Tobacco Cessation

What is Tobacco Cessation?

Tobacco cessation is an organized effort to eliminate or reduce the use of smoking products such as cigarettes, smokeless tobacco, e-cigarettes, marijuana, and other drug use. Dental hygienists can help patients who are interested in quitting by educating on the effects of smoking on overall and oral health, as well as provide practical suggestions to aid in accomplishing tobacco cessation goals. If you are interested in tobacco cessation, you have made the first step in improving your health and reducing your risk of cancer and other diseases. 

Statistics 

• Smoking causes the death of more than 490,000 people in the United States each year (American Lung Association State of Tobacco Control, 2025). 

• In 2024, 10.1% of high school students in the U.S. used tobacco products (American Lung Association State of Tobacco Control, 2025).

• Smoking is responsible for the development of 20% of cancers in the United States (American Cancer Society, 2024). 

• In the United States, smoking causes 30% of deaths caused by cancer.

• 80% of lung cancers and deaths caused by lung cancer are caused by smoking (American Cancer Society and American Society of Clinical Oncology, 2024).

• Smokers are 10 times more likely to develop oral cancer than non-smokers (Mydlarz, n.d.).

Health Risks

Smoking is a leading cause of cancer development. Smoking increases the risk for developing various types of cancer, such as lung and oral cancers because tobacco products are known to be carcinogenic (Mydlarz, n.d.). Oral cancer can occur anywhere in the oral cavity, such as in the larynx, pharynx, oral mucosa, tongue, and esophagus (American Cancer Society and American Society of Clinical Oncology, 2024). Treatment options for oral cancer can include radical surgeries that can compromise the quality of life, such as tongue and jaw removal procedures. 

Any form of smoking, including e-cigarette use, damages the lungs (American Cancer Society and American Society of Clinical Oncology, 2024). Many smokers develop chronic pulmonary diseases that compromise the quality of life, including chronic obstructive pulmonary disease (COPD). COPD is made up of two lung diseases: emphysema and chronic bronchitis. Symptoms of these conditions include difficulty breathing, wheezing, shortness of breath, and a chronic cough. This condition cannot be cured and will worsen with continued smoking (American Cancer Society and American Society of Clinical Oncology, 2024). 

Smoking also affects the oral cavity. Smoking increases the risk for developing periodontal disease, a gum disease which can cause loose teeth and tooth loss (Colgate, 2023). The heat produced by smoking causes trauma to the oral tissues which causes blood vessels to constrict. The decreased blood flow to the gums and supporting structures of the teeth makes it more difficult for the gums to resist bacterial pathogens. The decreased blood flow also makes it more difficult for the gums to heal and respond favorably to dental hygiene services such as prophylaxis dental cleanings and scaling and root planing procedures. Smoking also increases the risk for developing cavities. Smoking causes xerostomia (dry mouth) due to a decrease in saliva production. Smoking also promotes bacterial retention on the teeth. Decreased saliva and increased bacterial plaque buildup increase the risk for tooth decay (Colgate, 2023).

Smokeless tobacco pouches can cause tobacco pouch keratosis (Food and Drug Administration, 2024). Tobacco pouch keratosis causes thickening and wrinkling of the oral tissues due to keratinization. Smokeless tobacco can also cause leukoplakic (white) and erythroplakic (red) patches on the oral tissues that may become cancerous (Food and Drug Administration, 2024). 

Nicotine Replacement Therapy

Nicotine replacement therapy (NRT) has been approved by the FDA as a means to quit tobacco use (American Cancer Society and American Society of Clinical Oncology, 2024). 5 nicotine replacement products are approved by the FDA, such as patches, gum, inhalers, lozenges, and nasal sprays. The addictive ingredient in tobacco products is nicotine. NRT utilizes products that contain small amounts of nicotine to allow the user to gradually decrease intake of nicotine while quitting. This therapy helps reduce the withdrawal effects of tobacco cessation (American Cancer Society and American Society of Clinical Oncology, 2024). Evidence based research has proven that individuals who used NRT were 10-17% more successful at quitting tobacco long-term (Green, 2023). One study demonstrated that the use of NRT has allowed past smokers to cease Tobacco use for many years, and minimizes the risk of a relapse (Etter and Stapleton, 2006).