortality throughout the world justifies the study of its causes and development. Hungary has the highest mortality rate from oropharyngeal cancer out of forty-six countries. Tobacco use is implicated in the development of oral cancer, and oral leukoplakia as well. The aim of the study was to give an overview of the connection between tobacco use and oral leukoplakia, considering the epidemiologic patterns of tobacco habits, the prevalence of smoking in oral leukoplakia, and the effect of smoking on clinically healthy oral mucosa with special respect to central Europe and Hungary. In the data, strong evidence has been found for the role of smoking in the development of both oral cancer and oral leukoplakia. Epidemiologic patterns of cigarette smoking show a steep increase in central European countries. Cross-sectional studies show a higher prevalence rate of leukoplakia among smokers, with a dose-response relationship between tobacco use and oral leukoplakia, and intervention studies show a regression of the lesion after stopping the smoking habit.Journal of dental education 05/2001; 65(4):322-7. · 0.99 Impact Factor