Precancerous Oral Conditions in Nevada Adolescents Associated with Tobacco and Marijuana Use

Purpose: The purpose of this study was to determine significant associations between cigarettes/marijuana use and precancerous oral conditions (oral lesions and enlarged lymph nodes) in Nevada adolescents.  

Methods: This cross-sectional observational study was conducted by trained/calibrated/licensed oral health professionals who conducted oral health screenings with adolescents (n=31,306, 13-19 yrs. old) from 2006/2010 as part of an annual, statewide, Nevada, school-based, dental screening initiative following approval of The Nevada Clean Indoor Air Act.   Demographics, exposure to second-hand smoke, and use of marijuana were self-reported in interviews.

Results: Of the subjects screened, 826 presented with oral lesions (~2.6%); 958 presented with enlarged lymph nodes (~3%); and 4% (n=71) with both. Of those who reported using tobacco/marijuana, almost 500 (59.2%) presented with oral lesions, 407 (42.5%) with enlarged lymph nodes, and 56 (80%) with both. Over 90% (869) of those who reported being exposed to second-hand smoke presented with lesions or enlarged lymph nodes.

Discussion: Although oral cancer in adolescents is extremely rare, the death rate in the US due to oral cancer is higher than that of cervical cancer; Hodgkin’s disease; cancer of the brain, liver, testes, kidney and ovarian cancer. These data indicated prevalence of tobacco use was slightly higher than the national average (19.5% vs. 18.5%); however, there were significantly higher rates of marijuana use (12.0% vs. 3.3%), suggesting these behaviors are associated with the increasing trends in precancerous and cancerous oral conditions in this cohort.