It is well known that smoking contributes to the development of lung cancer and cardiovascular disease, and there is weighty evidence that it has a considerable influence on oral health. Smoking has many negative effects on the mouth, including staining of teeth and dental restorations, reduction of the ability to smell and taste, and the development of oral diseases such as smoker’s palate, smoker’s melanosis, coated tongue, and, possibly, oral candidosis and dental caries, periodontal disease, implant failure, oral precancer and cancer. From a qualitative point of view the latter is obviously the most serious tobacco-related effect in the mouth. Quantitatively, however, importance has been attached to periodontitis, which affects a large proportion of the population, and during recent years more attention has been given to implant survival rates. Dentists have an important role to play in preventing the harmful effects of smoking in the mouth, and consequently smoking counselling should be as much a part of the dentist’s job as plaque control and dietary advice.
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- Oral health
- Doll R, Hill AB: Smoking and carcinoma of the lung: Preliminary report. Br Med J 1950;77:739–748.
- Doll R, Peto R, Wheatley K, Gray R, Sutherland I: Mortality in relation to smoking: 40 years’ observations on male British doctors. BMJ 1994;309:901–911.
- Peto R, Darby S, Deo H, Silcocks P, Whitley E, Doll R: Smoking, smoking cessation, and lung cancer in the UK since 1950: Combination of national statistics with two case-control studies. BMJ 2000;321:323–329.
- Funk GF, Karnell LH, Robinson RA, Zhen WK, Trask DK, Hoffman HT: Presentation, treatment, and outcome of oral cavity cancer: A National Cancer Data Base report. Head Neck 2002;24:165–180.
- Christen AG, McDonald JL, Christen JA: The Impact of Tobacco Use and Cessation on Nonmalignant and Precancerous Oral and Dental Diseases and Conditions. Indianapolis, Indiana University School of Dentistry, 1991.
- Mecklenburg RE, Greenspan D, Kleinman DV, Manley MW, Niessen LC, Robertson PB, Winn DE: Tobacco Effects in the Mouth: A National Cancer Institute and National Institute of Dental Research Guide for Health Professionals. Bethesda, US Department of Health and Human Services, Public Health Service, National Institutes of Health, 1994.
- EU Working Group on Tobacco and Oral Health Consensus Meeting, Copenhagen, October 1997. Oral Dis 1998;4:48–67.
- Parkin DM, Pisani P, Ferlay J: Estimates of the worldwide incidence of 25 major cancers in 1990. Int J Cancer 1999;80:827–841.
- Parkin DM, Whelan SL, Ferlay J, Raymond L, Young J: Cancer Incidence in Five Continents. Lyon, International Agency for Research on Cancer, 1997, vol VII.
- McCoy GD, Hecht SS, Wynder EL: The roles of tobacco, alcohol, and diet in the etiology of upper alimentary and respiratory tract cancers. Prev Med 1980;9:622–629.
- International Agency for Research on Cancer: Tobacco Smoking. Lyon, IARC, 1986.
- Blot WJ, McLaughlin JK, Winn DM, Austin DF, Greenberg RS, Preston-Martin S, Bernstein L, Schoenberg JB, Stemhagen A, Fraumeni JF Jr: Smoking and drinking in relation to oral and pharyngeal cancer. Cancer Res 1988;48:3282–3287.
- Franceschi S, Talamini R, Barra S, Baron AE, Negri E, Bidoli E, Serraino D, La Vecchia C: Smoking and drinking in relation to cancers of the oral cavity, pharynx, larynx, and esophagus in northern Italy. Cancer Res 1990;50:6502–6507.
- Franceschi S, Levi F, La Vecchia C, Conti E, Dal Maso L, Barzan L, Talamini R: Comparison of the effect of smoking and alcohol drinking between oral and pharyngeal cancer. Int J Cancer 1999;83:1–4.
- La Vecchia C, Boyle P, Franceschi S, Levi F, Maisonneuve P, Negri E, Lucchini F, Smans M: Smoking and cancer with emphasis on Europe. Eur J Cancer 1991;27:94–104.
- Garrote LF, Herrero R, Reyes RM, Vaccarella S, Anta JL, Ferbeye L, Munoz N, Franceschi S: Risk factors for cancer of the oral cavity and oro-pharynx in Cuba. Br J Cancer 2001;85:46–54.
