Meera Patel critically discusses the effects of smoking tobacco on endodontic disease.

Introduction

Smoking is a major cause of premature death worldwide, as it can adversely affect all parts of the human body (Figure 1).

Some global and national smoking statistics make for grim reading.

World Health Organization (WHO) (2012) facts

• Approximately 1 billion people smoke worldwide
• Tobacco kills nearly six million people each year (5 million are users and ex users and more than 600,000 are non-smokers exposed to second-hand smoke). If this continues, the annual death toll estimated in 2030 is greater than eight million
• Approximately 80% smokers live in low-income and middle-income countries
• Consumption of tobacco products is rising globally, although it is declining in some high-income and upper middle-income countries.

United Kingdom facts:

• Almost 10 million adults in the UK smoke cigarettes, this is about a sixth of the total UK population
• 21% of women and 22% of men
• Two-thirds of smokers start before 18 years of age
• Over 100,000 smokers in the UK die from smoking related causes each year (Action and smoking and health, 2011).

Smoking – general effects

Tomar and Asma in 2000 showed that the harmful effects of smoking are proportional to the number of cigarettes a person currently smokes, together with the duration of smoking.

Smoking is linked to:

• Disruption of the physiological equilibrium between anabolic and catabolic mechanisms due to the changed immune and tissue responses (Palmer, Wilson, Hasan & Scott, 2005)
• Increased susceptibility to bacterial infection (Radek et al, 2010), as it reduces immunity, lowers oxidation potential and affects the bacterial ecosystem (Garcia, Penarrocha & Marti, 2007)
• Increases bone loss in…