Margot Rolandsson

Periodontal disease in relation to smoking and the use of Swedish snus: epidemiological studies covering 20 years (1983–2003)

AIM The aim of the present study was to examine how deleterious current smoking and the use of Swedish moist snuff (snus) is for periodontal health compared with non-tobacco users. MATERIALS AND METHODS The studies comprised three epidemiological cross-sectional studies, in 1983, 1993 and 2003, of stratified random samples aged 20, 30, 40, 50, 60 and 70 years. The numbers of dentate participants were 550, 552 and 523, respectively. The participants were examined clinically and radiographically. Diagnostic criteria were the number of teeth, plaque, gingival status, probing pocket depth (PPD) ≥ 4 mm, height of the alveolar bone level and classification by periodontal disease experience. In addition, participants were asked about their tobacco habits. RESULTS Multiple logistic regression shows, after adjusting for age, gender and sociodemographic variables, that relative to non-tobacco users, cigarette smokers had statistically significant less gingivitis, a higher frequency of PPD ≥ 4 mm and a higher incidence of severe periodontitis. There was no significant association between gingivitis, frequency of PPD ≥ 4 mm and periodontal disease experience and snus use. CONCLUSIONS Cigarette smokers were found to have a statistically significant higher risk of severe periodontitis than non-tobacco users and users of snus. Using snus did not seem to be a risk factor for periodontitis.

Dental caries in relation to smoking and the use of Swedish snus: epidemiological studies covering 20 years (1983–2003)

Abstract Objective. The aim of this study was to evaluate some intra-oral caries-associated variables and tobacco use on dental caries. Materials and methods. The participants were randomly recruited from three cross-sectional studies in Jönköping, Sweden, in 1983, 1993 and 2003. Each study consisted of 130 individuals in each of the 20, 30, 40, 50, 60 and 70-year age groups. Of these, 550, 552 and 523 dentate individuals attended respective year of examination. They were all examined both clinically and radiographically. A questionnaire was completed in conjunction with the examination. In the studies, 345 were smokers, 104 snus users and 1142 non-tobacco users, in total 1591 individuals. Results. In 1983 and 1993, there were no significant differences in mean DFS between non-users and smokers, but a statistically significantly higher mean DFS in comparison with snus users. In 2003, there was no statistically significant difference in mean DFS between the groups. Multiple regressions showed that, after adjusting for age, gender and socio-demographic variables, there was a statistically significant association between DFS and smoking in 1983 (smoking excluded in favour of lactobacilli when further analysed) and DFS and plaque index (PLI) in 1993. In 2003, there was no association, apart from buffer capacity (Power rising) between DFS and the examined intra-oral caries-associated variables and tobacco use. Conclusions. The results of these epidemiological studies, performed in 1993 and 2003, indicate that daily smoking or snus use does not increase the risk of dental caries.

Tobacco use in relation to socioeconomic factors and dental care habits among Swedish individuals 15-70 years of age, 1983-2003

OBJECTIVES The aim of this study was to describe the use of tobacco and changes in its use over time among individuals living in Jönköping, Sweden, and to analyse tobacco habits in relation to socioeconomic conditions, personality aspects and dental care habits. METHODS This study comprised three epidemiological cross-sectional studies, involving a random selection of individuals aged between 15 and 70 years, and was conducted in 1983, 1993 and 2003. The participants were asked to complete a questionnaire. RESULTS The results revealed a statistically significant reduction from 34% tobacco users in 1983 to 27% in 1993 and 28% in 2003. The main decrease was seen among smokers. At the same time, the number of users of snuff increased in all the age groups between 20 and 60 years of age. The use of tobacco was therefore largely unchanged in 1993 and 2003. In 2003, there was a statistically significant difference between users and non-tobacco users when it came to the frequency of dental visits; more tobacco users than non-tobacco users did not visit a dentist at all or did not visit a dentist regularly. In 1993, non-tobacco users brushed their teeth more frequently than tobacco users and this difference was statistically significant. CONCLUSIONS During the 20-year study, there was a reduction in the number of smokers and an increase in the number of snuff users. There was a difference between tobacco users and non-tobacco users when it came to the frequency of dental visits and oral hygiene habits.

Influence of the ice-hockey environment on taking up snuff: An interview study among young males

In Sweden, snuff-use is an established and accepted phenomenon in society, especially in connection with certain sports. The aim of this qualitative study was to analyze and describe the psychosocial environment influencing young male ice-hockey players into starting to use snuff. The study sample comprised 16 male participants between 15 and 32 years of age strategically selected for being active or having been active as ice-hockey players – snuff-users and non-users alike. A grounded theory design, including in-depth interviews, was used to generate a theory from data and thereby create theoretical concepts explaining social phenomena, human behavior, and process. An interview guide containing different themes was used to cover the study area. Five higher-order categories were developed and labeled: having a role model, residing in a consenting environment, experiencing performance demands, experiencing a sense of community and creating an image. Socialization in and through psychosocial norms of the ice-hockey environment was identified as a core category describing the central meaning of the informants’ experiences of snuff in the ice-hockey environment. In the present study, the identified categories that integrate within the environment in which the young people reside and pursue their sports activities have been interpreted as factors enhancing the commencement of snuff-use. We suggest health promotion activities within the ice-hockey environment based on a health psychology model of planned behavior.