- Macfarlane GJ, Zheng T, Marshall JR, Boffetta P, Niu S, Brasure J, Merletti F, Boyle P. Alcohol, tobacco, diet and the risk of oral cancer: A pooled analysis of three case-control studies. Eur J Cancer [B] 1995;31B:181–187.
- Scully C, Bedi R: Ethnicity and oral cancer. Lancet Oncol 2000;i:37–42.
- Zain RB: Cultural and dietary factors of oral cancer and precancer: A brief overview. Oral Oncol 2001;37:205–210.
- Axell TE: Oral mucosal changes related to smokeless tobacco usage: Research findings in Scandinavia. Eur J Cancer [B] 1993;29B:299–302.
- Lewin F, Norell SE, Johansson H, Gustavsson P, Wennerberg J, Biorklund A, Rutqvist LE: Smoking tobacco, oral snuff, and alcohol in the etiology of squamous cell carcinoma of the head and neck: A population-based case-referent study in Sweden. Cancer 1998;82:1367–1375.
- Winn DM: Surveillance of and Knowledge about Cancer Associated with Smokeless Tobacco Use; in: Smokeless Tobacco or Health: An International Perspective. Bethesda, US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Cancer Institute, 1993, pp 11–18.
- Nylander K, Dabelsteen E, Hall PA: The p53 molecule and its prognostic role in squamous cell carcinomas of the head and neck. J Oral Pathol Med 2000;29:413–425.
- La Vecchia C, Franceschi S, Levi F, Lucchini F, Negri E: Diet and human oral carcinoma in Europe. Eur J Cancer [B] 1993;29B:17–22.
- La Vecchia C, Tavani A, Franceschi S, Levi F, Corrao G, Negri E: Epidemiology and prevention of oral cancer. Oral Oncol 1997;33:302–312.
- Lesch CA, Squier CA, Cruchley A, Williams DM, Speight P: The permeability of human oral mucosa and skin to water. J Dent Res 1989;68:1345–1349.
- Zavras AI, Douglass CW, Joshipura K, Wu T, Laskaris G, Petridou E, Dokianakis G, Segas J, Lefantzis D, Nomikos P, Wang YF; Diehl SR: Smoking and alcohol in the etiology of oral cancer: Gender-specific risk profiles in the south of Greece. Oral Oncol 2001;37:28–35.
- Szabo G, Klenk G, Veer A, Nemeth Z: Correlation of the combination of alcoholism and smoking with the occurrence of cancer in the oral cavity: A screening study in an endangered population. Mund Kiefer Gesichtschir 1999;3:119–122.
- Kerawala CJ: Oral cancer, smoking and alcohol: The patients’ perspective. Br J Oral Maxillofac Surg 1999;37:374–376.
- Baric JM, Alman JE, Feldman RS, Chauncey HH: Influence of cigarette, pipe, and cigar smoking, removable partial dentures, and age on oral leukoplakia. Oral Surg Oral Med Oral Pathol 1982;54:424–429.
- Banoczy J, Gintner Z, Dombi C: Tobacco use and oral leukoplakia. J Dent Educ 2001;65:322–327.
- Schepman KP, Bezemer PD, van der Meij EH, Smeele LE, van der Waal I: Tobacco usage in relation to the anatomical site of oral leukoplakia. Oral Dis 2001;7:25–27.
- Greer RO Jr, Poulson TC: Oral tissue alterations associated with the use of smokeless tobacco by teenagers. I. Clinical findings. Oral Surg Oral Med Oral Pathol 1983;56:275–284.
- Andersson G: Snuff-induced changes associated with the use of loose and portion-bag-packed Swedish moist snuff: A clinical, histological and follow-up study. Swed Dent J Suppl 1991;75:1–89.
- Idris AM, Warnakulasuriya KA, Ibrahim YE; Nielsen R, Cooper D, Johnson NW: Toombak-associated oral mucosal lesions in Sudanese show a low prevalence of epithelial dysplasia. J Oral Pathol Med 1996;25:239–244.
- Zhang X, Schmitz W, Gelderblom HR, Reichart PA: Shammah-induced oral leukoplakia-like lesions. Oral Oncol 2001;37:609–612.
- Larsson A, Axell T, Andersson G: Reversibility of snuff dippers’ lesion in Swedish moist snuff users: A clinical and histologic follow-up study. J Oral Pathol Med 1991;20:258–264.
- Silverman S Jr, Gorsky M, Lozada F: Oral leukoplakia and malignant transformation: A follow-up study of 257 patients. Cancer 1984;53:563–568.
