Abstract
Combustible cigarettes have detrimental effects on periodontal disease. However, little evidence is available regarding new heated tobacco product (HTP) use and combined product use (both combustible cigarettes and HTPs). This study aimed to examine the association of combustible cigarettes, HTPs, and combined product use with periodontal disease simultaneously. This cross-sectional study was conducted using data from the 2019 arm of the longitudinal Japan "Society and New Tobacco" Internet Survey. Combustible cigarette users, HTP users, combined product users, never-users, and former users' data were separately obtained. In the present study, the primary outcome was self-reported periodontal disease. We estimated adjusted prevalence ratios (PRs) and confidence intervals (CIs) using multivariable modified Poisson regression analysis after adjusting for 12 confounders. Of the 10,439 JASTIS respondents, the numbers of users of combustible cigarettes only, HTPs only, and both products were 1,304, 437, and 1,049, respectively. Compared with never-users, HTP use was significantly associated with the prevalence of self-reported periodontal diseases (PR 1.43, 95% CI 1.03-1.62). Moreover, former users, combustible cigarette users, and combined product users also showed significant associations (PR 1.56, 95% CI 1.35-1.80; PR 1.29, 95% CI 1.03-1.62; and PR 1.55, 95% CI 1.20-1.99, respectively). Users of HTPs, combustible cigarettes, and combined products as well as former users were all significantly associated with a higher prevalence of periodontal diseases compared to never-users.
Highlights
Smoking is a global public health problem, as it is a leading risk factor for cancer and chronic respiratory diseases, and was the second leading risk factor for early death and disability worldwide in 2015 [1]
This study aimed to examine the association of combustible cigarettes, heated tobacco product (HTP), and combined product use with periodontal disease simultaneously
Compared with never-users, HTP use was significantly associated with the prevalence of self-reported periodontal diseases (PR 1.43, 95% confidence intervals (CIs) 1.03–1.62)
Summary
Smoking is a global public health problem, as it is a leading risk factor for cancer and chronic respiratory diseases, and was the second leading risk factor for early death and disability worldwide in 2015 [1]. Tobacco industries advertise that HTPs are less harmful to health than combustible cigarettes, presenting HTPs as appealing alternatives to use for smoking cessation [3, 5, 6]. Recent studies indicate that HTPs are not always safer than combustible cigarettes. It has been reported that HTPs contain more harmful substances than combustible cigarettes [3], and their use has cytotoxic effects on human bronchial epithelium [7]. Global investigations are needed to clarify the health impacts of HTPs. Combustible cigarettes have detrimental effects on periodontal disease. Little evidence is available regarding new heated tobacco product (HTP) use and combined product use (both combustible cigarettes and HTPs). This study aimed to examine the association of combustible cigarettes, HTPs, and combined product use with periodontal disease simultaneously
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