612 - Smokeless tobacco, Vaping 4/3

Terms for smokeless tobacco (4)

- Spit tobacco

- Snuff

- Dip

- Chew

Economics of tobacco

The tobacco industry spends more then 12.4 billion per year marketing its products

______________ is the addictive substance in tobacco

Nicotine

T/F: Smokeless tobacco is more carcinogenic than cigarettes

** test question **

False -

Takes longer to get cancer from smokeless tobacco

What malignancy is associated with smokeless tobacco use?

Squamous Cell Carcinoma

How could you help someone who dips but is not ready to quit?

Move the dip around in your mouth

Is vaping a good smoking cessation technique? Why or why not?

No, there are dangers associated with vaping

- contains nicotine that is carcinogenic when mixed with other things

What is the most dangerous aspect of vaping?

Vapes can explode

Can a basal cell carcinoma kill you from metastasis?

If not, how could it kill you?

No

T/F: 10 people die every hour from oral cancer

False - 1 person dies every hour from oral cancer

____ people per hour are diagnosed with head and neck cancer

4

Which condition is associated with topical tobacco use?

Verrucous carcinoma

- Nicknamed "snuff dippers cancer"

T/F: Verrucous carcinoma is considered a high grade variant of SCC

False - low grade variant of SCC

T/F: Verrucous carcinoma is fast growing

False - slow growing

How does verrucuous carcinoma invade?

Invades as a "moving front"

- has not breached basement membrane yet

- very slow pattern of invasion

Which HPV strains is verrucous carcinoma associated with?

HPV 16 and 18 (high risk), 2, 32

Verrucous carcinoma in an edentulous pt

- txt?

White, warty leukoplakia with thickened areas

- Txt: Serial biopsies over time, can use CO2 laser

T/F: Basel cell carcinoma can occur on the skin and inside the mouth

False - can only occur on the skin

Basal cell carcinoma - histology

- Dark basaloid cells growing downward and separating off from main mass

-- has invaded, NOT metastasized

- Myxoid stroma has mucin around basaloid cells that makes collagen deteriorate that allows it to move through

Will a basal cell metastasize?

No - but they keep growing and will invade

How do e-cigarettes work?

- Battery-operated devices that heat a liquid solution into an aerosol

-- usually contains nicotine, flavorings, and other chemicals that help to make the aerosol

-- users inhale e-cigarette aerosol into their lungs

- Diff names: "e-cig", "vape pen", "tank systems", "electronic nicotine delivery systems"

T/F: People who have vaped are more likely to smoke combustible cigarettes

True

Lung injury from vaping

As of January 2020:

- 2,668 lung injury cases

- 60 confirmed deaths

--> most pts used THC-containing products --> Vitamin E acetate (cannot rule out the contribution of other chemicals of concern)

What can cause a vape to explode? (5)

- Charging it with a phone or tablet charger

- Dropping it

- Unprotected batteries

- Exposing device to water

- Adding something to it (ie marijuana)

T/F: Vaping is a safe harm reduction tool

False - increasing # of e-cig related lung injuries and deaths, expanded # of youth exposed to nicotine, which can lead to future use of conventional cigarettes

T/F: Smoking cessation can increase the risk of aphthous ulcer accumulation

True - multiple recurrent symptomatic irregular ulcers on nonkeratinized tissue

- smoking increases amount of keratinization, so when you quit, you will lose that keratinization, which increases risk for aphthous ulcers

E-cigarettes can cause ______________which is a known risk factor for RAU (recurrent aphthous ulcers)

xerostomia

What may the flavorings in vapes cause?

A hypersensitivity reaction -- also a risk factor for RAU

How can vaping cause traumatic ulcer?

Nicotine interferes with fibroblast differentiation and maturation

- nicotine and flavor chemicals in the e-cig vapr prevent fibroblast cells from getting the energy needed to heal a wound properly

2 factors that increase the risk of recurrent apthous ulcers (RAU):

*test q*

- Smoking cessation

- Use of vaping

How can vaping cause periodonal disease?

E-cig vapor could also trigger inflammation in the mouth, increasing the risk of gingivitis and periodontal disease

- when the vapors from e-cig are burned, they cause cells to release inflammatory proteins that stress cells, resulting in damage that could lead to various oral diseases