- Schepman KP, van der Meij EH, Smeele LE, van der Waal I: Malignant transformation of oral leukoplakia: A follow-up study of a hospital-based population of 166 patients with oral leukoplakia from The Netherlands. Oral Oncol 1998;34:270–275.
- Gupta PC, Murti PR, Bhonsle RB, Mehta FS, Pindborg JJ: Effect of cessation of tobacco use on the incidence of oral mucosal lesions in a 10-yr follow-up study of 12,212 users. Oral Dis 1995;1:54–58.
- Jaber MA, Porter SR, Gilthorpe MS, Bedi R, Scully C: Risk factors for oral epithelial dysplasia: The role of smoking and alcohol. Oral Oncol 1999;35:151–156.
- Roed-Petersen B: Effect on oral leukoplakia of reducing or ceasing tobacco smoking. Acta Derm Vener 1982;62:164–167.
- Pindborg JJ, Reibel J, Roed-Peterson B, Mehta FS: Tobacco-induced changes in oral leukoplakic epithelium. Cancer 1980;45:2330–2336.
- Kinane DF, Chestnutt IG: Smoking and periodontal disease. Crit Rev Oral Biol Med 2000;11:356–365.
- Johnson GK, Slach NA: Impact of tobacco use on periodontal status. J Dent Educ 2001;65:313–321.
- Bolin A: Proximal alveolar bone loss in a longitudinal radiographic investigation. Swed Dent J Suppl 1986;35:1–108.
- Bergstrom J, Preber H: Tobacco use as a risk factor. J Periodontol 1994;65(suppl):545–550.
- Grossi SG, Zambon JJ, Ho AW, Koch G, Dunford RG, Machtei EE, Norderyd OM, Genco RJ: Assessment of risk for periodontal disease. I. Risk indicators for attachment loss. J Periodontol 1994;65:260–267.
- Grossi SG, Genco RJ, Machtei EE, Ho AW, Koch G, Dunford R, Zambon JJ, Hausmann E: Assessment of risk for periodontal disease. II. Risk indicators for alveolar bone loss. J Periodontol 1995;66:23–29.
- Machtei EE, Dunford R, Hausmann E, Grossi SG, Powell J, Cummins D, Zambon JJ, Genco RJ: Longitudinal study of prognostic factors in established periodontitis patients. J Clin Periodontol 1997;24:102–109.
- Axelsson P, Paulander J, Lindhe J: Relationship between smoking and dental status in 35-, 50-, 65-, and 75-year-old individuals. J Clin Periodontol 1998;25:297–305.
- Norderyd O, Hugoson A, Grusovin G: Risk of severe periodontal disease in a Swedish adult population. A longitudinal study. J Clin Periodontol 1999;26:608–615.
- Bergstrom J, Preber H: The influence of cigarette smoking on the development of experimental gingivitis. J Periodontal Res 1986;21:668–676.
- Danielsen B, Manji F, Nagelkerke N, Fejerskov O, Baelum V: Effect of cigarette smoking on the transition dynamics in experimental gingivitis. J Clin Periodontol 1990;17:159–164.
- Albandar JM, Streckfus CF, Adesanya MR, Winn DM: Cigar, pipe, and cigarette smoking as risk factors for periodontal disease and tooth loss. J Periodontol 2000;71:1874–1881.
- Bergstrom J, Eliasson S, Dock J: A 10-year prospective study of tobacco smoking and periodontal health. J Periodontol 2000;71:1338–1347.
- Haffajee AD, Socransky SS: Relationship of cigarette smoking to attachment level profiles. J Clin Periodontol 2001;28:283–295.
- Scabbia A, Cho KS, Sigurdsson TJ, Kim CK, Trombelli L: Cigarette smoking negatively affects healing response following flap debridement surgery. J Periodontol 2001;72:43–49.
- Tomar SL, Asma S: Smoking-attributable periodontitis in the United States: Findings from NHANES III. National Health and Nutrition Examination Survey. J Periodontol 2000;71:743–751.
- van der Weijden GA, de Slegte C, Timmerman MF, van der Velden U: Periodontitis in smokers and non-smokers: Intra-oral distribution of pockets. J Clin Periodontol 2001;28:955–960.
- Chen X, Wolff L, Aeppli D, Guo Z, Luan W, Baelum V, Fejeskov O: Cigarette smoking, salivary/gingival crevicular fluid cotinine and periodontal status: A 10-year longitudinal study. J Clin Periodontol 2001;28:331–339.
