Dissertations and Theses (Open Access)

Date of Award

Summer 8-2024

Degree Name

Doctor of Philosophy (PhD)

Advisor(s)

DR. STEVEN H. KELDER PHD

Second Advisor

DR. HENRY S BROWN III PHD

Third Advisor

DR. BAOJIANG CHEN PHD

Abstract

This dissertation aimed to quantify the relationship between methods of tobacco and marijuana use and their impact on oral health. Tobacco use was defined as smoking combustible tobacco (cigarettes, cigars, and hookah) or electronic aerosolized vaping nicotine with an e-cigarette.5,9 Similarly, marijuana use was defined as smoking combustible marijuana (joints, blunts, and spliffs) or vaping marijuana with an e-cigarette.8 Despite the prevalence of nicotine vaping and marijuana use among young adults1,3-4,7,14-15, there is limited evidence of their association with oral health in Texas. To address this issue, this dissertation comprising three studies analyzed longitudinal data from the Texas Adolescent Tobacco and Marketing Surveillance System (TATAMS) across four waves (Wave 11, Spring 2020; Wave 12, Fall 2020; Wave 13, Spring 2021; Wave 14, Fall 2021) to quantify tobacco and marijuana exposure and assess oral health outcomes in Wave 14 (outcome was assessed only in Fall 2021). Research Question 1: Combustible Smoking This study examined the association between combustible tobacco/marijuana smoking and oral health outcomes (toothaches, tooth decay, gum disease, oral health status, and dental services utilization) among young adults aged 18-25 years in Texas. We found a significant association with current (past 30 day use in >=1 wave) tobacco smokers having twice the risk of gum disease compared to never smokers. Also, current (past 30-day use in all waves) marijuana smokers had thrice the risk of gum disease, toothaches, and tooth decay compared to never marijuana smokers. Research Question 2: Electronic Aerosolized Vaping This study examined the association between nicotine/marijuana vaping and oral health outcomes. We found significant associations between nicotine vaping and toothaches, with current (past 30 day use in >=1 wave) vapers having 1.7 times the risk compared to never vapors. Also, current marijuana vapors had twice the risk of gum disease compared to never vapers. Research Question 3: Tobacco or Marijuana Users This study examined the combined effect of tobacco smoking/vaping or marijuana smoking/vaping on oral health. No significant interaction was found between tobacco and marijuana use on oral health outcomes. This study highlights the significant associations between tobacco/marijuana use and oral health. These findings underscore the need for more research, targeted interventions, and education efforts to improve oral health among young adults in Texas. It is important to address smoking and vaping behaviors separately to possibly mitigate oral health risks.

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