Tobacco use and high caries risk in the United States Air Force active duty population

Objective: To examine the relationship between current tobacco use and high caries risk status for Untied States Air Force active duty personnel.

Methods: Caries risk, as defined by the American Dental Association, and current tobacco use were recorded during annual dental exams (N=291,651). Demographic variables were extracted from personnel files. Multiple logistic regression techniques were used to study the relationship between high caries risk (yes/ no) and current tobacco use status (non-tobacco user, smoker, smokeless tobacco user, and smoker using smokeless) while controlling for demographic covariates: sex, age, race, ethnicity, marital status, education level, rank, and years of military service. Confounding and two-way interactions were assessed by chi-square and likelihood ratio tests. Variables retained as covariates in the final model were sex, age, rank, marital status, race, and ethnicity. Unadjusted and adjusted odds ratios and associated 95% confidence intervals were reported.

Results: The overall prevalence of high caries risk for this population was 9.2% (equal for both genders). Of these, almost 27% used tobacco: 22.0% smoked; 3.9% used smokeless tobacco; and 0.7% smoked and used smokeless tobacco. An independent effect on high caries risk was found for all forms of tobacco use. The multivariable-adjusted odds ratios were: 1.55 (CI=1.28-1.88) for smokeless tobacco users, 1.78 (CI=1.67-1.90) for smokers (cigarette, cigar or pipe), and 2.02 (CI=1.27-3.20) for smokers using smokeless tobacco.

Conclusion: Results of this study reveal a significant association between high caries risk and current tobacco use. This reinforces the need for more aggressive smoking cessation efforts within the Air Force.