- Norderyd O, Hugoson A: Risk of severe periodontal disease in a Swedish adult population: A cross-sectional study. J Clin Periodontol 1998;25:1022–1028.
- Haber J, Wattles J, Crowley M, Mandell R, Joshipura K, Kent RL: Evidence for cigarette smoking as a major risk factor for periodontitis. J Periodontol 1993;64:16–23.
- Machtei EE, Hausmann E, Dunford R, Grossi S, Ho A, Davis G, Chandler J, Zambon J, Genco RJ: Longitudinal study of predictive factors for periodontal disease and tooth loss. J Clin Periodontol 1999;26:374–380.
- Machuca G, Rosales I, Lacalle JR, Machuca C, Bullon P: Effect of cigarette smoking on periodontal status of healthy young adults. J Periodontol 2000;71:73–78.
- Bostrom L, Bergstrom J, Dahlen G, Linder LE: Smoking and subgingival microflora in periodontal disease. J Clin Periodontol 2001;28:212–219.
- Darby IB, Hodge PJ, Riggio MP, Kinane DF: Microbial comparison of smoker and non-smoker adult and early-onset periodontitis patients by polymerase chain reaction. J Clin Periodontol 2000;27:417–424.
- Haffajee AD, Socransky SS: Relationship of cigarette smoking to the subgingival microbiota. J Clin Periodontol 2001;28:377–388.
- Faddy MJ, Cullinan MP, Palmer JE, Westerman B, Seymour GJ: Ante-dependence modeling in a longitudinal study of periodontal disease: The effect of age, gender, and smoking status. J Periodontol 2000;71:454–459.
- Barbour SE, Nakashima K, Zhang JB, Tangada S, Hahn CL, Schenkein HA, Tew JG: Tobacco and smoking: Environmental factors that modify the host response (immune system) and have an impact on periodontal health. Crit Rev Oral Biol Med 1997;8:437–460.
- Bostrom L, Linder LE, Bergstrom J: Smoking and GCF levels of IL-1beta and IL-1ra in periodontal disease. J Clin Periodontol 2000;27:250–255.
- Lie MA, Loos BG, Henskens YM, Timmerman MF, Veerman EC, van der Velden U, van der Weijden GA: Salivary cystatin activity and cystatin C in natural and experimental gingivitis in smokers and non-smokers. J Clin Periodontol 2001;28:979–984.
- Mooney J, Hodge PJ, Kinane DF: Humoral immune response in early-onset periodontitis: Influence of smoking. J Periodontal Res 2001;36:227–232.
- Persson L, Bergstrom J, Ito H, Gustafsson A: Tobacco smoking and neutrophil activity in patients with periodontal disease. J Periodontol 2001;72:90–95.
- Rezavandi K, Palmer RM, Odell EW, Scott DA, Wilson RF: Expression of ICAM-1 and E-selectin in gingival tissues of smokers and non-smokers with periodontitis. J Oral Pathol Med 2002;31:59–64.
- Bergstrom J, Bostrom L: Tobacco smoking and periodontal hemorrhagic responsiveness. J Clin Periodontol 2001;28:680–685.
- Palmer RM, Matthews JP, Wilson RF: Non-surgical periodontal treatment with and without adjunctive metronidazole in smokers and non-smokers. J Clin Periodontol 1999;26:158–163.
- Robertson PB, Walsh M, Greene J, Ernster V, Grady D, Hauck W: Periodontal effects associated with the use of smokeless tobacco. J Periodontol 1990;61:438–443.
- Gelskey SC: Cigarette smoking and periodontitis: Methodology to assess the strength of evidence in support of a causal association. Community Dent Oral Epidemiol 1999;27:16–24.
- Esposito M, Hirsch JM, Lekholm U, Thomsen P: Biological factors contributing to failures of osseointegrated oral implants. II. Etiopathogenesis. Eur J Oral Sci 1998;106:721–764.
- Berge TI, Gronningsaeter AG: Survival of single crystal sapphire implants supporting mandibular overdentures. Clin Oral Implants Res 2000;11:154–162.
- Carlsson GE, Lindquist LW, Jemt T: Long-term marginal periimplant bone loss in edentulous patients. Int J Prosthodont 2000;13:295–302.
- Lambert PM, Morris HF, Ochi S: The influence of smoking on 3-year clinical success of osseointegrated dental implants. Ann Periodontol 2000;5:79–89.
