The perils of smoking

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  Posted by: Dental Design      26th October 2024

By 1950, 50% of people in industrialised countries smoked. It was an accepted behaviour, glamourised by film stars and the wealthy.[i] Now, smoking is one of the most preventable causes of illness and death in the world.[ii]

The UK plans to be ‘smoke-free’ by 2030 but researchers believe this target will be missed as one of the impacts of the pandemic was a growth in new smokers – hospital admissions due to smoking increased by 5% in 2023.[iii]

25% of mouth and oropharyngeal cancers are caused by smoking.[iv] Acetone, tar, nicotine and carbon monoxide are some of the unsafe substances found in cigarettes – there are over 600 ingredients in a cigarette and at least 69 of these are carcinogenic.[v] The intake of these into the mouth promotes the build-up of malignant cells, increasing the risk of cancer developing in the mouth or the back of the throat.

Oral cancer is common and aggressive. It has a high morbidity, mortality and recurrence rate across the world. In the UK, the number of people dying from oral cancer has increased every year for the last ten years.[vi] Identifying early stages of oral cancer can help reduce mortality and it is also vital to understand how smoking cessation can decrease the risk of developing it.

The risk among men

Oral cancer affects twice as many men as it does women.[vii] Furthermore, in the UK, men are 35% more likely to die from cancer than women – when comparing only non-sex-specific cancers, like oral cancer, this grows to 67%.[viii] The disproportionate number of male victims may be connected to the fact that more men smoke than women, with 14.6% of the male population smoking against 11.2% of the female population.[ix]

More worryingly, men are less likely than women to have a regular dental check-up and more likely to have never been to a dentist, meaning that there is a greater chance for oral cancer to develop undetected.[x] Studies have similarly noted that men seemingly go missing in global cancer policy as they are underrepresented and underfunded.[xi] Being the most susceptible demographic to oral cancer, it is crucial for practices to keep up patient recall for male patients, especially those over 40 and who may be known smokers.[xii]

Paying attention to the growing number of women, particularly among the middle-class, who have started smoking is just as important. There has been a 25% jump in the last decade for young middle-class women smoking, with the pandemic years contributing to this.[xiii] The long-term effects will soon start to materialise.[xiv] Unlike lung cancer, no direct causality has been established between second-hand smoking and oral cancer.

The rise of vaping

The use of e-cigarettes in younger adults and teenagers has tripled in recent years.[xv] Marketed as a better alternative to smoking cigarettes, e-cigarettes, or vapes, are misconceived as being safe.[xvi] The direct causality between e-cigarette use and oral cancer remains unclear because the long-term effects of vaping have yet to be fully realised and studied. Chemically analysed e-cigarettes have been found to contain organic compounds with the potential for carcinogenicity, but this has not led to a direct risk increase in oral cancer.

However, case reports of oral cancer in heavy e-cigarette users without other traditional risk factors, such as alcohol consumption and weakened immunity, do exist.[xvii] For now, e-cigarettes remain recommendable as a cessation aid as they are lower risk than the more damaging traditional cigarette.[xviii] Keeping updated on any breakthroughs regarding the long-term implications of e-cigarettes is imperative.

Finding oral cancer early

To fight oral cancer in its early stages, there is a need for early identification. This starts with making sure that all patients who are smokers are educated on the health impacts, are encouraged to quit, and maintain regular check-ups.[xix] Unusual lesions and symptoms such as sore throats and ear pain may give dentists grounds to suspect oral cancer. Testing methods like tissue biopsies, CT scans, endoscopies and MRI scans have lengthy waiting times to confirm the results. Using a newly emerging and non-invasive pre-diagnostics test can efficiently test for cancer risks in patients to ensure this referral pathway is optimised.

The BeVigilant™ OraFusion™ System from Vigilant Biosciences® offers the solution to more confident testing. It identifies the presence of biomarkers associated with oral cancer in 15 minutes or less.[xx] With or without symptoms you can use the system’s non-invasive saliva test to accurately report a low, moderate or elevated risk of oral cancer for that patient. The BeVigilant™ OraFusion™ will empower clinicians to make assured assessments and confident referrals for cancer tests.

The future of smoking in the UK is at a crossroads, with increases in some demographics offsetting the ‘smoke-free’ goal and the long-term impacts of e-cigarettes needing for more research. Staying alert and ensuring high-risk patients maintain regular check-ups is integral to battling oral cancer.

For more information, visit www.vigilantbiosciences.com or email info@vigilantbiosciences.com

Author: Philip Silver

Founded in 2018, Total TMJ was created by Phil Silver, after a long career in medical devices, which gave him the knowledge to set up in his own right. The Dorset company is a specialist provider of medical devices. It distributes innovative technologies from leading healthcare manufacturers to dentists and clinicians around the UK. Their vision is to combine a portfolio of complimentary medical devices that both help the clinician and improve the outcome for their patients.

The privately-owned family business Total TMJ in Bournemouth fully supports the clinicians it works with through educational support by offering local and international surgeon peer to peer led courses. If you would like to find out more about their courses, please click here.

Total TMJ also supplies innovative medical devices offering solutions for temporomandibular joint disorders (TMD) & trismus within the healthcare sector.

[i] Hilton, M.J. (2019). Smoking – The age of the cigarette. In: Encyclopædia Britannica. [online] Available at: https://www.britannica.com/topic/smoking-tobacco/The-age-of-the-cigarette.

