title: A cytologic study of oral mucosal cell alterations in smokeless tobacco users and efficacy of a related cessation program.
abstract: OBJECTIVE
  The primary objective of the study was to determine if oral tissue changes, as documented by cytologic study and reported to the smokeless tobacco user, provide incentive to discontinue use of smokeless tobacco products.
  
  
  METHODS
  Smokeless tobacco users who presented for treatment in the University of Arkansas for Medical Sciences dental hygiene clinic served as the 10 subjects of this one-year study. Calibrated dental hygiene faculty collected cellular specimens from the oral mucosa of subjects at the site of smokeless tobacco placement and a clear site as control. Specimens were collected by a moistened tongue blade scrape, then fixed, stained, and diagnosed by faculty in the department of pathology. Subjects participated in a cessation program: a standardized session in which results of the cytologic findings and risks of smokeless tobacco usage were discussed, using visuals and pamphlets. The subjects, with the exception of the last, were contacted at three- and six-month intervals to determine their compliance with cessation recommendations.
  
  
  RESULTS
  Three of the 10 subjects displayed significant tissue changes; these subjects discontinued smokeless tobacco use. The cytologic studies of the other seven subjects revealed only various amount of hyperkeratosis.
  
  
  CONCLUSIONS
  Cytologic assessment and results may be a valuable component of a smokeless tobacco cessation program. This area merits further research.
authors.affiliation: Department of Dental Hygiene, University of Arkansas for Medical Sciences, Little Rock, USA.
authors.forename: V
authors.initials: V
authors.lastname: Goral
authors.forename: W
authors.initials: W
authors.lastname: Culbreth
authors.forename: C
authors.initials: C
authors.lastname: Green
authors.forename: T
authors.initials: T
authors.lastname: Nelms
authors.forename: K
authors.initials: K
authors.lastname: Truax
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D007972:Leukoplakia, Oral / Q000473:pathology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009061:Mouth Mucosa / Q000473:pathology*; D010947:Plants, Toxic; D020340:Tobacco Use Cessation; D014030:Tobacco, Smokeless