- Quirynen M, Peeters W, Naert I, Coucke W, van Steenberghe D: Peri-implant health around screw-shaped c.p. titanium machined implants in partially edentulous patients with or without ongoing periodontitis. Clin Oral Implants Res 2001;12:589–594.
- Bain CA: Smoking and implant failure: Benefits of a smoking cessation protocol. Int J Oral Maxillofac Implants 1996;11:756–759.
- Esposito M, Couthard P, Worthington HV, Jokstad A: Quality assessment of randomized controlled trials of oral implants. Int J Oral Maxillofac Implants 2001;16:783–792.
- Hirsch JM, Livian G, Edward S, Noren JG: Tobacco habits among teenagers in the city of Goteborg, Sweden, and possible association with dental caries. Swed Dent J 1991;15:117–123.
- Jette AM, Feldman HA, Tennstedt SL: Tobacco use: A modifiable risk factor for dental disease among the elderly. Am J Public Health 1993;83:1271–1276.
- Sakki T: Lifestyle and oral health of 55-years-olds; thesis, Oulu, 1999.
- Sgan-Cohen HD, Katz J, Horev T, Dinte A, Eldad A: Trends in caries and associated variables among young Israeli adults over 5 decades. Community Dent Oral Epidemiol 2000;28:234–240.
- Sakki T, Knuuttila M: Controlled study of the association of smoking with lactobacilli, mutans streptococci and yeasts in saliva. Eur J Oral Sci 1996;104:619–622.
- Williams SA, Kwan SY, Parsons S: Parental smoking practices and caries experience in preschool children. Caries Res 2000;34:117–122.
- Tomar SL, Winn DM: Chewing tobacco use and dental caries among US men. J Am Dent Assoc 1999;130:1601–1610.
- Eriksen HM, Nordbo H: Extrinsic discoloration of teeth. J Clin Periodontol 1978;5:229–236.
- Asmussen E, Hansen EK: Surface discoloration of restorative resins in relation to surface softening and oral hygiene. Scand J Dent Res 1986;94:174–177.
- Ness L, Rosekrans DL, Welford JF: An epidemiologic study of factors affecting extrinsic staining of teeth in an English population. Community Dent Oral Epidemiol 1977;5:55–60.
- Frye RE, Schwartz BS, Doty RL: Dose-related effects of cigarette smoking on olfactory function. JAMA 1990;263:1233–1236.
- Pasquali B: Menstrual phase, history of smoking, and taste discrimination in young women. Percept Mot Skills 1997;84:1243–1246.
- Jackson JA: Heavy smoking and sodium chloride hypogeusia. J Dent Res 1967;46:742–744.
- Salonen L, Axell T, Hellden L: Occurrence of oral mucosal lesions, the influence of tobacco habits and an estimate of treatment time in an adult Swedish population. J Oral Pathol Med 1990;19:170–176.
- Andersson G, Vala EK, Curvall M: The influence of cigarette consumption and smoking machine yields of tar and nicotine on the nicotine uptake and oral mucosal lesions in smokers. J Oral Pathol Med 1997;26:117–123.
- Axell T: Occurrence of leukoplakia and some other oral white lesions among 20,333 adult Swedish people. Community Dent Oral Epidemiol 1987;15:46–51.
- Mehta FS, Jalnawalla PN, Daftary DK, Gupta PC, Pindborg JJ: Reverse smoking in Andhra Pradesh, India: Variability of clinical and histologic appearances of palatal changes. Int J Oral Surg 1977;6:75–83.
- Axell T, Hedin CA: Epidemiologic study of excessive oral melanin pigmentation with special reference to the influence of tobacco habits. Scand J Dent Res 1982;90:434–442.
- Unsal E, Paksoy C, Soykan E, Elhan AH, Sahin M: Oral melanin pigmentation related to smoking in a Turkish population. Community Dent Oral Epidemiol 2001;29:272–277.
- Hedin CA, Pindborg JJ, Axell T: Disappearance of smoker’s melanosis after reducing smoking. J Oral Pathol Med 1993;22:228–230.
- Campisi G, Margiotta V: Oral mucosal lesions and risk habits among men in an Italian study population. J Oral Pathol Med 2001;30:22–28.
- Arendorf TM, Walker DM, Kingdom RJ, Roll JR, Newcombe RG: Tobacco smoking and denture wearing in oral candidal leukoplakia. Br Dent J 1983;155:340–343.
