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Oral Health and Tobacco Use

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These selected resources offer high-quality information about tobacco and oral health. Use the tools below for further searching, or contact us for personalized assistance.

Key Facts

  Share these facts to help improve the oral health of pregnant women, children, adolescents, and their families.

  • Using smokeless tobacco and smoking are risk behaviors for oral cancer, dental caries, periodontal disease, and other oral conditions.1
  • Dental visits represent an opportunity to identify individuals who smoke and help them quit smoking, yet dental settings remain an untapped venue for treatment of tobacco dependence. 2
  • Dental school clinical faculty would benefit from in-service training and hands-on tobacco-treatment practice to gain knowledge about and confidence in modeling important communication skills to students. This training should include information on tobacco-use assessment and how to help patients quit, including those who are not ready to quit, using brief motivational counseling. 3
  • Training oral health professionals is essential to enable them to implement guidelines and provide effective interventions to help patients quit smoking. 4
  • When taking health histories, oral health professionals should ask about all forms of tobacco, including cigars, cigarettes, e-cigarettes, chewing tobacco, sinus, and other forms of smokeless tobacco. 5
  • Behavioral counseling interventions, such as face-to-face or phone interaction with a health professional, print materials, and computer applications, can reduce the risk for smoking initiation among school-age children and adolescents. 6
  • Tobacco quit-lines are underused by oral health professionals and should include oral health care settings in their educational outreach to increase adoption of these evidence-based services. 2
  • Since 2010, the proportion of 12th grade students who used marijuana during the preceding 30 days (21.4 percent) has surpassed the proportion who used cigarettes (19.2 percent). 7
  • Increased exclusive marijuana among high school students, as well as increased use of marijuana among high school students who smoke cigarettes or cigars, could undermine success in reducing tobacco use in this population. 7
  • Closer collaboration between public health professionals to address prevention of tobacco and marijuana use might be beneficial in the development of evidence-based policies and programs to prevent tobacco and marijuana use among high school students. 7


  1. Wiener RC. 2013. Association of smokeless tobacco use and smoking in adolescents in the United States: An analysis of data from the Youth Risk Behavior Surveillance System survey, 2011. Journal of the American Dental Association 144(8):930–938.
  2. Wiener RC. 2015. Children, sealants, and guardians who smoke: Trends in NHANES 2001–2002 to 2010–2012. Dental, Oral and Craniofacial Research 1(1):3–9.
  3. Jannat-Khah DP, McNeely J, Pereyra MR, Parish C, Pollack HA, Ostroff J, Metsch L, Shelley DR. 2014. Dentists’ self-perceived role in offering tobacco cessation services: Results from a nationally representative survey, United States, 2010–2011. Preventing Chronic Disease. 11:E196.
  4. Davis JM, Arnett MR, Loewen J, Romito L, Gordon SC. 2016. Tobacco dependence education: A survey of US and Canadian dental schools. Journal of the American Dental Association 147(6):405–412.
  5. Omaña-Cepeda C, Jané-Salas E, Estrugo-Develsa A, Chimenos-Küstner E, López-López J. 2016. Effectiveness of dentist’s intervention in smoking cessation: A review. Journal of Clinical and Experimental Dentistry 8(1):e78–e83.
  6. Tomar SL, Fox CH, Connolly GN. 2015. Electronic cigarettes: The tobacco industry’s latest threat to oral health? Journal of the American Dental Association 146(9):651–653.
  7. Moyer VA. 2103. Primary care interventions to prevent tobacco use in children and adolescents: U.S. Preventive Services Task Force recommendation statement. Pediatrics 132(3):560–565.
  8. Rolle IV, Kennedy SM, Israel A, Everett Jones S, Bunnell R, Caraballo R, Xu X, Schauer G, McAfee T. 2015. Cigarette, cigar, and marijuana use among high school students—United States, 1997–2013. Morbidity and Mortality Weekly Report (MMWR) 64(40);1136–1141.

OHRC Publications

This section contains OHRC-produced materials.


Casamassimo P, Holt K, eds. 2016. Bright Futures: Oral health—Pocket guide (3rd ed.). Washington, DC: National Maternal and Child Oral Health Resource Center, 90 pp

National Maternal and Child Oral Health Resource Center
Georgetown University Box 571272
Washington, DC 20057-1272

Telephone: (202) 784-9771
E-mail: OHRCinfo@georgetown.edu
Website: https://www.mchoralhealth.org
Available from the website.

This pocket guide offers health professionals an overview of preventive oral health supervision for five periods—pregnancy and postpartum, infancy, early childhood, middle childhood, and adolescence. The pocket guide is designed to help health professionals implement specific oral health guidelines during these periods. For each period, information about family preparation, risk assessment, interview questions, screening, examination, preventive procedures, anticipatory guidance, measurable outcomes, and referrals are discussed. The content aligns with Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents (4th ed.). [Funded by the Maternal and Child Health Bureau]


National Center on Early Childhood Health and Wellness. 2012–. Brush up on oral health. Elk Grove Village, IL: National Center on Early Childhood Health and Wellness, monthly

Early Childhood Learning and Knowledge Center
Telephone: (866) 763-6481
E-mail: health@ecetta.info
Website: https://eclkc.ohs.acf.hhs.gov
Available from the website.

