title: Prolonged pacifier use during infancy and smoking initiation in adolescence: evidence from a historical cohort study.
abstract: OBJECTIVE
  To investigate the association between prolonged pacifier use during childhood and smoking in adolescence and early adulthood.
  
  
  METHODS
  A historical cohort study including patients from a dental private office was designed. Dental records were used, which contained complete data about sucking habits from 314 children (2-10 years of age) who had attended a private dental office from 1988 to 1994 in Ibiá, Brazil. Then, we collected data about the smoking habits from 261 subjects who were successfully contacted again from 2004 to 2006. Our outcome variable was smoking, and subjects who had smoked more than 100 cigarettes during their lifetime were classified as smokers. Poisson regression analysis matched the association between oral habits and smoking. Incidence rate ratios (IRR) and 95% confidence intervals (95% CI) were calculated. The level of significance was set at 5%.
  
  
  RESULTS
  We observed a statistically significant association between prolonged pacifier use (more than 24 months) and smoking (IRR = 4.48; 95% CI 2.32-8.65). Breastfeeding, in contrast, was a protective factor (IRR = 0.64; 95% CI 0.42-0.96).
  
  
  CONCLUSIONS
  Prolonged pacifier use during childhood is positively associated with smoking initiation in adolescence and early adulthood.
authors.affiliation: Division of Pediatric Dentistry, Cruzeiro do Sul University, São Paulo, Brazil.
authors.forename: Helenice R
authors.initials: HR
authors.lastname: Ferreira
authors.forename: Ecinele F
authors.initials: EF
authors.lastname: Rosa
authors.forename: José Leopoldo F
authors.initials: JL
authors.lastname: Antunes
authors.forename: Danilo A
authors.initials: DA
authors.lastname: Duarte
authors.forename: José Carlos P
authors.initials: JC
authors.lastname: Imparato
authors.forename: Claudio M
authors.initials: CM
authors.lastname: Pannuti
authors.forename: Fausto M
authors.initials: FM
authors.lastname: Mendes
mesh_terms: D000293:Adolescent; D001903:Bottle Feeding / Q000706:statistics & numerical data*; D001938:Brazil / Q000453:epidemiology; D001942:Breast Feeding / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005386:Fingersucking; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009259:Nail Biting; D041361:Pacifiers / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology*; D055815:Young Adult