- Holmstrup P, Bessermann M: Clinical, therapeutic, and pathogenic aspects of chronic oral multifocal candidiasis. Oral Surg Oral Med Oral Pathol 1983;56:388–395.
- Arendorf TM, Walker DM: Tobacco smoking and denture wearing as local aetiological factors in median rhomboid glossitis. Int J Oral Surg 1984;13:411–415.
- Rindum JL, Stenderup A, Holmstrup P: Identification of Candida albicans types related to healthy and pathological oral mucosa. J Oral Pathol Med 1994;23:406–412.
- Silverman S Jr, Gallo JW, McKnight ML, Mayer P, deSanz S, Tan MM: Clinical characteristics and management responses in 85 HIV-infected patients with oral candidiasis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:402–407.
- Telivuo M, Kallio P, Berg MA, Korhonen HJ, Murtomaa H: Smoking and oral health: A population survey in Finland. J Public Health Dent 1995;55:133–138.
- Chestnutt IG, Binnie VI: Smoking cessation counselling: A role for the dental profession? Br Dent J 1995;179:411–415.
- Cowan CG, Gregg TA, Kee F: Prevention and detection of oral cancer: The views of primary care dentists in Northern Ireland. Br Dent J 1995;179:338–342.
- John JH, Yudkin P, Murphy M, Ziebland S, Fowler GH: Smoking cessation interventions for dental patients: Attitudes and reported practices of dentists in the Oxford region. Br Dent J 1997;183:359–364.
- Warnakulasuriya KA, Johnson NW: Dentists and oral cancer prevention in the UK: Opinions, attitudes and practices to screening for mucosal lesions and to counselling patients on tobacco and alcohol use: Baseline data from 1991. Oral Dis 1999;5:10–14.
- Allard RH: Tobacco and oral health: Attitudes and opinions of European dentists. A report of the EU working group on tobacco and oral health. Int Dent J 2000;50:99–102.
- Tomar SL, Husten CG, Manley MW: Do dentists and physicians advise tobacco users to quit? J Am Dent Assoc 1996;127:259–265.
- Dolan TA, McGorray SP, Grinstead-Skigen CL, Mecklenburg R: Tobacco control activities in U.S. dental practices. J Am Dent Assoc 1997;128:1669–1679.
- Lodi G, Bez C, Rimondini L, Zuppiroli A, Sardella A, Carrassi A: Attitude towards smoking and oral cancer prevention among northern Italian dentists. Oral Oncol 1997;33:100–104.
- Fiore MC, Bailey WC, Cohen SJ: Treating Tobacco Use and Dependence. Rockville, US Department of Health & Human Services, Public Health Service, 2000.
- McCartan BE, Shanley DB: Policies and practices of European dental schools in relation to smoking: The place of tobacco education in the undergraduate dental curriculum. Br Dent J 1995;179:306–308.
- Akerberg O: Editorial. FDI World 1996;5:5–6.
- Watt R, Robinson M: Helping Smokers to Stop: A Guide for the Dental Team. London, Health Education Authority, 1999.
- Fiore MC, Bailey WC, Cohen SJ: A clinical practice guideline for treating tobacco use and dependence: A US Public Health Service Report. JAMA 2000;283:3244–3254.
- Bolliger CT, Zellweger JP, Danielsson T, van Biljon X, Robidou A, Westin A, Perruchoud AP, Sawe U: Smoking reduction with oral nicotine inhalers: Double blind, randomised clinical trial of efficacy and safety. BMJ 2000;321:329–333.
- Silagy C, Lancaster T, Stead L, Mant D, Fowler G: Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev 2001:CD000146.
- West R, Shiffman S: Effect of oral nicotine dosing forms on cigarette withdrawal symptoms and craving: A systematic review. Psychopharmacology (Berl) 2001;155:115–122.
- Skjoldebrand J, Gahnberg L: Tobacco preventive measures by dental care staff: An attempt to reduce the use of tobacco among adolescents. Swed Dent J 1997;21:49–54.
- Kentala J, Utriainen P, Pahkala K, Mattila K: Can brief intervention through community dental care have an effect on adolescent smoking? Prev Med 1999;29:107–111.
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Medical Principles and Practice
International Journal of the Kuwait University Health Sciences Centre A Publicationof the Academic Publications Council
Vol. 12, No. Suppl. 1, Year 2003 (Cover Date: Released April 2003)
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