This tip sheet series provides Head Start staff with information on current practice, practical tips for promoting oral health to share with parents, and recipes for healthy snacks that children can make with Head Start staff or at home with their parents. Topics include children with special health care needs, community water fluoridation, dental caries, dental home, fluoride varnish, health literacy, home visiting, injury, nutrition, pregnancy, school readiness, and tobacco.


OHRC Library

This section contains recent materials, not including OHRC-produced materials.


Connecticut Department of Public Health, Office of Oral Health. 2014–. Smoking and oral health quit kit information. Hartford, CT: Connecticut Department of Public Health, Office of Oral Health, multiple items

Connecticut Department of Public Health, Office of Oral Health
P.O. Box 340308
Hartford, CT 06134-0308

Telephone: (860) 509-7382
Fax: (860) 509-7853
E-mail: linda.ferraro@ct.gov
Website: http://www.ct.gov/dph/cwp/view.asp?a=3125&q=388844&dphNav_GID=1601
Available from the website.

These resources are designed to help oral health professionals in Connecticut screen and counsel their clients who use tobacco products. Contents include a letter that provides information about an evidence-based approach to eliminate tobacco use (the 5 A's), resources and tools, and cessation counseling reimbursement for professionals who participate in the state Medicaid/HUSKY Health programs. Additional contents include questions and answers about the state quit line, a quit line wallet card, information about treatment methods, a quit tips note sheet, and a poster with tips from former smokers. The wallet cards and posters are available in English and Spanish.


Deming S. 2015. Final report for Phase I Tobacco Dependence Treatment Through Dental Providers Project for 2014–15. Lansing, MI: Michigan Department of Health and Human Services, Oral Health, 13 pp

Michigan Department of Health and Human Services, Oral Health
201 Townsend Street Box 30195
Lansing, MI 48913

Telephone: (517) 373-3740
Website: http://www.michigan.gov/mdch/0,1607,7-132-2942_4911_4912_6226---,00.html
Available from the website.

This report summarizes a pilot project to reduce tobacco use and improve oral health by training oral health professionals on recommended guidelines for tobacco dependence treatment. Contents include information about the participating dental clinics, reimbursements for clients receiving tobacco dependence interventions, administrative support activities, project outcomes, and next steps. Training pretest, mid, and posttest surveys results; and final report numbers and comments are included.


Romito L, Mandiwala R. 2014. Tobacco cessation toolkit for Indiana dental practices. Indianapolis, IN: Indiana Dental Association, 93 pp

Indiana Dental Association
1319 East Stop 10 Road
Indianapolis, IN 46227

Telephone: (317) 634-2610
Secondary Telephone: (800) 562-5646
Fax: (317) 634-2612
E-mail: jhawke@indental.org
Website: http://www.indental.org/
Available from the website.

This toolkit provides information on how oral health professionals can develop a tobacco-cessation-intervention program and outlines key roles for each member of the oral health team. Contents include information about tobacco use and prevalence, risks of tobacco use, secondhand smoke, benefits of cessation, nicotine and the physiology of dependence, tobacco-cessation counseling, pharmacotherapy, insurance coverage and coding, the role of dentists and the dental team, barriers and solutions, and resources.


U.S. Department of Health and Human Services. 2014. The health consequences of smoking: 50 years of progress–A report of the Surgeon General. Atlanta, GA: National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 943 pp, exec summ (22 pp)

National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health
Centers for Disease Control and Prevention 1600 Clifton Road
Atlanta, GA 30329-4027

Telephone: (800) 232-4636
Secondary Telephone: (888) 232-6348
E-mail: cdcinfo@cdc.gov
Website: http://www.cdc.gov/tobacco
Available from the website.

This report chronicles the consequences of 50 years of tobacco use in the United States. Topics include the relationship between smoking and health outcomes; smoking-attributable morbidity, mortality, and economic costs; patterns of tobacco use among children, adolescents, and adults; status of and future directions in tobacco control; and a vision for ending tobacco-caused death and disease.


World Health Organization. 2017. WHO monograph on tobacco cessation and oral health integration. Geneva, Switzerland: World Health Organization.

World Health Organization
20, Avenue Appia
Geneva, Switzerland

Telephone: (+ 41 22) 791 21 11
Fax: (+ 41 22) 791 3111
E-mail: info@who.int
Website: http://www.who.int/en
Available from the website.

This monograph provides information about systematic reviews of the association between tobacco use and oral diseases and potential benefits of tobacco-use cessation on oral health outcomes. For each systematic review, the methodology, results, and a discussion are presented. The monograph also includes policy recommendations related to integrating brief tobacco interventions into oral health programs in primary care.


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