[ii] Cancer Research UK (2018). Tobacco statistics. [online] Cancer Research UK. Available at: https://www.cancerresearchuk.org/health-professional/cancer-statistics/risk/tobacco#heading-Zero.

[iii] Smoking decline stalls since Covid as more young people take up the habit – study. (2023). BBC News. [online] 14 Dec. Available at: https://www.bbc.co.uk/news/health-67703066.

NHS (2023). NHS England» Hospital admissions due to smoking up nearly 5% last year, NHS data shows. [online] www.england.nhs.uk. Available at: https://www.england.nhs.uk/2023/12/hospital-admissions-due-to-smoking-up-nearly-5-per-cent-last-year-nhs-data-shows/.

[iv] cancer research uk. (2022, July 5). Risks and Causes | Mouth Cancer | Cancer Research UK. Www.cancerresearchuk.org. https://www.cancerresearchuk.org/about-cancer/mouth-cancer/risks-causes

[v] Hobbs, H. (2017). 26 Health Effects of Smoking on Your Body. [online] Healthline. Available at: https://www.healthline.com/health/smoking/effects-on-body#Respiratory-system.

[vi] Anon, (n.d.). Mouth Cancer Facts and Figures | Mouth Cancer Foundation. [online] Available at: https://www.mouthcancerfoundation.org/mouth-cancer-facts-and-figures/#:~:text=8864%20people%20in%20the%20UK.

[vii] National Institute of Dental and Craniofacial Research (2018). Oral Cancer. [online] www.nidcr.nih.gov. Available at: https://www.nidcr.nih.gov/health-info/oral-cancer.

[viii] Menshealthforum.org.uk. (2014). Men and Cancer: Saving Lives expert report. [online] Available at: https://www.menshealthforum.org.uk/men-and-cancer-saving-lives-expert-report [Accessed 23 May 2024].

[ix] www.ons.gov.uk. (n.d.). Adult smoking habits in the UK – Office for National Statistics. [online] Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/bulletins/adultsmokinghabitsingreatbritain/2022#:~:text=In%20the%20UK%2C%2014.6%25%20of.

[x] GOV.UK. (n.d.). Adult oral health survey 2021: service use and barriers to accessing care. [online] Available at: https://www.gov.uk/government/statistics/adult-oral-health-survey-2021/adult-oral-health-survey-2021-service-use-and-barriers-to-accessing-care#:~:text=Men%20were%20more%20likely%20than.

[xi] Europa Uomo. (n.d.). Cancer in men is ‘neglected and underfunded’. [online] Available at: https://www.europa-uomo.org/news/cancer-in-men-is-neglected-and-underfunded/ [Accessed 23 May 2024].

[xii] National Institute of Dental and Craniofacial Research (2018). Oral Cancer. [online] www.nidcr.nih.gov. Available at: https://www.nidcr.nih.gov/health-info/oral-cancer.

[xiii] Bawden, A., Health, A.B. and correspondent, social affairs (2024). Smoking among middle-class women in England up by 25% in 10 years – study. The Guardian. [online] 18 Apr. Available at: https://www.theguardian.com/society/2024/apr/18/smoking-among-middle-class-women-in-england-up-by-25-in-10-years-study.

[xiv] Jackson, S.E., Brown, J., Notley, C., Shahab, L. and Cox, S. (2024). Characterising smoking and nicotine use behaviours among women of reproductive age: a 10-year population study in England. BMC medicine, 22(1). doi:https://doi.org/10.1186/s12916-024-03311-4.

[xv] GOV.UK (2022). Nicotine vaping in England: 2022 evidence update main findings. [online] GOV.UK. Available at: https://www.gov.uk/government/publications/nicotine-vaping-in-england-2022-evidence-update/nicotine-vaping-in-england-2022-evidence-update-main-findings.

Jackson, S.E., Brown, J., Notley, C., Shahab, L. and Cox, S. (2024). Characterising smoking and nicotine use behaviours among women of reproductive age: a 10-year population study in England. BMC medicine, 22(1). doi:https://doi.org/10.1186/s12916-024-03311-4.

[xvi] Raj, A.T., Sujatha, G., Muruganandhan, J., Kumar, S.S., Bharkavi, S.I., Varadarajan, S., Patil, S. and Awan, K.H. (2020). Reviewing the oral carcinogenic potential of E-cigarettes using the Bradford Hill criteria of causation. Translational Cancer Research, 9(4), pp.3142–3152. doi:https://doi.org/10.21037/tcr.2020.01.23.

[xvii] Chhina, M.S. (2023). Are e-cigarettes a safer alternative to reduce incidences of oral cancer? Evidence-Based Dentistry. [online] doi:https://doi.org/10.1038/s41432-023-00956-7.

[xviii] CANCER RESEARCH UK (2023). Is vaping harmful? [online] Cancer Research UK. Available at: https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/smoking-and-cancer/is-vaping-harmful.

[xix] Design, D. (2024). Screen every patient for oral cancer. [online] British Dental Nurses’ Journal. Available at: https://bdnj.co.uk/2024/01/13/screen-every-patient-for-oral-cancer/ [Accessed 23 May 2024].

[xx] Vigilant Biosciences®. (n.d.). BeVigilantTM OraFusionTM System**. [online] Available at: https://vigilantbiosciences.com/bevigilant-orafusion-system/ [Accessed 23 May 2024].

 


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