Trends in Tobacco and Vaping use and their Oral Health Consequences in Adolescents

Abstract

Background: The landscape of nicotine use among adolescents has shifted dramatically with the emergence of electronic cigarettes (e-cigarettes) and vaping products. While traditional tobacco use has declined, vaping prevalence has surged, raising concerns about potential oral health consequences that remain incompletely characterized in younger populations. Objective: This cross-sectional study aimed to examine current trends in tobacco and vaping use among adolescents and evaluate associated oral health consequences, including periodontal status, mucosal lesions, and xerostomia. Methods: A total of 612 adolescents aged 14–18 years were recruited from secondary schools and categorized into four groups: non-users (n=298), exclusive vapers (n=156), exclusive tobacco users (n=72), and dual users (n=86). Participants completed validated questionnaires assessing substance use patterns. Clinical oral examinations evaluated periodontal status using the Community Periodontal Index (CPI), oral mucosal lesions, xerostomia, and halitosis. Salivary flow rate was measured using unstimulated collection methods. Results: Overall nicotine product use prevalence was 51.3%, with vaping (39.5%) exceeding traditional tobacco use (25.8%). Exclusive vapers demonstrated significantly higher CPI scores (1.42 ± 0.68) com-pared to non-users (0.86 ± 0.54; p<0.001). Dual users exhibited the poorest periodontal status (CPI: 1.89 ± 0.72; p<0.001). Xerostomia prevalence was significantly elevated in vapers (42.3%) and dual users (58.1%) compared to non-users (14.8%; p<0.001). Oral mucosal lesions were observed in 18.6% of vapers and 31.4% of dual users versus 6.4% of non-users (p<0.001). Salivary flow rates were significantly reduced in all nicotine user groups. Conclusion: Vaping and tobacco use are associated with significant adverse oral health consequences in adolescents, including compromised periodontal health, xerostomia, and mucosal pathology. The high prevalence of vaping necessitates urgent preventive interventions and clinical awareness among dental professionals.