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Smoking and Drugs
Worldwide smoking is the single most important public health problem.
The detrimental effects of smoking and tobacco use on oral health are well recognized. Oral cancers and pre-cancers, periodontal diseases and poor wound healing are the most significant and serious effects of smoking on the mouth. In addition, staining of the teeth, soft tissue changes and halitosis are aesthetic and social impacts of smoking directly related to oral health.
Smoking is the largest single preventable cause of death and disability in the UK. Each year smoking kills 120,000 people, amounting to one in five of all deaths, and it costs the NHS £1700 million annually on treating smoking related diseases.
More than 2000 cases of oral cancer are reported each year where smoking is a major aetiological factor. Besides oral cancer smoking and chewing tobacco are related to a number of other oral health problems, including periodontal disease.
Millions of otherwise apparently healthy smokers visit a dentist every year for a check-up or dental treatment. Members of the dental team can therefore play a major role in helping people give up smoking by referring smokers wanting to quit to their local service.
Tobacco smoke contains more than 5000 different chemicals. These include:
- Polonium 210
At least 70 of the chemicals in tobacco smoke are known to cause cancer. They do this by weakening the immune system and damaging the DNA of normal cells causing mutations that can lead to cancer.
Cigarettes, cigars and pipe smoking carry all carry risks.
Some people believe shisha pies (hookahs) are safer than cigarettes as the smoke is filtered through water, however many toxins still get through and as the tobacco is burned in charcoal the carbon monoxide content is up to 17 times higher than cigarettes. It is believed shisha is just as dangerous as any other use of tobacco.
The main forms are:
- Chewing tobacco
Both significantly increase the risk of mouth cancer
Also known as paan or gutkha this consists of betel or areca nut, slaked lime, herbs, spices and often tobacco wrapped in a leaf and chewed or held in the side of the mouth. It is most popular among Asian cultures. Betel nut itself causes cancer and mixed with other ingredients produces a highly toxic cocktail. Use of paan is also associated with the condition called submucous fibrosis which causes the skin and underlying tissues of the mouth to become hard, limiting speech, eating and movement of the jaw and frequently becoming cancer.
Marijuana suppresses the immune system. Recent research suggests that marijuana mixed with tobacco and smoked increases the risk of cancer in those infected with the human papilloma virus.
As well as causing mouth cancer smoking is responsible for 4 out of 5 cases of lung cancer. It also accelerates gum disease, the greatest cause of tooth loss in the UK as well as damaging the senses of taste and smell.
About 90% of people with mouth cancer use tobacco. Smoking increases the risk of mouth cancer and throat cancer about 6-fold. The good news is that quitting leads to a significant reduction of risk within 5 years.
Vaping and E-Cigarettes
There has been a lot of debate about vaping and the safety of their long term use. Vaping has been endorsed by government health experts after studies into its effects in ex-smokers.
E-cigarettes contain nicotine but not many of the harmful substances produced by smoking tobacco, such as tar or carbon monoxide.
Although considered an anti-social habit the negative effects on the body are considerably less than smoking. Care does need to be taken to ensure young people aren't encouraged to take up vaping instead of smoking.
The mouth cancer foundation would still encourage people to neither smoke nor vape or use any type of e-cigarette for optimum health benefits.