Principal Investigator: Christian Abnet

Funding Mechanism: National Institutes of Health-Intramural

ID number: 252304

Award Date: 10/1/2012

Institution: National Cancer Institute (NCI)

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Tobacco use is the primary cause of periodontal disease and causes other health consequences in the oral cavity including leukoplakia and cancers of the head and neck. Periodontal disease and the resulting tooth loss have been linked to other adverse health consequences including diabetes, heart disease, stroke, and premature births; gum bleeding associated with periodontal disease leads to chronic exposure to oral microbes, causing persistent inflammation and exposure to toxic secondary bacterial metabolites. However, no previous study has characterized the oral microbiome (i.e., the complete oral bacterial population) and assessed the effect of tobacco on oral bacteria in a large representative sample of the U.S. population. The goal of this study is to conduct a comprehensive assessment of the association between tobacco use and oral health measures using data from two cycles (2009-2010 and 2011-2012) of the National Health and Nutrition Examination Survey (NHANES), an extensive exposure and health information survey of a nationally representative sample of the U.S. population with oversampling of persons aged 60 and older, African-Americans, Asian-Americans, and Hispanics. Study aims are: (1) to characterize the association between tobacco and oral health in 11,000 NHANES participants (men and women aged 14-69; approximately 55% never smokers, 20% former smokers, 23% current smokers, and 2% tobacco chewers); (2) to investigate the association between types of tobacco use (e.g. cigarettes, pipes, cigars, and chewing tobacco) and the oral microbiome; and (3) to investigate the association between the oral microbiome and tobacco-related diseases (e.g., periodontitis, cardiovascular and respiratory disease, diabetes, etc.) and evaluate the degree to which the oral microbiome mediates the adverse health effects of tobacco use. To achieve these aims, investigators will use data and oral wash samples already collected by NHANES. Investigators will characterize the oral microbiome by using DNA extracted from oral samples and describe the bacterial species in each sample. They will then examine the effects of tobacco on the full microbiomic community; determine whether associations vary by type of tobacco used (e.g. menthol, filter, smokeless), household tobacco exposure, and ethnicity; and evaluate associations with tobacco-related diseases. Characterizing the effect of tobacco use on the oral microbiome may suggest new biomarkers of exposure that can be used to assess the effects of new and emerging tobacco products.