Switching from cigarette use to dual use with heated tobacco products and severe periodontitis risk
Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction: Severe periodontitis is a major global health concern, yet the impact of switching from combustible cigarettes to dual use of combustible cigarettes and heated tobacco products on periodontal status remains unclear. This study aimed to examine whether changes in smoking status influence the risk of severe periodontitis among Japanese adults. Methods: We conducted a longitudinal analysis using panel data from the Japan COVID-19 and Society Internet Survey. Participants were daily combustible cigarette smokers with periodontitis in 2021 and were followed through 2023. Smoking trajectories between 2021 and 2022 were categorized as: (1) continuous combustible cigarette smokers, (2) dual users (heated tobacco product-dominant), (3) dual users (combustible cigarette-dominant), and (4) quitters/reduced smokers. Severe periodontitis in 2023 was defined using validated self-reported criteria. Modified Poisson regression with robust variance was applied to estimate risk ratios and 95% confidence intervals (95% CIs), adjusting for potential confounders (age, sex, educational attainment, occupational status, marital status, equivalent income, alcohol consumption, diabetes mellitus status, periodontal pain, and smoking frequency). Results: A total of 193 participants (mean age 57.6 years; men 67.9%) were analyzed. Over 2 years, 61.1% developed severe periodontitis. Compared to continuous combustible cigarette smokers, the adjusted risk of severe periodontitis was 1.19 times (95% CI: 0.67-2.11), 1.41 times (95% CI: 1.04-1.91), and 0.99 times (95% CI: 0.76-1.28) higher for dual users (heated tobacco product-dominant), dual users (combustible cigarette-dominant), and quitters/reduced smokers, respectively. Sensitivity analyses using inverse probability weighting yielded consistent findings. Conclusion: Switching from daily combustible cigarette smoking to dual use with heated tobacco products may increase the risk of severe periodontitis. Combining combustible cigarettes with heated tobacco products, regardless of the frequency of combustible cigarette smoke, should not be considered a harm-reduction strategy in dental and public health practice.
Source: Frontiers in Oral Health
Institutions: Tohoku University, Nagoya University
Language: English
Subfield: Periodontics
Field: Dentistry
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,077
Awards: G1293060989, G1562464524, G1968018393, Epidemiological research for heated tobacco products use and the impact in the life-course, G2766818920, G3147924715, 貧困は食事の質を介して健康格差を引き起こすのか：全国規模の疫学データによる解明, Evoking smiles in the older adults: challenges from dentistry using machine learning and natural experiments, Positive Psychological Factor, Social Capital and its association with Healthy Aging(Fostering Joint International Research), 大規模疫学データベースを用いた加熱式タバコの心血管疾患発症リスクの解明, G4783750122, G4969382320, The determinant of rubella vaccination action among Japanese working population, G5233675677, Clarification of the relationship between periodontitis severity and the onset and progression of chronic obstructive pulmonary disease, Estimation of future needs of life support services among community-dwelling older adults, つくば型デジタルバイオエコノミー社会形成の国際拠点, Does Saying "Thank You" at Work Lead to Better Health? The Potential of Reciprocal Care through Gratitude, Identifying Social and Spatial Determinants for the Prevention of Elder Abuse, G8752179636, Exploring evidence on the relationship between oral health, healthy life expectancy, and medical and long-term care cost reduction by utilizing big data, ライフコースにおける口腔の健康と全身の健康との関連の解明:歯痛に着目した因果推論
OpenAlex ID: W7125736615