Adolescent Tobacco and Nicotine Prevention: Opportunities Missed in the Dental Office

Barnett TE, Choi A, Griner SB, Mungia R, Gimeno Ruiz de Porras D, Tomar SL.
Adolescent Tobacco and Nicotine Prevention: Opportunities Missed in the Dental Office
J Am Dent Assoc. 2025 Sep 19:S0002-8177(25)00463-5. doi: 10.1016/j.adaj.2025.08.002. Epub ahead of print. PMID: 40970853.

Background: Despite declining rates of adolescent cigarette smoking, emerging products continue to pose a threat to youth. Oral health care professionals, who often see adolescents more frequently than other clinicians, are uniquely positioned to intervene.

Methods: Data (N = 3,898 survey responses) were analyzed from the 2023 Florida Youth Tobacco Survey, a statewide, school-based assessment of tobacco behaviors. Additional analyses focused on high school students who reported a dental visit in the previous 12 months (n = 2,835). The Rao-Scott χ² test was used to examine whether the proportion of students who visited a dentist's office in the past 12 months differed by demographic characteristics. Logistic regression models were used to evaluate associations between demographic factors, electronic cigarette (e-cigarette) use, and reported discussion about the dangers of tobacco in dental settings.

Results: Although more than 70% of high school students visited a dental office within the past year, only 13.1% reported being told about tobacco dangers by dental personnel. No significant (P > .05) associations by demographics were found for tobacco-related discussions. However, Hispanic students had lower odds than non-Hispanic White students of reporting receiving e-cigarette discussion, even after adjustment for e-cigarette use.

Conclusions: Adolescents do not report having discussions at the dental office about tobacco product use. These findings reveal a missed opportunity for oral health care providers to engage in prevention and early intervention for adolescents, a population at high risk of initial tobacco exposure.

Practical implications: Continuing dental education along with guidelines emphasizing prevention-focused discussions could substantially increase youth awareness of tobacco's harms and reduce future tobacco-related morbidity.