The American journal of the medical sciences
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The Public Health Service Guideline, Treating Tobacco Use and Dependence, contains a wealth of information regarding current treatment practices. Unfortunately, guidance for tailoring standardized treatments to meet the needs of specific ethnic subgroups is limited. This article highlights features unique to African American smokers, a necessary precursor to developing intervention programs that hold promise for improving outcomes.
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Tobacco is a delivery system for the addictive agent nicotine. The dental profession is encouraged to perform oral examinations that focus on oral cancer detection, but other oral changes occur with tobacco use. The oral mucosa is composed of stratified squamous epithelium and masticatory/keratinized (hard palate, dorsum of the tongue, and keratinized gingival) and lining mucosa (floor of the mouth, ventrolateral surface of the tongue, soft palate complex, labial vestibule, and buccal mucosa). ⋯ The changes may range from an increase in pigmentation to thickening of the epithelium (white lesion). Tobacco use can also irritate the minor salivary glands on the hard palate and directly increase a person's risk for periodontal disease and oral cancer. This article will review some of the more common oral lesions that are associated with tobacco use-smoker's melanosis, nicotinic stomatitis, periodontal disease, smokeless tobacco keratosis, gingival recession/tooth abrasion, black hairy tongue, and oral cancer.
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A close link between smoking and depression has been documented by research primarily based on U.S. white populations. This study examined the association between depressive symptoms and smoking behaviors in Chinese American smokers. ⋯ The level of depressive symptoms among Chinese American smokers is comparable with that observed in other US populations reported. In the current sample, elevated depressive symptoms were more prominent among women or those who were unemployed, smokers who reported significant nicotine withdrawal at previous quit attempts, and high temptation to smoke when experiencing negative emotions. Findings support further examination of the role of depression in smoking among Chinese Americans and underscore the importance of addressing depressive symptoms when treating tobacco use in Chinese smokers.
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Millions of American girls and women have been drawn to smoking by an industry that has been clearly and systematically targeting women of all ages and life circumstances. Big tobacco's well-timed marketing strategies skillfully link cigarette use to typical female values: independence, self-reliance, weight control, stress management, social progress and popularity, personal attractiveness, autonomy, self-fulfillment, youth, happiness, personal success, health, and active, vigorous, and strenuous lifestyles. Biologically speaking, women are especially vulnerable to the legion of health problems of tobacco use. ⋯ Women and girls who smoke represent diverse subgroups of the population with unique issues and needs. The 2001 Surgeon General's Report on Women and Smoking stresses the importance of multistrategy programs for treating female smokers. This approach includes antitobacco media campaigns, increases in tobacco prices, promotion of nonsmoking in public places, curbs on tobacco advertising and promotion, enforcement of legislation to reduce youth access to tobacco products, and effective tobacco use treatment programs.